Here's how you can prevent non-alcoholic fatty liver disease

A significant 38 per cent of Indians suffer from fatty liver or non-alcoholic fatty liver disease, reveals a recent AIIMS study. The study had analysed published reports on non-alcoholic fatty liver disease in India.

According to the study, which has been published in the Journal of Clinical and Experimental Hepatology, non-alcoholic fatty liver disease (NAFLD) often goes unrecognised since there are no symptoms in the early stages. But, it may lead in some patients to severe liver disease.

Alcoholic vs non-alcoholic condition

Drinking a large amount of alcohol, even if only for just a few days, may lead to a build-up of fats in the liver. This is referred to as alcoholic fatty liver disease. This is often the first stage of alcohol-related liver disease (ARLD).

The greater epidemic in India is non-alcoholic fatty liver disease (NAFLD). Mayo Clinic defines NAFLD as “an umbrella term covering a range of liver conditions affecting people who drink little or no alcohol”. “As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells,” it says.

Why fatty liver?

One of the primary causes for people to get ‘fatty liver’ or ‘steatohepatitis’ is that diets have become so westernised of late, say doctors. We are eating more fast food, and not enough healthy fruits and vegetables on the plate. And, we lead an unhealthy and sedentary lifestyle.

However, though there is no approved drug treatment for fatty liver, the condition luckily is “reversible”.

How do you prevent non-alcoholic fatty liver disease?

Adopt a healthy lifestyle

Firstly, adopting a healthy lifestyle is key to conquering this new epidemic, stress doctors. For obese individuals, weight loss is essential, and they can reduce weight by “following an adequate diet, restrict junk and sugary food intake, and exercise regularly”.

Also read: 38% of Indians suffer from non-alcoholic fatty liver disease, says AIIMS study

Walk, run and play active video games

According to hepatologist and clinician-scientist Dr Cyriac Abby Philips, who tweets under the handle @theliverdr, walking 8,000-10,000 steps a day for young and 6,000-8,000 steps a day for the elderly increases longevity and well-being and reduces death from all-causes. Walk for a minimum of 30 minutes to one hour and not lesser, he said in a recent series of tweets.

He also advocates brisk walking for at least 150 minutes per week or running even once a week. Further, he recommends “active video games”, i.e., gaming which requires active participation without being sedentary, since this improves balance, posture, gait speed and mobility.

Adequate hours of sleep

Sleep at least seven hours a night, advises Dr Philips. Do not nap for more than one hour in the daytime (or try to completely avoid it) and try to catch up lost sleep hours (of weekdays) during the weekend. This reduces chances of getting fatty liver, improves fatty liver disease and reduces risk of developing progression of fatty liver.

Also read: Lancet study: Death risk from liver disease twice as high in lower-income countries

Try black coffee

Three cups of black coffee without milk or sugar (may use zero calorie sweeteners as desired, but would advise avoiding that too) in a day reduces risk of fatty liver, reverses liver fibrosis, reduces risk of progression of fatty liver disease to cirrhosis and lowers liver fat especially in those with diabetes, states the doctor.

Avoid common OTC drugs

Use of common over-the-counter drugs, which are generally considered safe, may also lead to liver damage, according to experts. Drugs used for the treatment of tuberculosis, antibiotics, antiepileptic drugs, and chemotherapy, are also associated with liver injury, as are those taken as complementary and alternative medications (CAM).

A study by the AIIMS reported 67 per cent deaths among patients with anti-tuberculosis drug-related acute liver failure. Of all, patients with anti-tuberculosis drug-related acute liver failure, 60 per cent were started on medicines without confirmed tuberculosis.

Self-medication must be avoided, said Dr Anoop Saraya, head of the department of gastroenterology, AIIMS, in a media interview.

Avoid night time eating and snacking

Night time eating or late-night snacking has been associated with increased risk of metabolic disease, obesity, poor quality of sleep and longer but more inefficient duration of sleep. Avoid eating food at least within three hours before bedtime (however there is weak evidence, says Dr Philip).

Foods that help to fight fatty liver

The normal treatment for fatty liver disease, whether it’s alcohol-related or not, is to reach a healthy weight through diet and exercise. So, what should you eat? Here are some suggestions:

Fish and seafood
Fruits
Whole grains
Nuts
Olive oil
Vegetables
Avocados
Legumes
Antioxidants like green tea, garlic
Fruits, especially berries
Vitamin E

Steer clear of alchohol

While the AIIMS study spoke of non-alcoholic liver disease, the ‘alcoholic’ version is equally worrisome. Alcohol intake often is another primary cause for liver disease in India. Intake of alcohol can lead to “alcoholic hepatitis” and cirrhosis, which can lead to liver cancer and death.

“Alcohol accounts for most of the cases of severe liver damage which are admitted to hospitals with diagnosis such as ‘acute chronic liver failure’ and these have a high mortality,” said Dr Saraya of AIIMS.

Since there is no specific drug to treat alcoholic hepatitis, the only way to avoid this deadly disease is to steer clear of alcohol intake as no alcohol is safe for the liver, say doctors. Dr Philips asserts that complete abstinence from alcohol increases longevity, well-being, productivity and absolutely reduces the chances of getting almost 30 types of cancers and several other metabolic diseases.