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May 31, 2022

Risk Factors, Symptoms, and Management of Non-Alcoholic Fatty Liver Disease

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The second-largest organ in the body, the liver, is essential for our digestive system. It breaks down food, stores energy, and removes waste products and toxins. A concern for patients with obesity, let’s look at one of the common liver diseases, Non-Alcoholic Fatty Liver Disease (NAFLD).

Why is it important?

It is usual for the liver to contain a small amount of fat. However, excessive deposition of fat in the liver could be harmful. NAFLD occurs when unhealthy fat deposition occurs in normal liver cells called hepatocytes. The fat accumulation can cause liver damage resembling the damage caused by alcohol. It can also happen in people who do not drink (hence the name non-alcoholic fatty liver disease). NAFLD can lead to advanced liver diseases like cirrhosis and liver cancer. This disease is commonly noticeable in people with diabetes, high cholesterol, obesity, and high blood pressure (metabolic syndrome). It can also occur in patients who have associated diseases like Hepatitis B and C and are at higher risk of developing permanent liver damage in the form of cirrhosis.

Risk factors

Lifestyle choices such as unhealthy diet and sedentary behavior have a significant role. Foods rich in high carbs and fructose content, such as carbonated drinks, processed fruit juices, or a diet rich in saturated fats, can also put a person at higher risk of developing NAFLD.


NAFLD can remain silent and does not present with any symptoms, but the advanced disease can be symptomatic with the following signs:

  1. Abdominal pain and or feeling of fullness in the right upper side of the abdomen
  2. Nausea, loss of appetite
  3. Yellowish skin or jaundice
  4. Swollen abdomen and legs
  5. Mental confusion
  6. Fatigue
  7. Enlarged blood vessels underneath the skin


  1. Healthy lifestyle: NAFLD is a sign of insulin resistance. Avoid simple sugars such as fructose corn syrup and fried, processed food. Increase intake of nuts like almonds and walnuts, green leafy vegetables, and fruits such as broccoli, kale, and spinach, as they contain vitamins and antioxidants, which prevent fatty acid oxidation and decrease inflammation. If nonvegetarian, add fish or lean meat to the meal and avoid red meat.
  2. Weight loss is the most critical factor in reversing the effects of non-alcoholic fatty liver disease. Weight loss of about 7-10% can improve insulin resistance and decrease the amount of fat in the liver. The recommendation is to reduce 500 kcal/day to achieve the weight loss goal.
  3. Physical activity: moderate to intense physical activity regularly 3-4 times a week can significantly improve weight, lower BP, and improve insulin sensitivity, hence reducing the deposition of fat in the liver.
  4. Addiction: Reduce the consumption of alcohol and carbonated beverages. Complete abstinence is vital as alcohol can increase the risk of making fatty liver disease worse, and illness can progress to complications like cirrhosis.
  5. Medication: Certain medications such as antibiotics, anti-tuberculosis medications, antiepileptics, and certain herbal medicines can also cause liver toxicity. However, there is no medication to help reverse NAFLD. However, treating BP, diabetes, weight loss, and high cholesterol together can improve disease progression.
  6. Vaccination: make sure to get Hepatitis B and C vaccinations.

Act now before it’s too late, as the good news is this disease can be reversible just by following a few healthy steps in your lifestyle. Take charge of your health and keep your liver healthy and fit.