All about non-alcoholic fatty liver disease, affecting 3 in 10 people in India

 Non-alcoholic fatty liver disease (NAFLD) is a condition where fat builds up in the liver without the influence of alcohol consumption. It is becoming a significant health concern globally, and its prevalence in India is rising. Around 3 in 10 people in India are affected by this condition, making it a widespread issue.

HOW TO REVERSE FATTY LIVER?

The fatty liver disease can be reversed via diet and exercise.

"Dietary measures include avoiding sugars or refined carbs. When the liver functions are deranged, patients are managed with drugs like vitamin E, Saroglitazar, Semaglutide, Obeticolic acid etc. Fibroscan is a non-invasive method to estimate liver damage," Dr Vijay Kumar HJ, Gastroenterologist, Apollo Clinic, HSR Layout, Bengaluru, earlier told India Today Digital.

Types of NAFLD

NAFLD can be categorized into two stages:

1. Simple fatty liver (Non-alcoholic fatty liver - NAFL): This stage involves the accumulation of fat in liver cells, but there is no inflammation or liver damage. It is usually harmless but can progress if not managed.
2. Non-alcoholic steatohepatitis (NASH): This is a more advanced stage of NAFLD, where fat accumulation leads to inflammation and liver cell damage. NASH can progress to cirrhosis or liver cancer if left untreated.

Causes and Risk Facors

The exact cause of NAFLD is not

 fully understood, but several factors contribute to its development:

1. Obesity and Overweight: One of the leading causes of NAFLD, as excess fat in the body, especially around the abdomen, is linked to fat buildup in the liver.
2. Insulin Resistance: People with conditions like type 2 diabetes or metabolic syndrome often have insulin resistance, leading to fat storage in the liver.
3. Diet: A diet high in calories, sugar, and unhealthy fats can contribute to the development of fatty liver. A high intake of processed foods and sugary beverages is particularly harmful.
4. Genetics: A family history of liver disease may increase the risk of developing NAFLD.
5. Sedentary Lifestyle: Lack of physical activity and exercise is associated with a higher risk of fatty liver disease.
6. Age and Gender: NAFLD is more common in people over 40, but younger people, particularly those who are obese or have metabolic disorders, are also at risk.
7. Other Conditions: Conditions like hypertension, high cholesterol, and polycystic ovary syndrome (PCOS) increase the risk of developing NAFLD.

Symptoms of NAFLD

Most people with NAFLD don’t experience symptoms in the early stages. However, as the disease progresses, some possible signs and symptoms may include:

• Fatigue
  
• Weight loss
• Weakness
• Dark urine or light-colored stools (in severe cases)
• Enlarged liver (detected during a physical exam)

Diagnosis

NAFLD is usually diagnosed through:

1. Blood tests: To check for liver enzymes that indicate inflammation or damage in the liver.
2. Imaging tests: Ultrasound, CT scan, or MRI can detect fat buildup in the liver.
3. Liver biopsy: In certain cases, a liver biopsy may be performed to assess the extent of liver damage, especially if NASH is suspected.

Tement

Currently, there reatment and Managare no specific medications approved to treat NAFLD or NASH. However, the condition can often be managed with lifestyle  changes:

1. Weight Loss: Losing even 5-10% of body weight can help reduce liver fat and inflammation.
2. Exercise: Regular physical activity, such as 30 minutes of moderate exercise most days of the week, is crucial for managing NAFLD.
3. Healthy Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and healthy fats (like those from nuts and olive oil) while avoiding sugary drinks, fried foods, and processed foods is important.
4. Control Blood Sugar and Cholesterol: Managing conditions like diabetes, hypertension, and high cholesterol can prevent further liver damage.
5. Avoid Alcohol and Toxins: While alcohol isn’t the cause of NAFLD, drinking alcohol can worsen liver damage, so it's important to avoid alcohol consumption.

Prevention

Preventing NAFLD is largely about lifestyle changes. Here are some ways to reduce the risk:

• Adopt a balanced, nutritious diet.
• Exercise regularly.
• Avoid excessive consumption of sugary foods and drinks.
• Control blood sugar levels and manage metabolic health conditions.

Impact in India

In India, the rising rates of obesity, diabetes, and poor dietary habits are contributing to the increasing prevalence of NAFLD. According to studies, approximately 25-30% of the Indian population is affected by fatty liver disease. This is of particular concern, as many people with NAFLD are unaware they have the condition, often because it doesn’t cause symptoms until it reaches an advanced stage like NASH or cirrhosis.

The high rate of metabolic diseases like obesity, diabetes, and hypertension in India, combined with urbanization and lifestyle changes, is exacerbating the problem. The economic burden on healthcare systems and the long-term impact on public health are serious concerns.

Conclusion

NAFLD is a growing public health issue in India and worldwide, primarily due to lifestyle factors such as poor diet, lack of exercise, and rising rates of obesity and diabetes. While the condition often goes unnoticed in the early stages, it is important to take proactive measures to prevent or manage it, such as adopting a healthy diet, staying active, and addressing any underlying health conditions.