Non-alcoholic fatty liver disease (NAFLD) (and recently modified to be known also as Metabolic-dysfunction Associated Fatty Liver Disease) is the term for a range of conditions caused by the build-up of fat in the liver. A healthy liver should contain little or no fat. The prevalence has been shown to be around 10-20% of the population (in USA). Early stages of NAFLD do not usually cause any harm, but when left untreated, can lead to serious liver damage when the condition gets worse. Having high level of fats in your liver is associated with an increased risk of diabetes, heart attacks and strokes, again pointing towards metabolic syndrome. If detected and managed at an early stage, it is possible to prevent the progression and even reverse the process. This is important because severe NAFLD is associated with a higher mortality and at earlier age.

Stages of NAFLD

There are 4 main stages of NAFLD. Most people will only develop the first stage BUT some will progress if they continue to lead unhealthy sedentary lifestyles.

Stage 1 – Simple fatty liver (steatohepatitis) is a largely harmless buildup of fat in the liver cells that can sometime be diagnosed during routine Health Screening blood tests

Stage 2 – Non- alcoholic steatohepatitis (NASH) is a more serious form of NAFLD where the liver has become inflamed. Around 2-5% get to this stage

Stage 3 – Fibrosis where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally

Stage 4 – Cirrhosis is the most serious stage, (usually occurring after years of inflammation), where the liver shrinks and becomes scarred. This damage unfortunately, is permanent and can lead to liver failure or liver cancer.

Symptoms of NAFLD

Usually there are NO symptoms in the initial stages (hence the term ‘silent liver disease’). Some might complain of dull ache over top right of the abdomen, generalized lethargy, weakness and weight loss.  Obvious symptoms only appear LATE at Stage 4 liver cirrhosis disease, when the signs and symptoms of liver failure can be seen. These include;

• Easy to get tired easily or fatigue
• Yellowing of the skin or eyes (jaundice)
• Spider-like blood vessels on the skin
• Vague itchy sensation over your body

Diagnosis of NAFLD

Usually a routine blood tests for liver function, liver Ultrasound scan or Fibroscan of the liver might pick up fatty liver. Sometimes, your doctor may suggest a liver biopsy to get more information to help stage your disease.

Treatment of NAFLD

Unfortunately, there is NO surgical or medical cure for NAFLD. However, there are strategies to control (and hopefully) reverse the fatty build-up in the liver. This involves some or all of the following;

• Keep good control of any cholesterol or diabetes health condition which you may have

• Lose weight – Losing 10% of your fat may remove the fat from your liver or reduce the inflammation by 45-80%. Reducing Waist Circumference (WC), weight (BMI) and total body fat are other important parameters
• Eat a healthy diet – Eat real food such as Asian or Mediterranean diet which is high in vegetables and seafood. Avoid the Westernised diet which is high in refined carbohydrates, fat and empty calorie foods. Sugars especially refined sugars also increase inflammation. Avoid preserved meats and processed foods. Try eating smaller portions of food as part of your weight control diet program
• Exercise regularly – Aerobic exercise like walking and cycling is good but any exercise is beneficial. The idea is just move.
• Stop smoking – This can cause overall inflammation and together with NAFLD is a risk factor for heart attacks and strokes
• Avoid alcohol – Alcohol is an important cause of inflammation of the liver and should be avoided to prevent further damage to the liver

Consider asking your doctor for a liver blood test or liver scan if you have the following risk factors namely, being overweight, high BMI, high triglycerides, high cholesterol or diabetes

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