Non-Alcoholic Fatty Liver Disease: 1-in-4 Adults Have This Serious Condition

Non-alcoholic fatty liver disease -- or NAFLD — doesn’t tend to grab headlines but this condition is pervasive and a growing health issue. About 100 million adults in the U.S. are estimated to have NAFLD, a figure which has doubled over the past 20 years – primarily fueled by epidemics in obesity and diabetes.

That’s because NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. The American Liver Foundation estimates that NAFLD affects up to 25 percent of people in the United States.

NAFLD refers to a build-up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to carry some fat. But if more than 5 percent to 10 percent of the liver’s weight is fat, then it is called a fatty liver, according to the American Liver Foundation. The liver, which is the second largest organ in the body, processes what you eat and drink into energy and nutrients. The liver also removes harmful substances from your blood.

‘Fatty Liver’ and Weight Management

In the most serious cases, NAFLD can cause the liver to swell (steatohepatitis), which can lead to scarring, or cirrhosis, over time — and may even lead to liver cancer or liver failure. But many people live normal lives with NAFLD as long as they improve their diet, exercise and maintain a healthy weight.

The condition can be preliminarily diagnosed in blood tests that come back with high levels of liver enzymes. However, other liver diseases are first ruled out through additional tests. An ultrasound can confirm the NAFLD diagnosis.

If the diagnosis is NAFLD, your primary care physician may start you on a healthier diet and an exercise program. Your doctor may also refer you to a liver specialist. There is no direct medical treatment for NAFLD, but your doctor may prescribe medication to control your cholesterol and triglycerides. Diabetics with NAFLD need to continue to control blood sugar levels.

“An initial blood test can start your doctor on the path to diagnosing NAFLD, and sometimes it takes a few other tests and diving deeper into one’s medical history to make a final determination,” said Yeisel Barquin, M.D., a Baptist Health Medical Group physician with Baptist Health Primary Care. “But NAFLD can be very manageable with lifestyle changes.  NAFLD can be prevented by also adopting a healthier diet and regular exercise, as well as controlling other conditions which could serve as a risk factor.”

Other diseases and conditions can increase your risk of NAFLD, including metabolic syndrome, polycystic ovary syndrome, sleep apnea and hypothyroidism and an underactive pituitary gland, says Dr. Barquin.

Symptoms and Treatments

Often, NAFLD has no symptoms. When they occur, they may include:

• Fatigue;
• Weakness;
• Weight loss;
• Loss of appetite;
• Nausea;
• Abdominal pain;
• Spider-like blood vessels;
• Yellowing of the skin and eyes (jaundice);
• Itching;
• Fluid buildup and swelling of the legs (edema) and abdomen (ascites);
• Mental confusion.

The American Liver Foundation says eating a healthy diet and exercising regularly may help prevent liver damage from starting or reverse it in the early stages. Here are the Foundation’s recommendations for treatment:

• See a doctor who specializes in the liver regularly;
• Talk to your doctor about ways to improve your liver health;
• Lose weight, if you are overweight or obese;
• Lower your cholesterol and triglycerides;
• Control your diabetes;
• Avoid alcohol.