A healthy diet is one way to reduce the impacts of nonalcoholic fatty liver disease. Guille Faingold/Stocksy Guille Faingold/Stocksy United
- Researchers say about 1 in 4 adults is affected by nonalcoholic fatty liver disease.
- They say the condition often isn’t diagnosed until its later stages.
- They say the disorder can increase your risk of heart disease.
- Experts say lifestyle factors such as diet and exercise can help reduce the impacts and risks of this condition.
If you have an abnormal buildup of fatty tissue in your liver, it could mean your risk of heart disease is much higher.
That liver disorder is often missed and it’s a lot more common than you might think.
That’s the message of a recent scientific statement from the American Heart Association.
In it, scientists say an estimated 1 in 4 adults worldwide is affected by nonalcoholic fatty liver disease (NAFLD). For people who have type 2 diabetes, the prevalence is even higher. The condition may affect more than half of that population.
“The one in four was kind of shocking to most people,” said Dr. P. Barton Duell, professor of medicine in the Division of Cardiovascular Medicine at the Oregon Health & Science University and lead author of the scientific statement.
“There aren’t many things that affect that many people and can damage both your heart and liver. It’s a pretty compelling message that more is needed in this regard” Duell told Healthline.
In the United States, scientists say the number of adults affected is about 24 percent. It varies by race and ethnicity. Hispanics have the highest prevalence, followed by whites and then Black Americans.
“We’ve made great advances in dealing with many risk factors for heart disease. Smoking is down, we’ve done pretty well in the treatment of hypercholesterolemia and hypertension” said Duell.
“But this issue of fatty liver disease is kind of under the table and out of sight to some extent” he added.
Disease often undiagnosed
Experts say NAFLD is typically silent until more advanced and potentially irreversible liver damage occurs.
“One of the problems with liver disease is we can survive just fine on about a third of our liver… which is good… but the downside is we can lose two-thirds of our liver silently and not realize it until it becomes too late in the process,” said Dr. Brent Tetri, the national medical advisor for the American Liver Foundation and a professor of internal medicine at Saint Louis University in Missouri.
Tetri says that over time the fatty tissue from NAFLD can become scar tissue. Then in the late stages, the scar tissue becomes fibrosis. And he says blood tests to detect liver disease aren’t always a reliable indicator.
“Traditionally, we have relied on liver enzymes, proteins made in the liver cells but released into the blood when the liver cells are damaged,” Tetri told Healthline “The ALT and AST can be elevated or not. That makes them imperfect for detecting any liver disease.”
He says some of the tests being used now to detect early liver damage include elastography, which measures the stiffness of the liver, and the noninvasive FIB-4, a scoring system based on several lab test results.
“We’re just starting to realize these are valuable and doctors should start using these to look for unsuspected liver disease,” Tetri added.
Because NAFLD can be so difficult to diagnose and because it can be linked to heart disease, Duell says the scientific statement was designed in part to warn practitioners.
“The feeling is that it wasn’t getting the attention clinically that it needed,” Duell said. “We reviewed the science to make people aware that this was a big deal.”
Prevention and treatment
If the prevention and treatment of this condition sound familiar, that’s because it is. What you eat and how much you exercise are key factors.
“Part of the good news is that from a lifestyle standpoint, things that are beneficial for either preventing or treating this condition are the same as we recommend for other health conditions. That makes it easier for patients,” Duell said.
“We really have our patients focus on much healthier eating habits and regular exercise,” Tetri said. “We know that a lot of sugars in our diet contribute to the fat of the liver and a lot of saturated fats contribute to the damage of the liver”
“So we spend a lot of time talking with our patients about healthier eating habits. The Mediterranean type diet is a really good choice, more complex carbohydrates, healthier oils, getting away from saturated fats,” he added.
“There are some genetic components. We can’t fix our genes, at least not right now, but at least we can fight back by doing the best we can by focusing on healthy eating and staying active,” Tetri said.
The bottom line is the researchers wanted to get this condition on your doctor’s radar.
“This is common and it’s important as a risk factor for heart disease and liver damage. And you won’t know about it unless you look for it. There are some interventions that are helpful to make this better,” Duell said.