Fatty Liver Disease: How Lifestyle Choices Can Help Prevent It

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Dear Doctors: My father passed away due to unexplained liver problems which we only now know were fatty liver disease. It’s 20 years later, and a CT scan shows fat in my own liver. My liver readings are normal, but I’m the same age as my dad when his problems started. Should I be worried?

Dear reader: Fatty liver disease refers to a range of liver disorders not caused by alcohol use, autoimmune disease, drug use, or a virus.

It is the most common liver disease in the United States, estimated to affect up to 30% of the population. Once known as non-alcoholic fatty liver disease, the condition is now more accurately called metabolism-associated fatty liver disease or MAFLD.

Your father’s health problems arose when this type of fatty liver disease was in its infancy. Although alcohol-induced liver changes were first described in the 1840s, it was not until the 1980s that a metabolic cause of fatty liver disease began to emerge.

Fatty liver disease is what it sounds like: an abnormal buildup of fat in the liver. Although a healthy liver contains some fat, when the amount begins to exceed 5-10%, it is called fatty liver disease. This excess fat triggers an inflammatory reaction which, over time, leads to liver damage.

This means that the liver’s hundreds of metabolic functions — which include filtering out toxins, aiding digestion, managing blood sugar, and creating and storing nutrients — are negatively affected. The condition is linked to overweight or obesity, high blood lipid levels, high blood pressure, prediabetes and diabetes.

There is evidence of a higher risk of developing MAFLD when the disease runs in a family. But lifestyle and environmental factors seem to play a bigger role.

The condition has few symptoms, making it difficult to diagnose. Some people describe a feeling of fatigue. Some experience discomfort or pain in the upper right abdomen.

Abnormal liver enzyme test results can be an indicator. The same goes for a stiff or enlarged liver as well as jaundice.

Imaging tests can assess the amount of fat in the liver. A biopsy may be done to check for abnormal amounts of scar tissue in the liver, called fibrosis.

Tell your doctor that you have a family history of fatty liver disease.

To reduce your risk, avoid alcohol, maintain a healthy weight, eat a diet rich in fresh plant-based foods, and exercise regularly.

Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.

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