What is Fatty Liver Disease?
Steatotic liver disease (SLD) is the medical term for a fatty liver. It happens when too much fat builds up in your liver cells.
A healthy liver naturally contains a small amount of fat. However, it becomes a health problem when fat makes up more than 5% of the liver's total weight.
- The liver is the body's main organ for processing food and waste. While a healthy liver contains very little or no fat, your body turns extra calories from food or alcohol into fat and stores it in your liver. You have this condition when fat makes up more than 5% of your liver’s total weight.
- Over time, this disease can cause liver scarring called cirrhosis. It is a very common condition; for example, about 1 in 3 Australian adults has it.
The Two Main Types
- Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): This is the most common type and is not caused by heavy drinking. It was previously called non-alcoholic fatty liver disease (NAFLD) or metabolic associated fatty liver disease (MAFLD). It is caused by cardiometabolic risk factors that affect your heart health.
- Alcohol-Related Liver Disease (ALD): This type is caused by drinking too much alcohol. Every time your liver filters alcohol, some cells die. The liver can usually replace them, but drinking too much prevents the liver from keeping up, which leads to fat buildup.
Symptoms
Fatty liver disease usually does not cause any early symptoms. If symptoms do appear, they may include:
- Feeling tired or generally unwell
- Pain in the top right side of your abdomen
- Unexplained weight loss
Signs of Serious Liver Damage
- Jaundice (yellowing of the eyes and skin)
- Easy bruising
- Dark urine
- A swollen stomach
- Vomiting blood
- Black stools
- Itchy skin
Doctors group this disease based on what causes it. The two main reasons are metabolic issues and alcohol use:
- Obesity: Carrying extra weight, especially around the belly.
- Diabetes: High blood sugar and insulin resistance force the body to store extra fat.
- High Cholesterol: Having high levels of bad cholesterol or triglycerides in your blood.
- Alcohol: Drinking too much alcohol stops the liver from breaking down fat properly.
- Other Factors: Family history, certain medications, or losing weight too quickly.
Common Symptoms
Fatty liver is often called a "silent" disease because it rarely shows symptoms in the early stages. If the disease grows worse, you might notice:
- Fatigue: Feeling completely exhausted or weak.
- Belly Pain: A dull ache or full feeling in the upper right side of your stomach.
- Severe Damage (Cirrhosis): Swelling in your legs or belly, yellow skin and eyes (jaundice), and itchy skin.
Causes
Fatty liver disease usually develops from multiple factors over a long period.
Common Causes
- Being overweight or obese, especially around the belly
- Having type 2 diabetes or insulin resistance
- Having high blood fats, such as cholesterol or triglycerides
- Drinking too much alcohol
Less Common Causes
- An underactive thyroid
- Certain medications
- Polycystic ovary syndrome (PCOS)
- Pregnancy (Acute Fatty Liver of Pregnancy is a rare complication that can happen in the third trimester or shortly after birth)
Diagnosis and Doctor Visits
Because the disease rarely causes obvious symptoms, you may only find out about it through routine medical tests. You should see a doctor immediately if you notice any signs of serious liver damage.
To diagnose the condition, your doctor will review your medical history and examine you. They may order:
- Blood tests: This includes a liver function test.
- Imaging scans: This includes an ultrasound, CT scan, or MRI.
- A liver biopsy: A small tissue sample is taken to check how much fat has built up.
Your doctor may also refer you to a gastroenterologist, who is a specialist in digestive and liver health.
Treatment and Prevention
There are currently no specific medicines available to treat fatty liver disease. However, making lifestyle changes can improve the condition and even reverse it. Prevention follows these exact same lifestyle steps:
- Improve your diet: Eat a healthy diet rich in fruits, vegetables, whole grains, and healthy fats. Avoid sugar, saturated fats, and processed foods.
- Manage your weight: Achieve and maintain a healthy body weight.
- Stay active: Exercise regularly on most days of the week.
- Manage existing health issues: Control your blood sugar and treat high cholesterol.
- Limit substances: Drink little to no alcohol, avoid medications that stress your liver, and quit smoking or vaping.
If your condition is caused by alcohol, the most important step is to stop drinking completely to prevent severe damage.
Complications
Without proper treatment, the extra fat causes liver inflammation. This leads to fibrosis (scarring) and can progress to cirrhosis. Cirrhosis can eventually cause liver failure, liver cancer, or cancers outside the liver. Some people with severe damage will ultimately need a liver transplant.
Furthermore, people with MASLD have a much higher risk of developing cardiovascular issues like heart disease, stroke, and kidney disease. Heart disease, rather than liver failure, is actually the leading cause of death for people with MASLD.
10 Best Foods to Reduce Fatty Liver
1. Garlic
Add more garlic to your daily diet. It helps reduce unwanted fat and cholesterol in the liver.
2. Black Coffee
Drink unsweetened black coffee twice a day. It stimulates healthy enzymes in the liver.
3. Lemon Water
Drink warm lemon water without sugar. It is a powerful antioxidant that promotes a healthy liver.
4. Olive Oil
Olive oil is enriched with healthy fats. Incorporating it into your daily cooking is highly beneficial for liver health.
5. Leafy Greens and Cruciferous Vegetables
Eat spinach (pasalai keerai), cabbage, cauliflower, and broccoli. These greens are rich in antioxidants and crucial for maintaining liver health.
6. Turmeric
Turmeric contains an active compound called curcumin. Adding more turmeric to your meals helps reduce liver inflammation.
7. Beetroot
Drink one glass of unsweetened beetroot juice daily. It purifies the blood and reduces inflammation in the liver.
8. Walnuts
Walnuts are rich in Omega-3 fatty acids, which are highly effective at lowering liver inflammation.
9. Amla (Indian Gooseberry / Nellikaai)
Amla is packed with Vitamin C and is excellent for detoxifying the liver.
10. Sunflower Seeds
These seeds are high in Vitamin E, which plays a major role in reducing liver inflammation.
Treatment and Management
There is no specific medicine to cure a fatty liver. Instead, treatment focuses on daily lifestyle changes to protect your liver:
- Lose Weight: Losing 3% to 5% of your body weight reduces liver fat. Losing 10% is even better.
- Change Your Diet: Eat more fruits, vegetables, and whole grains. Avoid processed foods, sugar, and saturated fats.
- Stop Drinking: Cut out or strictly limit alcohol.
- Exercise: Move your body and exercise most days of the week.
- Manage Health Issues: Take your prescribed medications to control your blood pressure, cholesterol, and diabetes.
- Medical Help: For severe liver scarring, doctors may use specialized medications or recommend a liver transplant.