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Why 1 in 4 Americans suffer from non-alcoholic fatty liver disease (NAFLD)
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Why 1 in 4 Americans suffer from non-alcoholic fatty liver disease (NAFLD)

How to know if you’re at risk of fatty liver disease: Diagnosis, prevention and treatment

Non-alcoholic fatty liver disease (NAFLD) is a medical condition characterized by the accumulation of excess fat in the liver cells, which is not caused by alcohol consumption. 

The disease ranges in severity from simple fat accumulation (steatosis) to more advanced stages, including non-alcoholic steatohepatitis (NASH), fibrosis, and even cirrhosis, which can be life-threatening.

The incidence of NAFLD in the United States has been on the rise, reflecting broader trends in obesity and metabolic syndrome. Estimates suggest that approximately 25% to 30% of the U.S. adult population has NAFLD. The prevalence can be even higher among individuals with type 2 diabetes or obesity.
This means that one out of every four people will suffer from NAFLD, which often remains undiagnosed in the early stages of the disease. This condition is a real concern because it's not only the most common liver disorder in the United States but also a leading cause of liver transplants.
Moreover, NAFLD is associated with an increased risk of cardiovascular diseases, which are the leading cause of death worldwide.

What causes fatty liver disease?

NAFLD is one of the most common forms of chronic liver disease and is often associated with conditions such as obesity, type 2 diabetes, and metabolic syndrome. These health issues can significantly increase your risk of developing the disease.

How does NAFLD impact your health?

Here's why fatty liver disease is more than just extra fat storage and how it could be affecting your overall health if ignored.

NAFLD is often asymptomatic in its early stages but can lead to liver inflammation, elevated liver enzymes, liver scarring, and ultimately liver failure if not managed appropriately.

Immediate impact

  • Low energy and abdominal discomfort: Feeling bloated and tired? NAFLD might be the culprit.

  • Liver troubles: Elevated liver enzymes are often the first red flag that your liver isn't doing its job properly. However, liver enzymes may remain at normal levels for some time.

Long-term consequences

  • Your liver could scar: Over time, NAFLD can lead to liver fibrosis, which is just as scary as it sounds.

  • Cirrhosis: Imagine your liver turning into a rigid, scarred organ. That's cirrhosis for you, and it's irreversible.

  • Liver cancer: NAFLD can increase your risk of liver cancer.

  • Heart issues: Yes, NAFLD can even mess with your heart, increasing your chances of heart disease and stroke.

  • Metabolic disease: Often, NAFLD comes with nasty conditions such as diabetes, obesity, and metabolic syndrome.

  • Mortality risk: Severe NAFLD can be a serious life-threatening problem.

Additional risks

Other health risks associated with non-alcoholic fatty liver disease include gallstones, memory loss, kidney disease, and overall metabolic decline.

NAFLD is more than just an extra fat storage problem — it's a serious condition with severe metabolic, health span and life expectancy implications. The sooner you catch it or take preventive measures, the better.

How to diagnose NAFLD?

1. Initial evaluation

  • Medical history: Your physician may ask about your medical history, alcohol consumption, and assess you for other risk factors such as obesity, diabetes, and high cholesterol levels.

  • Physical examination: During a physical examination, the doctor may check for liver enlargement.

  • Blood tests: Liver function tests, including Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST), are often conducted to assess liver health.

2. Imaging studies

  • Ultrasound: The most commonly used imaging test for diagnosing NAFLD. It's non-invasive and can effectively detect fat in the liver.

  • Computed tomography (CT) scan: Although less commonly used for NAFLD diagnosis due to radiation exposure, a CT scan can also detect liver fat.

  • Magnetic resonance imaging (MRI): More accurate but more expensive, an MRI can quantify the amount of fat in the liver.

3. Advanced testing

  • Transient elastography (FibroScan): This is a specialized ultrasound that measures liver stiffness, which can indicate fibrosis or scarring.

