Fatty Liver Disease: How You Can Slay This Silent Killer

Written by Dr. Pulyk Nataliya Omelanivna on Wed, 16 November 2022

Key Highlights

  • Fatty liver is caused by excessive accumulation of fatty lumps in the liver.
  • There are two types of fatty liver disease, viz. alcoholic and non-alcoholic.
  • A small part of fatty liver disease is also attributable to hepatic metabolic dysfunction, arising out of malnutrition or eating disorders.
  • An unhealthy diet leads to a fatty liver by deposition of excessive fats in the liver, derived directly from the unhealthy foods.
  • Excessive alcohol consumption causes fatty liver disease by excessive deposition of triglycerides, owing to problems with hepatic lipid metabolism.
  • Symptoms of fatty liver disease include yellowing of eye whites, loss of appetite, and swelling of feet, among others.
  • Symptoms show up only at a later stage, but are more probable in older people, who have genetic complications, eat an unhealthy diet, or have infections like Hepatitis C.
  • Prevention of the fatty liver requires foods rich in protein, fiber, and vitamins. Coffee, walnuts, flaxseed, and garlic are all good for fatty liver.
  • Meats like beef, lamb, and pork that are high in saturated fats are best avoided to prevent fatty liver. White meats like chicken and turkey, and fish like salmon and tuna are better choices.
  • Fatty liver, if allowed to continue for long, can lead to scarring and then cirrhosis.

The liver, when healthy, has a smooth surface. When suffering from fatty liver disease, this organ has a sickening appearance, lumps of fat pushing against its surface from inside, like warts.

So called because of the deposition of fat inside the liver, this disease is the first stage of liver trouble, and it can be of two types: alcoholic and non-alcoholic fatty liver disease (NAFLD).

Fatty liver disease progresses to hepatitis and then comes cirrhosis. The first two stages are reversible, the third is not. Cirrhosis may even lead to death.

Decoding fatty liver disease

Simply put, fatty liver disease is a health condition caused by the accumulation of excessive fats in the liver. Usually, a small amount of fat is stored in the liver. But, when more than 5% of the liver is composed of fat, the liver is said to be fatty.
In the initial stage, this does not alter the function of the liver as the body has mechanisms in place that allows the liver cells to regenerate. However, over time the liver may degenerate.
The excess fats lead to extra pressure on the liver, making it difficult to produce bile and remove toxins. This eventually leads to inflammation of the liver.

Usually, there are three stages through which a fatty liver disease progress:

  • Stage 1: Inflammation of the liver leading to tissue damage (steatohepatitis)
  • Stage 2: Formation of scar tissue in areas where the liver is damaged (fibrosis)
  • Stage 3: The scar tissue takes over healthy liver tissue, leading to cirrhosis. Cirrhosis is what leads to liver cancer and liver failure.

In the first two stages, the liver functions well despite the damage. In the third stage, things take a critical turn.

According to data:

  • Globally, around 4.5%-9.5% of the general adult population suffers from cirrhosis. Two of the three main factors for this cirrhosis are Alcoholic, and Non-Alcoholic steatohepatitis (NASH).
  • Globally, around 20% of the people having NAFLD, suffer from NASH, which is an inflammatory form of NAFLD.
  • Red meats and processed meats increase the chances of getting NAFLD by 50%.
  • While comprehensive data about the non-alcoholic fatty liver disease (NAFLD) in Africa is less, a meta-analysis has pegged the prevalence of NAFLD in Africa to be 13%, with Nigeria having a 9% prevalence of the same.
  • Liver cirrhosis, a complication of fatty liver disease, is responsible for between 53,000-103,000 deaths per year in Africa.
  • Globally, around 4.5%-9.5% of the general adult population suffers cirrhosis. Two of the three main factors for this cirrhosis are alcoholic and nonalcoholic steatohepatitis (ASH & NASH), which are advanced stages of fatty liver disease.
  • Globally, around 20% of people having NAFLD suffer from NASH, which is an inflammatory form of NAFLD.
  • Consumption of red and processed meats increases the chances of getting NAFLD by 50%.

Non-Alcoholic Fatty Liver Disease

NAFLD is caused by a diet heavy in saturated fats and the person carrying an excessive amount of body fat.

