2020 UCSF Fresno Liver Expo Program

Saturday, October 10, 2020

Saturday, October 10, 2020 9 a.m. – 12:30 p.m.

Spnsored by:

Via Zoom Webinar

About The Speakers Marina Roytman, MD, joined University of California San Francisco, Fresno in August 2017 as Clinical Professor of Medicine for the Department of Medicine and Director of the Liver Program in the Division of Gastroenterology, Hepatology and Nutrition. Dr. Roytman’s involvement in research encompasses areas in Hepatitis B, Hepatitis C, Drug Induced Liver Injury, Non-Alcoholic Steatohepatitis (NASH), Cirrhosis and Liver Fibrosis.

Marina Roytman, Roytman, MD, FACP

https://www.universitymds.com/ md-profiles/marina-roytman/

Michael Haight MD, MHA Clinical Professor, UCSF Michael Haight, M.D., MHA is board certified in Pediatrics and Pediatric Gastroenterology. Dr. Haight has held teaching positions in Pediatric Gastroenterology for more than 20 years.

He has multiple awards including the UCSF Fresno Medical Education Program Pediatric Pearls Teaching Honor and the UC Davis Department of Pediatrics Teaching Award.

Michael Haight, MD, MHA

Kristen Coleman RD, CNSC Clinical Dietitian Specialist, Pediatrics Community Regional Medical Center Pediatric Specialty Clinics Kristen Coleman is a registered dietitian that works in the Pediatric Specialty Clinic at CRMC. Kristen is a graduate of California State University Fresno and has over 10 year of experience working with adults and children with nutrition education.

Kristen Coleman, RD, CNSC

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Agenda

Lecture I: Things that Go Boo in the Night: The Silent Epidemics of Liver Disease Marina Roytman, MD, FACP Liver Program Director, UCSF Fresno

9:45 – 10:15 AM

Virtual Exercise Class Tim Clark, BS, CRT Director, CRMC Fitness

10:15 – 11 AM

Lecture II: Update on Pediatric Liver Issues Michael Haight MD, MHA Chief, Pediatric Gastroenterology and Nutrition, UCSF Fresno

11 – 11:15 AM

Break

11:15 – 11:30 AM

Cooking Demo Chris Shackelford Chef/Owner, Trelio Restaurant

11:30 - 12:15 PM

Lecture III: Diet and Fatty Liver Disease Kristen Coleman RD, CNSC Clinical Dietitian Specialist, Pediatrics, CRMC

12:15 – 12:30 PM

Final Q&A and Raffle

AGENDA

9 – 9:45 AM

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Fatty Liver Disease in Adults and Children People who are overweight or obese, have diabetes, high cholesterol or high blood pressure are at increased risk of fatty liver disease. This condition leads to buildup of fat in the liver which may cause inflammation and scarring of the liver similar to drinking alcohol or having viral hepatitis. Fatty liver disease can be suspected based on the blood tests or pictures of the liver (CAT scan or ultrasound). As children become more sedentary and eat less healthy, their risk for fatty liver disease increases as well. In the past, liver biopsy was needed to determine the severity of fatty liver disease. FibroScan (vibration controlled transient elastography) is a new, non-invasive technology that allows us to determine how much fat and how much scarring is in your liver. The good news is that weight loss, exercise and healthy eating can reverse the damage caused by fatty liver disease in children and adults!

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Hepatitis C Hepatitis C is a viral infection of the liver. Over time, if left untreated, this infection can lead to liver damage including liver cirrhosis (severe scarring of the liver) and liver cancer. In the past, it was believed that baby boomers (born between 1945 and 1965) were at particularly high risk for hepatitis C. In the last few years, it has become clear that the epidemic of hepatitis C is spreading to younger people and often goes undiagnosed as the infection can be asymptomatic for many years. This understanding led to the new CDC recommendation in 2020 to test all people over the age of 18 for hepatitis C. The good news is that hepatitis C can be cured!

Hepatitis C Antibody + (Positive)

Hepatitis C Antibody (Negative)

You may have been exposed to the hepatitis C virus in the past. You may or may not be currently infected. Further testing is necessary.

You do not have hepatitis C. No further testing is needed.