  • Liver biopsy: In some cases, a liver biopsy may be necessary, especially to confirm a diagnosis of non-alcoholic steatohepatitis (NASH), the more severe form of NAFLD. A small sample of liver tissue is removed and examined under a microscope for signs of inflammation and scarring.

4. Additional tests

Additional tests might be needed to rule out other liver diseases, such as chronic hepatitis C or alcoholic liver disease, especially if initial tests are inconclusive. 

5. Disease monitoring

Once NAFLD is diagnosed, further tests may be conducted periodically to monitor liver function and assess progression of the disease, especially if treatment interventions are initiated.

It's crucial to consult healthcare professionals for diagnosis and management, as fatty liver disease can progress to more severe conditions if not adequately managed.

Liver disease prevention, supplement support and detox

If you have no other medical conditions, you can control or even reverse the fat storage buildup in your liver and improve organ function through simple lifestyle changes and nutritional supplementation.

Special treatment is generally required if the disease has progressed and you're suffering from other chronic health issues.

PART 1 - Lifestyle changes that support liver health

  • Weight loss: The most effective treatment for NAFLD is weight loss, which has been shown to reduce liver fat and fibrosis. Even a moderate reduction in weight (around 5-10% of body weight) can have a significant impact.

  • Dietary changes:
    • Low-sugar, low-carbohydrate diets: Diets rich in sugars and simple carbohydrates can contribute to NAFLD. Consider adopting a diet low in sugar and high in fibre and protein.

    • Avoid sugary drinks, soda and even juices to reduce the consumption of fast-absorbing sugar. Fruit and whole grains are fine.

    • Healthy fats: Choose unsaturated fats like those found in olive oil and fish over saturated fats found in red meat.

    • Increased intake of fruits and vegetables: These are high in antioxidants and fibre, which are beneficial for liver health.
  • Regular exercise: Aerobic exercise, like walking, running, or swimming, and strength training can help reduce liver fat. Aim for at least 150 minutes of moderate-intensity exercise per week.

  • Avoid alcohol: Even though NAFLD is "non-alcoholic," alcohol can exacerbate liver problems and should be avoided.

  • Give up smoking: Smoking can worsen liver disease and contribute to other health issues.

PART 2 - Treatment & medication 

  • Blood sugar control: For those with diabetes, maintaining good blood sugar control can help manage NAFLD.

  • Lowering cholesterol: Statins or other medications may be prescribed to control high cholesterol levels.

  • Treating hypertension: Controlling high blood pressure is essential for liver health.

  • Vitamin E supplementation: Some studies suggest that vitamin E can help reduce liver inflammation in people with NASH (the most severe form of NAFLD), however, this should be done under medical supervision.

  • Specialized medications: While there are no medications specifically approved for the treatment of NAFLD, some drugs like pioglitazone or obeticholic acid are being researched and used in certain cases.

IMPORTANT: It's crucial to work closely with healthcare providers, including hepatologists, dietitians, and other specialists, for a comprehensive approach to treating NAFLD.

Disclaimer: Any information provided here is for educational purposes only and is not intended to substitute professional medical care.

PART 3 - Supplements for natural prevention of chronic liver disease

STEP 1: A semi-annual liver cleanse and detox as part of preventive care.

STEP 2: Fermented multivitamin supplements will ensure sufficient levels of choline, vitamin E and other vitamins that are important in preventing NAFLD. Fermented vitamins are known to absorb better, be gentle on the stomach and have increased nutrient bioavailability and positive health benefits.

STEP 3: Healthy fats and omega-3 fatty acids are another important element of NAFLD prevention. Regular medical check-ups, including blood tests and imaging studies, can help monitor progression of the disease and effectiveness of treatment interventions.



About the author

Dr. Peter Dobias, DVM is an Integrative veterinarian, nutritionist and creator of natural supplements for dogs and people. Helping you and your dog prevent disease, treat nutritional deficiencies, and enjoy happier, healthier, and longer lives together.

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