Fatty liver disease

25-30 percent of the global population has non-alcoholic fatty liver disease (NAFLD), a condition where fat makes up more than five percent of the liver. Fatty liver can occur commonly with excessive consumption of alcohol- Alcoholic fatty Liver Disease (AFLD). Those who don’t consume alcohol can develop fatty liver disease in the back ground of sedentary lifestyle, unhealthy food habits, a condition called Non alcoholic fatty liver disease (NAFLD). When you eat more than the level of physical exercise you engage in, excess calories taken in which are not burned out, transforms into fat and gets deposited in the Liver. Over time—years or decades in some cases—NAFLD progresses to a more serious condition called “fatty swelling” or “Non-Alcoholic Steato Hepatitis” (NASH), where the liver becomes inflamed and scarred and ultimately liver structure and function are deranged. Without treatment, the disease worsens to liver cirrhosis, a late-stage disease.

1. Overweight and Obesity: Body Mass Index (BMI) is used to indicate whether a person is at a healthy weight for their height. (Overweight: BMI of 25-30; Obese: BMI above 30)
2. Diabetes: Sugar intake from food and beverages should be limited to prevent excessive calorie intake from high sugar.
3. Elevated triglyceride levels: High triglyceride levels can be a clue that you have fatty liver disease.
4. Blood pressure disease:
High blood pressure known as portal hypertension may be due to the stress on portal vein which slows down the blood flow.

Whether it be due to alcohol or NALFD, ultimately liver cirrhosis and liver cancer results.

NAFLD is not entirely lifestyle mediated. Genetics also seems to play a role. Specific genes like PNPLA3 have been identified which predisposes individuals to diabetes and fatty liver disease. NAFLD occurs in the back ground of diabetes and high cholesterol levels (Dyslipidemia) and Blood pressure disease (systemic hypertension). It is a known fact that Asians are genetically more prone for diabetes. The four necessary ingredients which fire NAFLD genesis, namely- obesity, diabetes, high Cholesterol and blood pressure disease share a common metabolic malfunctioning (different disease manifestations of the same genetic predilection). The diabetes and fatty liver inducing “bad genetics” is seen more commonly in Asian population than in the western world. Till now this bad genetics did not surface in Asia/India due to poverty and agrarian economy where physical exercise was part and parcel of common man’s lifestyle. With Asian economies evolving in a big way, sedentary lifestyle, over eating and alcoholism contributed to unmasking of the bad genetics inducing fatty liver disease. Purchasing power of the common man, especially urban dwellers has definitely gone up, but this has resulted in assuming unhealthy food habits. With blue collar job craze and consumerism, a thorough mismatch between exercise and food intake has happened. What seems to be alcoholic liver disease in fact could be a combination of genetically linked NAFLD and alcohol induced liver damage. Both alcoholic and nonalcoholic fatty liver disease with its attendant liver scarring, liver failure and liver cancer risk is the growing epidemic in India.

Need not always be. Lean NAFLD is an entity unique to Asia/India. The person may be having normal body weight, or even can be very lean, but his body handles energy metabolism defectively to the extent that he develop diabetes, high cholesterol levels and in due course fatty liver disease. Unfortunately, visibly lean gives a false impression of “good health” and make them seek medical support only at late stages of the chronic fatty liver disease.

No, kids are also prone to fatty liver disease with a prevalence ranging from 20- 60%. Affluent children consume aerated sugary beverages & Fast food. This coupled with a lack of physical exercise leads to fatty liver. All fast food brands from the western world have opened their outlets in Indian cities now. Most western snacks to meals have extra fat in it- cheese-based meals are ideal for cold European and north American climate , but when it comes to sunny tropics, cheese , pizzas and burgers just make your child heavy. An additional point to note here is the fact that food technology behind these junk foods need not be the same as when the same food brand in the developed world. Junk food culture in every nook and corner of the country is taking a heavy toll on liver health of our children by making then obese and inducing fatty liver disease.

Is there an added risk for those with diabetes, regarding turning into cirrhosis? The answer is YES. Diabetes and alcohol combo is literally adding oil to the fire! Those with a history of Metabolic syndrome (Diabetes, hypertension, dyslipidemia) are already prone to fatty liver disease and on top of that alcoholic injury occurs. The development of cirrhosis at an earlier age can be the consequence when diabetic patients consume alcohol.