In the past 10 years, there is a deadly condition that has become much more prevalent and yet many people have never even heard of it.  It is suspected that in the next 10-20 years it will be the most common cause for liver transplantation—yikes!  In fact, it is already suspected to affect up to 25% of the US population.

What is it?

The condition is called Non-Alcoholic Fatty Liver Disease (NAFLD).  This is when excess fat cells build up in the liver.  The liver normally does contain some fat, but if the liver becomes more than about 5-10% fat, then it is termed “fatty liver”, or in medical jargon: steatosis.

Who is at risk for developing it?

Anyone can develop it, including children, but the populations most at risk for developing this condition include:

  • Those who are overweight or obese
  • People with diabetes
  • People with high cholesterol or triglycerides

Why is it so dangerous?

The excess fat can cause the liver to swell (termed hepatitis, which means swelling of the liver) which in turn can cause scarring (or cirrhosis in medical lingo).  This leads to a condition known as NASH, which stands for Non-Alcoholic Steatohepatitis.  This is the medical term for when the liver is damaged from too much fat and chronic swelling that has occurred over time.  Once the liver becomes too severely damaged, the only option left is a liver transplant.

What are the symptoms?

NAFLD often has no symptoms, which is why it is deemed a “silent killer”.  When symptoms do occur, they often include:

  • Fatigue
  • Weakness
  • Weight loss
  • Loss of appetite
  • Nausea
  • Abdominal pain
  • Spider-like blood vessels
  • Yellowing of the skin and eyes
  • Itching
  • Swelling of the legs (edema)
  • Build-up of fluid in the abdomen (ascites)
  • Mental confusion

How is it diagnosed?

Blood is taken to check the liver enzyme levels.  Ultrasound is often used to confirm the diagnosis.

How is it treated?

There are no specific therapies for NAFLD or NASH.  If liver damage becomes too extensive, a liver transplant may be required.  However, there are some basic recommendations you can follow that can both manage an existing fatty liver, and most importantly, prevent a fatty liver:

  • Reduce weight if overweight or obese
  • Follow a balanced and healthy diet
  • Increase physical activity
  • Avoid alcohol
  • Avoid unnecessary medications

Weight loss has been shown to improve liver enzymes in patients with NASH, and has actually helped reverse the disease to an extent.

There have been some experimental treatments done with supplements, however currently there is not enough clinical evidence to support the safety or benefit of their use.  Also, as the supplement industry is not well-regulated, caution should always be taken before considering their use, and the risks/benefits should be discussed with a qualified professional.

Even if you have not been diagnosed with NAFLD or NASH, following the basic recommendations provided above can help reduce your risk of developing it in the future.  These recommendations, while seemingly “basic”, can still be very challenging to accomplish on your own.  As a registered dietitian and nutritionist, I can work with you to come up with a realistic plan on how to better follow many of the above recommendations.  Specifically, I can help you:

If you would like some extra help, or just want some more information, I am only a phone call, text, or email away.  You can now also schedule an appointment for yourself directly from my website.



The Silent Killer Most People Don’t Know About – And How to Avoid It
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