1. Non-alcoholic fatty liver disease (NAFLD) is excess fat deposition in the liver of an individual who does not consume significant amounts of alcohol.
2. NAFLD in India affects males more frequently than females (2:1).
3. It usually manifests after 40 years of age, but can occur even earlier, for example, in those who are obese when young.
REASONS FOR OCCURRENCE
1. Our normal liver has minimal amount of fat, but when more than 5% of the liver weight is due to fat, it is called ‘fatty liver’.
2. The main reason why excess fat gets deposited in the liver is weak metabolism coupled with unhealthy diet.
3. People most predisposed to NAFLD are the ones who have the ‘metabolic syndrome’ – individuals suffering from obesity, diabetes, hypertension, hyperlipidemia and hyperuricemia.
4. The presence of fat alone is not that harmful, but if the liver reacts to the fat it gets inflamed leading to a condition called the non-alcoholic steatohepatitis (NASH).
5. This is a stage when NAFLD progresses to scarring (fibriosis) over
time, finally leading to cirrhosis and many complications.
6. NASH is thus a more severe subgroup of NAFLD and can be very dangerous if not treated early.
NAFLD AND BMI
1. As NAFLD is closely linked to obesity, it is useful to know the BMI (Body Mass Index) before taking preventive measures.
2. In India, the prevalence is high even in those with ‘normal’ BMI.
3. The BMI is derived by dividing a person’s weight in kilograms by his/her height in metres squared (kg/m2).
4. In adults, the BMI specifications are:
a) Normal weight – between 20 and 25
b) Overweight – between 25 and 30
c) Obesity – between 30 and 35
d) Significant obesity – between 35 and 40 and
e) Morbid obesity – between 40 and 45.
5. The cut-off BMI levels for NAFLD risk in India may be as low as 22, i.e. waist circumference of 90 cm in men and 80 cm in women, and waist hip ratio of 0.88 in men and 0.8 in women.
SYMPTOMS AND DIAGNOSIS
1. NAFLD and NASH are problems that usually have no symptoms.
2. The diagnosis is made during a routine health check up (ultrasonography and biochemical liver profile) or when the patient undergoes these test for some other reasons.
3. Generally, those who are obese and are predisposed to ‘metabolic syndrome’ will, in all probability, have a fatty liver problem as well.
4. Also, there is an entity loosely called ‘lean NASH’ where the condition occurs even in lean individuals, although the exact mechanism for this occurrence is not fully known.
TREATMENT
1. Treatment should be not just of the condition but the cause too.
2. Treatment for control of obesity or diabetes is a part and parcel of holistic lifestyle management, but even medications such as the UDCA and anti-oxidants are prescribed to protect the liver.
PREVENTION
1. But the most preventive measure you can take is the age-old, time-tested norm of maintaining a healthy lifestyle and avoiding the associated lifestyle disorders.
2. You must abstain from alcohol completely.
3. You must get evaluated for other medical disorders that may inflame the liver (e.g. hepatitis B or C) before the diagnosis is confirmed.
4. You may have to consult a gastroenterologist to get a full idea of the entity.
5. You should get moving and start exercising, as only mental activity is not enough.
6. You should give up processed food totally and stick to the normal Indian thali.
7. Improper sleep and smoking can aggravate the condition, hence, try and audit your stress levels.
2. NAFLD in India affects males more frequently than females (2:1).
3. It usually manifests after 40 years of age, but can occur even earlier, for example, in those who are obese when young.
REASONS FOR OCCURRENCE
1. Our normal liver has minimal amount of fat, but when more than 5% of the liver weight is due to fat, it is called ‘fatty liver’.
2. The main reason why excess fat gets deposited in the liver is weak metabolism coupled with unhealthy diet.
3. People most predisposed to NAFLD are the ones who have the ‘metabolic syndrome’ – individuals suffering from obesity, diabetes, hypertension, hyperlipidemia and hyperuricemia.
4. The presence of fat alone is not that harmful, but if the liver reacts to the fat it gets inflamed leading to a condition called the non-alcoholic steatohepatitis (NASH).
5. This is a stage when NAFLD progresses to scarring (fibriosis) over
time, finally leading to cirrhosis and many complications.
6. NASH is thus a more severe subgroup of NAFLD and can be very dangerous if not treated early.
NAFLD AND BMI
1. As NAFLD is closely linked to obesity, it is useful to know the BMI (Body Mass Index) before taking preventive measures.
2. In India, the prevalence is high even in those with ‘normal’ BMI.
3. The BMI is derived by dividing a person’s weight in kilograms by his/her height in metres squared (kg/m2).
4. In adults, the BMI specifications are:
a) Normal weight – between 20 and 25
b) Overweight – between 25 and 30
c) Obesity – between 30 and 35
d) Significant obesity – between 35 and 40 and
e) Morbid obesity – between 40 and 45.
5. The cut-off BMI levels for NAFLD risk in India may be as low as 22, i.e. waist circumference of 90 cm in men and 80 cm in women, and waist hip ratio of 0.88 in men and 0.8 in women.
SYMPTOMS AND DIAGNOSIS
1. NAFLD and NASH are problems that usually have no symptoms.
2. The diagnosis is made during a routine health check up (ultrasonography and biochemical liver profile) or when the patient undergoes these test for some other reasons.
3. Generally, those who are obese and are predisposed to ‘metabolic syndrome’ will, in all probability, have a fatty liver problem as well.
4. Also, there is an entity loosely called ‘lean NASH’ where the condition occurs even in lean individuals, although the exact mechanism for this occurrence is not fully known.
TREATMENT
1. Treatment should be not just of the condition but the cause too.
2. Treatment for control of obesity or diabetes is a part and parcel of holistic lifestyle management, but even medications such as the UDCA and anti-oxidants are prescribed to protect the liver.
PREVENTION
1. But the most preventive measure you can take is the age-old, time-tested norm of maintaining a healthy lifestyle and avoiding the associated lifestyle disorders.
2. You must abstain from alcohol completely.
3. You must get evaluated for other medical disorders that may inflame the liver (e.g. hepatitis B or C) before the diagnosis is confirmed.
4. You may have to consult a gastroenterologist to get a full idea of the entity.
5. You should get moving and start exercising, as only mental activity is not enough.
6. You should give up processed food totally and stick to the normal Indian thali.
7. Improper sleep and smoking can aggravate the condition, hence, try and audit your stress levels.