Is fatty liver an epidemic?


With a prevalence of 20-30% in the general population of Western countries, non-alcoholic fatty liver disease (NAFLD) is rapidly becoming the most common liver disease worldwide.

Furthermore, the prevalence of NAFLD among children is 3-10%, rising up to 40-70% among obese children.

The prevalence of NAFLD is 80-90% in obese adults, 30-50% in patients with diabetes and up to 90% in patients with hyperlipidemia.

And these may be conservative numbers in that the diagnosis of NAFLD in population studies is usually obtained by ultrasonography, which is known to underestimate the prevalence of fatty liver.

Routine blood work (for a physical exam) typically checks liver enzyme levels, which are markers for liver inflammation (aminotransferase), but these are usually normal and therefore unhelpful in identifying NAFLD.

The most important risk factors for NAFLD are:

  1. Male gender (by a 2:1 ratio),
  2. Increasing age,
  3. Obesity (although even thin people can have NAFLD),
  4. Insulin resistance and the cardiometabolic alterations that define the metabolic syndrome.
  5. Pre-diabetes and diabetes (most diabetics have NAFLD).

From this one can see that one doesn’t necessarily have to drink alcohol to have an unhealthy liver.

Other contributors and correlates of  fatty liver include:

  1. High blood pressure,
  2. High triglycerides,
  3. Pregnancy (rarely),
  4. Toxins (herbicides),
  5. Viruses (hepatitis A, etc.), and
  6. Drugs (aspirin, steroids, tamoxifen, and tetracycline, etc.), and lastly,
  7. Genetics and family history may play a role in fatty liver.

How these factors are linked together is not fully understood, but it is clear that one of the root causes of fatty liver disease is a poor diet and carrying around excess weight.

As the liver becomes dysfunctional the body tries to protect itself and compensate by pumping extra blood to the liver, which may lead to unexplained symptoms to include:

  1. Fatigue (disease-related tiredness) eventually leading to severe energy loss,
  2. Inability to participate in once enjoyed social activities,
  3. Worsening depression and anxiety,
  4. Muscle wasting and weakness,
  5. Confusion, poor judgment, and trouble concentrating,
  6. Pain in the center or right upper part of the abdomen,
  7. Patchy discolored neck or under-arm skin,
  8. Worse symptoms after heavy drinking (if one drinks),
  9. Yellow skin and eyes (jaundice) and tiny yellow eyelid bumps,
  10. Broken blood vessels (spider veins),
  11. Red palms, white nail beds, and enlarged finger tips,
  12. Dark pungent thickened urine and difficulty voiding,
  13. Whitish, clay colored, or tarry stools omitting a severe odor,
  14. Fluid retention in the belly (ascites) and legs,
  15. No initial symptoms (this is why fatty liver has been called a silent killer).

Could it be that experiences such as these could be the end result of not taking ones health and weight seriously?  If so it would seem, one would have to ask them self if poor dietary choices were, in the big picture, really worth it.

Your doctor may advise the following for reducing or preventing fatty liver:

  1. Lose weight: If one chronically carries extra weight, losing as little as 10 percent of total weight often decreases liver inflammation sufficiently to allow liver enzymes to normalize and existing liver damage to reverse. Unfortunately, improper dieting (such as yo-yo dieting) can worsen fatty liver.
  2. Eat better: Even if one is thin they may have fatty liver.  If one consumes quickly digesting carbohydrates such as white rice, white bread, concentrated sugar, and many prepared breakfast cereals, dramatically reducing consumption of these reverses fatty liver.
  3. Drink less alcohol: If one enjoys alcohol, consuming up to one glass of wine per day, may counter intuitively, correlate with less liver fat. However, regularly imbibing in more than 12 ounces of beer or 1 ounce of liquor escalates ones risk of developing NASH by 400% percent.  Avoiding this lifestyle is beneficial to the liver.
  4. Avoid chemicals:  If one is around household, automotive, or industrial toxins, remember that liver toxins can absorb through the skin and lungs.  Avoiding exposure and if necessary, wearing rubber gloves and respirators can be a smart move.


This information is not to be considered or used as a substitute for medical advice, diagnosis, or treatment. Please talk to your health care provider for anything related to your health including but not limited to diagnosis, treatment advice and/or care. Always seek the advice of a health care professional. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and are experiencing a medical emergency, please call 911 or call for emergency medical help on the nearest telephone.