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What is Non-Alcoholic Fatty Liver Disease (NAFLD)? Are YOU at Risk?

What is Fatty Liver? What is NASH? Read this article to see if you're symptomatic to this silent disease.

Nonalcoholic Fatty Liver Disease & its Symptoms

One in four Americans suffers from liver disease. There are various risk factors linked to Nonalcoholic Fatty Liver Disease(NAFLD). It is the number one cause of liver disease and affects approximately 20% of Americans. Damage to the liver occurs slowly over the course of years, making it a silent disease. It is often only when signs of the liver not working well occur, that people realize there is a problem.

As the name suggests, NAFLD is fat that deposits itself in the liver cells which is not related to alcohol intake. As smoking is not the cause of all lung cancers in the same way alcohol consumption is not the cause of all liver diseases. It is most often diagnosed incidentally at the time of assessment for other health issues or insurance review. Sometimes a person’s liver enzymes may be slightly higher than normal. This indicates the liver cells are irritated, or it may be during an ultrasound that fat is seen in the liver. Your doctor will likely do other blood tests to make sure there are no other causes for liver disease. They may also have you do a test called Fibroscan™ to look for scar tissue and fat content in the liver.

Nonalcoholic Fatty Liver Disease can be difficult to treat in its early stages as there are few symptoms. However, patients can develop dull or aching pain in the top right of their abdomen later on. Some of the symptoms might be extreme tiredness, unexplained weight loss, and weakness. Not all of these symptoms mean a person has NAFLD or liver disease, but it doesn’t mean their cause shouldn’t be investigated. If NAFLD is allowed to develop without treatment cirrhosis of the liver can occur and alongside it, more severe symptoms include jaundice, itchy skin, swelling of the legs, ankles, feet, and oedema.

Warning Signs You Have a “Fatty Liver,” Say Experts


A less common but important type of NAFLD is Non-alcoholic steatohepatitis (NASH). Approximately 20% of individuals with NAFLD will have NASH. It is inflammation of the liver tissue (hepatitis) caused by fat in the liver. This is diagnosed by liver biopsy and requires intervention to slow down ongoing damage to the liver. Over time NASH can lead to liver cancer or cirrhosis (a scarred liver).

Who is at risk of NAFLD?

Individuals with obesity, high lipid/cholesterol levels, and/or diabetes are more at risk of developing NAFLD. However other things can lead to fat depositing in the liver. These include genetic factors, rapid weight loss often associated with bariatric surgery, starvation, and some medications.

Other Risk Factors include if a person:

  • Is obese or overweight
  • Has type 2 diabetes
  • Has a condition that affects how the body uses insulin
  • Is insulin resistant
  • Has an underactive thyroid
  • High blood pressure or high cholesterol.
  • Has metabolic syndrome
  • Is over the age of 50
  • Smokes.

Additionally, To avoid NAFLD and Liver disease stick to basic lifestyle practices including eating a balanced diet, exercising regularly, minimizing alcohol consumption, and not smoking.

A 10% gradual weight loss can lead to an improvement in the fat content of the liver, however fast food is convenient and quick when you are on the road. Modifying your diet to healthier choices may result in improvement in your overall health. Healthy choices are more difficult to find on the road, but even small changes done over time can help. Although there are no current medications that will control NAFLD or NASH, lifestyle changes can lessen long-term damage. It can improve liver fat content and scar tissue. These changes are often difficult to implement, as many factors such as societal, family, and occupational realities exist that make change difficult. Long haul trucking is one of those occupations that is laden with setting individuals up for NAFLD and presents many challenges to its prevention.

For more information about liver disease contact the NHS or consult with your GP.

Lifestyle changes include

  • Losing weight
  • Consuming a healthy diet
  • Drinking water no sweet drinks
  • Regularly exercise
  • Quitting smoking.

Although NAFLD isn’t caused by alcohol, this substance could make it worse so avoiding consumption is advised.

A sedentary lifestyle is common, as many occupations such as long-haul trucking require long periods of sitting or inactivity. Studies have shown that both aerobic and anaerobic activity can improve the amount of fat in the liver, even in the absence of weight loss. A quick walk around the parking lot a few times a day, can be beneficial.

Moreover, exercising has a number of benefits which include physical and psychological. Not only this, it can improve fitness and improve mental health by releasing endorphins to improve a person’s mood.

For individuals with sleep apnea, using CPAP not only helps with the overall improvement in sleep and decreased fatigue levels, but also helps to support liver health. Those with sleep apnea are more likely to develop NAFLD, so another reason to use your CPAP machine.


NAFLD currently has no cure, the main treatment is through healthy lifestyle choices.

In order to treat conditions associated with NAFLD such as high blood pressure, diabetes, and cholesterol, a prescription is provided for its treatment.

Further, the patient may be put forward for a partial liver transplant if the condition reaches a point where liver cirrhosis occurs.

The liver has the ability to regenerate, therefore both the remaining and new sections of the liver can regrow to normal size.

Furthermore, the NHS suggests adopting better lifestyle habits is the best way to manage NAFLD and Liver diseases.

Prevention and/or management of diabetes, high cholesterol, and high blood pressure are important to overall health but will also lessen the chances of developing NAFLD.

Then there is COFFEE, drinking 3-4 cups of coffee (with minimal cream and sugar) has been shown to lower the risk of developing liver disease and liver cancer. Enjoy your coffee!

For more detailed information about NAFLD and lifestyle changes that can be incorporated into anyone’s life, follow Fatty Liver Alliance ( fattyliver.ca). Let us know if you have specific things you would like us to discuss.

About Fatty Liver Alliance

As a not-for-profit organization, we raise awareness and educate about the risks, causes, and complications of fatty liver disease. Also, help those already diagnosed with nonalcoholic fatty liver disease (NAFLD), metabolic-associated fatty liver disease (MAFLD), and nonalcoholic steatohepatitis (NASH) by advocating for access to approved treatments and care.

Tarek Hassanein, MD, FACP, FACG, AGAF, FAASLD

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