Non-Alcoholic Fatty Liver Disease: A Major Health Concern in India

Non-alcoholic fatty liver disease (NAFLD), medically termed as Metabolic dysfunction-associated steatotic liver disease (MASLD) nowadays, is a major public health concern in India. This lifestyle disorder quietly infects about 1 to 3 out of every 10 individuals in the nation, corresponding to international estimates of 25-30% prevalence. MASLD is a leading metabolic disorder in India, commonly found together with obesity, diabetes, and cardiovascular disease.

 

Understanding MASLD

 

MASLD occurs when excess fat accumulates in the liver. While initially asymptomatic, it poses a serious risk, especially for individuals with diabetes and obesity. The disease can progress to hepatitis, an inflammation of the liver, and potentially lead to liver cirrhosis, a state of irreversible liver damage. Early diagnosis is crucial to prevent these complications. The rising rates of obesity and type 2 diabetes contribute to the increasing incidence of MASLD.

Causes of MASLD

 

MASLD develops over time, with key contributing factors including smoking, consumption of ultra-processed foods, and physical inactivity. Excess calorie intake, as highlighted in a study presented at ENDO 2023, is a primary trigger. The condition arises when the liver struggles to process fats efficiently, resulting in their storage. Obesity, diabetes, and elevated triglyceride levels also contribute to its development.

Signs and Symptoms

 

Signs of liver damage associated with MASLD include jaundice (yellowing of the skin and eyes), itchy skin, abdominal swelling due to fluid accumulation, swelling in the feet, and anorexia. Other symptoms may include extreme fatigue, unexplained weight loss, and loss of appetite.

Reversing Fatty Liver

 

MASLD is reversible with diet modification and exercise. Dietary measures involve restricting sugars and carbohydrates. Medical management can be achieved with drugs like vitamin E, Saroglitazar, Semaglutide, and Obeticolic acid, especially when there is compromised liver function. Fibro scan is a non-invasive test to evaluate liver injury.

A paper in Cell Metabolism showed that a diet high in resistant starch can lower the accumulation of fat in the liver. Resistant starch, which is present in foods such as brown rice, beans, whole grains, quinoa, cashews, lentils, plantains, oats, and potatoes, is a prebiotic that encourages the growth of good bacteria in the gut. This, in turn, helps in fat loss and transport in the liver.

Routine physical exercise, such as 150 minutes of combined strength training and aerobic weekly activity, also effectively reverses MASLD-induced liver injury.