Saturated fats put a lot of pressure on the liver. They're found in food items like butter, beef, cream, and bacon, as well as in foods that are deep-fried, processed, or contain high levels of artificial sweeteners.


Being overweight or obese leads to excessive intrahepatic triglycerides (IHTG), a condition medically known as steatosis. This condition can be with or without inflammation. Either way, prolonged burdening of the liver with IHTG can lead to Type 2 diabetes, cardio-metabolic abnormalities like hypertension, and cardiac diseases.

When the volume of IHTG reaches more than 5% of the liver's weight, it is said to be the onset of fatty liver disease. As the IHTG starts shooting up, it skews the metabolism of lipoproteins, fatty acids, and glucose. This disrupts the liver's metabolic activities, leading to a ripple effect on the health of several organs.

NASH, the sub-type of NAFLD, is of greater concern because it causes inflammation of the liver. If not treated in time, NASH can lead to fibrosis, cirrhosis, and liver cancer.


Alcoholic Fatty Liver Disease

This is caused when the liver is tasked with metabolizing excessive amounts of alcohol. Heavy drinking for many years or frequent binge drinking over a shorter period puts a huge strain on the liver. This organ is primarily responsible for metabolizing ethanol, which is the main component of any alcoholic drink. The strain leads to scars and lesions, and other problems.

To begin with, excessive amounts of alcohol can lead to a rise in IHTG. That's because more alcohol disrupts the ethanol oxidation process, and the hepatic lipid metabolism is messed up to the extent that the liver becomes a lipid-storing organ instead of a lipid-burning one.

Over time, these fat deposits can progress to inflammation, also because alcohol converts into formaldehyde, a toxic systemic inflammation-causing poison.

Without due intervention, an alcohol-burdened liver can suffer from various complications ranging from an enlarged liver, enlarged spleen, fluid build-up in the belly, alcoholic cirrhosis, alcoholic hepatitis, and liver failure.

Other causes of fatty liver

In very rare cases, a woman may develop acute fatty liver of pregnancy (AFLP). This is a genetic complication that arises in the third trimester of pregnancy. If it arises, imminent delivery of the child is the only way to treat the issue.

Surprisingly, malnutrition or eating disorders like anorexia can also lead to fatty liver disease. The sharp drop in food intake causes mitochondrial and metabolic dysfunction in the liver. Severely inadequate intake of proteins leads to a reduction in plasma triglycerides and phospholipids, along with an increase in free fatty acids. Taken together, these factors lead to a fatty liver.

Read more: Signs Your Liver Is Not Doing So well

Symptoms of fatty liver disease

Quite often, the fatty liver disease does not make itself obvious till it progresses to the stage of hepatitis and maybe even cirrhosis. There are a few symptoms, which must be recognized and responded to without waiting. They are:

  • Pain in the upper-right side of the abdomen
  • Yellowing of eye whites, nails, and skin (could be a sign of jaundice)
  • Water retention and swelling in the ankles and feet
  • Loss of appetite for many days on end
  • Nausea and vomiting
  • Drastic weight loss
  • Fatigue and sluggish mental state

The symptoms can more often manifest in:

  • People eating an unhealthy diet full of saturated fats
  • People drinking excessive alcohol
  • Menopausal women developing visceral fats
  • Overweight or obese people
  • Older individuals
  • Diabetes patients
  • People with high cholesterol
  • People experiencing chronic stress
  • People taking certain medications
  • People with genetic complications that affect the liver
  • People with infections like Hepatitis C

The best diet for Non-Alcoholic Fatty Liver

Fats are essential to the human body for the insulation of organs and as a storehouse of energy. However, excessive fats (especially, saturated fats) can mark the onset of fatty liver disease, even in people who are otherwise in good health.



Dr. Pulyk Nataliya Omelanivna

Dr. Pulyk Nataliya Omelanivna is an Internal Medical Expert who is based out of Ukraine. With a special interest in internal medicine Dr Pulyk graduated from the Ternopil National Medical Academy in Ukraine, in the year 2001. Between the years 2002-2009, Dr Pulyk worked as an emergency physician. Her years of work as an emergency physician gave her immense exposure to a range of patients and an opportunity to learn on the job, and gather extensive experience.

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