What if I am Diagnosed with Hepatitis C? • You can be cured with a simple, oral regimen (pills) in as little as 8 to12 weeks • 98% chance of cure! • Curing the disease will stop the progression of liver disease and allow you liver to heal

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FibroScan Results FibroScan (vibration controlled transient elastography) is a new, non-invasive technology that can help us understand the extent of liver damage from multiple causes. The FibroScan uses non-invasive uses sound wave technology to estimate the degree of liver scarring (ďŹ brosis). A lot of scarring in the liver is also known as cirrhosis. Knowing the degree of scarring can help your doctor to decide on how to treat your liver disease. FibroScan can also measure the amount of fat in the liver (which is one of the causes of liver damage) and help guide you towards a healthier lifestyle.

FibroScan Measures 2 things: Liver ďŹ brosis (scarring) and liver steatosis (amount of fat).

Fibrosis (scarring) F0-1:

None to minimal scarring of the liver.

F2:

Mild scarring of the liver

F3:

Moderate scarring of the liver

F4:

Severe scarring of the liver also known as cirrhosis.

Steatosis (fat accumulation)

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S0:

No fat in the liver

S1:

Mild accumulation of fat in the liver, <10% of liver cells are affected by fat

S2:

Moderate accumulation of fat in the liver, <30% of liver cells are affected by fat

S3:

Severe accumulation of fat in the liver, >66% of liver cells are affected by fat

Do You Need a FibroScan?

If you have any of the following, you may want to consider a FibroScan: Excessive alcohol use, past or present Fatty Liver

Autoimmune Liver Disease

Hepatitis B

Abnormal liver blood tests of imaging

Hepatitis C (even if cured)

FIBROSCAN NEEDED

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Body Mass Index BMI stands for body mass index and it assess your weight to height ratio. It does not take muscle mass or body frame into account. For people with a high muscle mass, BMI will appear higher but not necessarily indicate obesity. Measure your own BMI by finding your height and weight on the chart below.

Click here to view an enlarged version of the chart.

If your BMI places you in the ‘Increased Risk’ category, a healthier lifestyle and weight loss may decrease your risk for many serious diseases and health conditions.

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Fitness At Home The human body is VERY good at adapting to the needs of its environment. If that means chronic sitting, then the body will become VERY efďŹ cient at holding that position. The problem is that the body is meant to move. When we become sedentary, some muscles will become long and slack over time and some muscles will become tight and shorten. This will cause muscular imbalances that will lead to things like pain in the knees, hips, lower back, shoulders, neck, etc. Human movement is critical to our quality of life so get up and move!

Virtual Workout: Pandemic Edition Equipment Needed Beach Towel 2 x 1 Gallon Jugs of Water Small Rubber Ball Workout List 45o Chop w/jugs Plank Push-Ups Squat Press w/jugs Arm Curls w/jugs Mt. Climbers Stationary Lunges / Drop Lunges

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Diet and Fatty Liver Disease How do diet choices effect/cause fatty liver disease?  When we eat carbohydrates or simple sugars they all are broken down into glucose  Glucose travels through the blood stream and delivers energy to our cells  If our cells do not need energy, the glucose will travel though the blood stream and back to the liver. The liver will then store that sugar as fat and it will deposit on organs such as the liver

How can you use diet to treat fatty liver?  A great place to start is to decrease your carbohydrate and sugar intake  Stop intake of concentrated sweets No Soda, Fruit Juices, Sports Drinks, Energy Drinks, Sweetened Coffee Drinks  Stop intake of simple carbohydrate foods White rice, white bread, fried potatoes, sweet breads, chips, cereals  Stop intake of deep fried foods, high fat foods, and high carbohydrate containing foods • Avoid Alcohol

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Cooking Demonstration Liver Healthy Foods Cooking Demonstration brought to you by Chris Shackelford, Chef/Owner of Trelio Food & Wine in Clovis Orange & Fennel Salad with Black Garlic Vinaigrette Vinaigrette: 2-3 cloves black garlic 3 tablespoons fresh lemon juice 3 tablespoons olive oil 1 tablespoon honey Salt to taste Black pepper to taste Salad: 1 bulb fennel (thinly sliced) 1 orange (segmented) 1 cup arugula 1 sprig fresh thyme 1 sprig Italian parsley ½ cup kalamata olives Combine all vinaigrette ingredients in a blender and blend until smooth. Set aside. Toss the salad ingredients together in a large bowl with half of the vinaigrette. Pile the salad on a serving plate and pour additional dressing around the outside of the plate to serve.

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Thanks to all of our sponsors

LIVER expo 2019 2020 Is Your Liver Well?

www.fresno.ucsf.edu @UCSFFRESNO

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