In today’s fast-paced world, as people work harder and earn more, many are also unknowingly putting their health at risk. One such concern is Nonalcoholic fatty liver disease (NAFLD) fatty liver disease, which is quickly becoming a silent urban epidemic. It’s now common among young professionals who are obese or suffering from type 2 diabetes; their risk is higher. Surprisingly, it affects people who do not drink alcohol. NAFLD, which is also known as ‘Metabolic Dysfunction-Associated Steatotic Liver Disease’ (MASLD), is a condition in which excess fat builds up in the liver. This buildup is not caused by alcohol consumption. When excess drinking causes fat deposits, it is called Alcohol-associated Liver Disease (ALD).

Types of NAFLD

Fatty liver disease has two types. One, Nonalcoholic Fatty Liver (NAFL) and two, Nonalcoholic Steatohepatitis (NASH). NAFL is a form of NAFLD in which fat is deposited in the liver, but no inflammation or liver damage occurs. Normally, NAFL does not progress to liver damage. However, NASH will cause swelling and inflammation in the liver, later turn to fibrosis and cirrhosis, and lead to liver cancer and liver failure. Doctors say up to 30 per cent of NAFL may progress to NASH and 20 per cent of NASH to cirrhosis.

Sedentary Lifestyle

Fatty liver disease cases are increasing in the country, especially among urban youth. Currently, 25–45per cent of urban adults are affected by the disease. Long hours of sitting, more screen time, lack of exercise, and high processed food intake are major contributors to the disease. A sedentary lifestyle and lack of exercise often lead to insulin resistance, which is another significant reason for NAFLD. It develops silently and, in the early stages, no noticeable symptoms will appear. Only a medical screening can detect the disease at that point. If the disease is left untreated, it may progress to liver cancer (Hepatocellular Carcinoma) and end-stage liver failure, which will necessitate a liver transplant, a hugely expensive procedure in India.

Major Risk Factors

Many diseases can increase the risk of NAFLD. They include family history of fatty liver disease, obesity, growth hormone deficiency, high cholesterol, high levels of triglycerides, insulin resistance, metabolic syndrome, polycystic ovary syndrome, obstructive sleep apnea, type-2 diabetes, hypothyroidism and hypopituitarism. NASH often develops in people aged above 50, having some genetic factors, obesity, diabetes, high blood pressure, high triglycerides, and a large waist size.

Children at Risk

Studies estimate that fatty liver disease affects 30per cent to 40per cent of the global adult population. Alarmingly, it can affect people of any age, including children. Research suggests that close to 10 per cent of US children, aged between 2 and 19, suffer from NAFLD. In India, too, some studies say 10 to 20 per cent of children and teenagers in certain urban areas are susceptible to the disease. The reason is, the proportion of overweight or obese children/ adolescents is around 20per cent in India, and it is increasing in both low-income and high-income groups. The prospective obesity-related risks are alarming, as weight gain during school years carries a higher risk of NAFLD than weight gain in late adulthood.

Early Symptoms

NAFLD offers no symptoms, but at an advanced stage, it may exhibit fatigue, not feeling well, and pain in the upper right belly area. When the disease is progressed to NASH or cirrhosis, symptoms such as itchy skin, abdominal swelling (also called ascites), shortness of breath, swelling of the legs, spider-like blood vessels beneath the skin surface, enlarged spleen, red palms, and yellowing of the skin and eyes (jaundice) will appear.

Neurological Problems

Apart from the kidneys, the liver also filters toxins from the blood. When it gets damaged, the filtering process becomes ineffective. As a result, some chemicals and harmful substances accumulate in the blood, which may lead to chronic neurological problems like memory loss, mood swings, depression, and sleeplessness.

Role of AI in Diagnosis

The use of AI in liver fat quantification (CT/MRI), fibrosis scoring, and risk prediction are very effective. It is found that genetics also plays a crucial role in triggering disease. Though conventional medical diagnostic systems are unable to detect such elements, AI-driven diagnostic tools can trace the genetic features and predict the likelihood of contracting NAFLD. Thus, early detection can be useful not only in limiting the progression of the disease but also averting the huge financial burden that is associated with long-term treatment, including liver transplants.

Lifestyle Matters

The prevalence of NAFLD is increasing globally, with projections indicating a significant rise by 2030. Since India has an increasing number of ageing populations, obesity cases, and type 2 diabetes, NAFLD and co-morbidities are expected to jump in the coming years. In addition to periodic screening among the high-risk groups, lifestyle changes like regular exercise and reduction of high-fat diets will help people stay healthy. Notably, a weight loss of 7–10per cent can reverse NASH/fibrosis condition, which is significant for a patient since it prevents the disease from progressing to the cancer stage. Moreover, it is better to avoid sugar-sweetened beverages and increase the intake of fibre-rich foods. Above all, an exercise schedule of at least 150 minutes a week of moderate activities is good for preventing diseases.