• Brian Dooreck, MD

Nonalcoholic Fatty Liver Disease (NAFLD) affects 25% to 45% of US adults

Updated: Mar 14




Nonalcoholic fatty liver disease (NAFLD) or "fatty liver" is common. It affects approximately 75 to 100 million adults in the United States. That is 25% to 45% of all US adults. NAFLD or fatty liver is the leading cause of chronic liver disease. This is becoming more so prevalent because of the ongoing epidemic of obesity and metabolic syndrome.


Did you know?


Approximately "25% to 45% of US adults" have Nonalcoholic fatty liver disease (NAFLD) or "fatty liver."

NAFLD is the liver (hepatic) manifestation of the metabolic syndrome. According to the Mayo Clinic, "metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke, and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels."


What is Nonalcoholic fatty liver disease (NAFLD)?


Nonalcoholic fatty liver disease (NAFLD) is when there is a presence of at least 5% hepatic steatosis (fat) on liver biopsy without evidence of hepatocellular injury. Risk factors of NAFLD are insulin resistance, obesity, and as mentioned above, the metabolic syndrome.


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What is Nonalcoholic steatohepatitis (NASH)?


Nonalcoholic steatohepatitis (NASH) is a subset of NAFLD. It is more progressive and represents a more advanced form of fatty liver disease. There is a greater risk of fibrosis (scarring) and eventual cirrhosis (end-stage liver disease) that carries complications that can lead to high morbidity and mortality (death).


Body Mass Index (BMI)


"Current estimates suggest that approximately 68% of all US adults meet body mass index criteria for being overweight or obese."

What is the big deal of having "fatty liver"?


Because "fatty liver" can progress from NAFLD to NASH. Then the risk of liver-specific morbidity (complications) and mortality (death) increases by a factor of 50 to 80 in patients with advanced fibrosis related to NASH. For this reason, correctly diagnosing and staging is critical for disease monitoring and prognosis.


Diagnosing NAFLD


Liver biopsy is the gold standard. However noninvasive means include ultrasound, blood testing, ultrasound elastography, and other radiographic options, like MRI studies. The early diagnosis and a sense of the severity of hepatic steatosis (fatty liver) may prompt further evaluation and more aggressive management of metabolic comorbidities; such as obesity, diabetes, etc.


Treatment of NAFLD


The US Food and Drug Administration has not yet approved any NAFLD-specific drug treatment. Nor is there any therapy for the management of NASH. There are clinical trials ongoing.


The only treatment is lifestyle interventions such as a balanced diet, weight loss, and healthy forms of regular exercise. Weight loss of at least 10% is the first goal. Studies highlight the underlying and true importance of diet in the management of fatty liver or NAFLD.


What do I do if I have NAFLD or "fatty liver"?


The only treatment is lifestyle interventions such as a balanced diet, weight loss, and healthy forms of regular exercise.

Personally


I eat a high fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.


"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"

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