One in three Indians have fatty liver, most unaware: AIIMS study

With fatty liver disease rapidly becoming one of the most common liver conditions across India, Dr Amit Singhal, Director & Chief Consultant at the Premier Gastroenterology Institute (PGI), Jalandhar, shares insights into its causes, symptoms, diagnosis and prevention. Speaking to Tribune News Service, Dr Singhal emphasised that this disease is not confined to alcohol drinkers and warned that even children are increasingly being diagnosed with fatty liver. According to a nationwide study by AIIMS, more than one-third of Indians are already affected, most of them unknowingly.

What is fatty liver? Fatty liver is a condition in which fat begins to accumulate in liver cells. The liver, being a vital organ, performs essential functions like processing nutrients, detoxifying the blood and regulating metabolism. When the number of calories consumed exceeds what the body needs, or when insulin resistance hampers the body’s ability to process fats effectively, fat starts to build up in the liver. A small amount of fat in the liver is considered normal, but once it crosses five to ten per cent of the liver’s weight, it becomes problematic and may begin to damage the liver.

What are the causes? Is it just related to alcohol? Fatty liver is commonly misunderstood as a disease that only affects those who drink heavily, but that is not true. The primary causes include unhealthy lifestyle habits such as lack of physical activity, consumption of a high-calorie or junk food diet and conditions like obesity or being overweight. Diabetes and high cholesterol are also major contributors. While excess alcohol intake certainly plays a role, fatty liver can also be caused by certain medications and infections. So, it’s not just a drinker’s disease—it can affect anyone leading an unbalanced or sedentary lifestyle.

Why is it considered dangerous? The most concerning aspect of fatty liver disease is that it typically shows no symptoms in its early stages. People often don’t feel any pain or discomfort, which makes early detection difficult. However, over time, the condition can become far more serious. It may progress to liver inflammation, known medically as hepatitis and can then develop into fibrosis, which is scarring of the liver. If left untreated, this scarring can worsen and lead to cirrhosis and eventually liver failure. Beyond liver-related complications, fatty liver significantly increases the risk of liver cancer and is also associated with a higher likelihood of heart disease and complications from diabetes.

Who is at greater risk of developing fatty liver? Those most at risk include people who are overweight or obese, as well as those suffering from Diabetes Mellitus or high levels of triglycerides or cholesterol. A family history of liver disease also increases one’s vulnerability. Lifestyle factors such as a sedentary daily routine and the regular consumption of high-calorie or processed foods are key contributors. Additionally, individuals who actively consume alcohol are more likely to experience rapid progression of the disease if other risk factors are already present.

How is the disease diagnosed?

Fatty liver disease is often diagnosed during a routine health screening. A simple ultrasound of the abdomen can detect the presence of fat in the liver. Liver function blood tests are also used to identify abnormalities in liver enzymes that might indicate early damage. In some cases, doctors may recommend more advanced imaging like FibroScan or MRI, particularly when they need a detailed assessment of liver stiffness and the extent of fat accumulation.

What are the options for prevention and management?

The most reassuring fact about fatty liver disease is that it is often reversible, especially when detected in its early stages. Making key lifestyle changes is central to both prevention and treatment. Maintaining a healthy weight is crucial, as is consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Reducing the intake of sugar, fried items, and processed foods can make a substantial difference. Regular physical activity, ideally for at least 30 minutes a day, five days a week, plays a vital role. Alcohol should be avoided or kept to a minimum and individuals who already have underlying conditions like diabetes, high cholesterol, or hypertension should keep these well-controlled with the help of regular medical check-ups.