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What is 'Non-alcoholic fatty liver disease' or NAFLD?

Non-alcoholic fatty liver disease (NAFLD) is a condition characterized by the accumulation of fat in the liver cells, which is not caused by excessive alcohol consumption. It is commonly associated with obesity, insulin resistance, and metabolic syndrome.

NAFLD can range from simple fatty liver, also known as steatosis, which involves a build-up of fat in the liver, to non-alcoholic steatohepatitis (NASH), a more severe form of the disease. NASH is characterised by liver inflammation and damage, along with the presence of fat in the liver. Over time, NASH can progress to cirrhosis, a condition where there is irreversible scarring of the liver.

The exact cause of NAFLD is not fully understood, but it is believed to be influenced by a combination of genetic, environmental, and lifestyle factors. Risk factors for developing NAFLD include obesity, type 2 diabetes, high cholesterol, high blood pressure, insulin resistance, and metabolic syndrome. However, not everyone with these risk factors will develop NAFLD.

NAFLD often does not cause noticeable symptoms in the early stages. However, as the disease progresses, some individuals may experience fatigue, abdominal discomfort, and in advanced cases, signs of liver dysfunction such as jaundice (yellowing of the skin and eyes).

The diagnosis of NAFLD is typically made through blood tests, imaging studies such as ultrasound, and occasionally a liver biopsy to assess the extent of liver damage. Treatment for NAFLD focuses on addressing the underlying risk factors and making lifestyle modifications. This may include weight loss, regular exercise, a healthy diet, managing diabetes and cholesterol levels, and avoiding alcohol and unnecessary medications that may contribute to liver damage.

It is important to monitor and manage NAFLD because if left untreated and the underlying causes persist, it can progress to more severe liver conditions such as cirrhosis, liver failure, and liver cancer. Regular medical follow-up and adherence to recommended lifestyle changes are crucial for individuals with NAFLD.

How do I manage it?

Managing non-alcoholic fatty liver disease (NAFLD) involves a combination of lifestyle modifications and medical interventions. Here are some strategies that can help in managing NAFLD:

1. Healthy Diet: Adopting a healthy eating plan is crucial in managing NAFLD. Focus on a balanced diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit your intake of saturated fats, refined carbohydrates, sugary foods and beverages, and processed foods. Consider consulting a registered dietitian for personalised dietary guidance.

2. Weight Loss: If you are overweight or obese, losing weight is an essential aspect of managing NAFLD. Gradual weight loss, typically around 1-2 pounds per week, is recommended. Aim for a combination of calorie reduction, portion control, and increased physical activity. However, consult with a healthcare professional or a dietitian before starting any weight loss program.

3. Regular Exercise: Engage in regular physical activity as it can help improve insulin sensitivity, promote weight loss, and reduce liver fat. Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week. Additionally, include strength training exercises to build muscle mass.

4. Control Diabetes and Cholesterol: If you have diabetes or high cholesterol, it's important to manage these conditions effectively. Monitor your blood sugar levels and take prescribed medications as directed by your healthcare provider. Adopt a heart-healthy diet and, if necessary, take medications to control cholesterol levels.

5. Avoid Alcohol: Even though NAFLD is not caused by alcohol, it is advisable to avoid or limit alcohol consumption. Alcohol can worsen liver inflammation and contribute to liver damage.

6. Regular Medical Follow-up: Attend regular check-ups with your healthcare provider to monitor the progression of NAFLD and assess liver function. They may recommend blood tests and imaging studies to evaluate the condition.

7. Medications: In some cases, medications may be prescribed to manage specific aspects of NAFLD, such as controlling blood sugar, managing cholesterol levels, or reducing liver inflammation. These medications should be taken under the guidance of a healthcare professional.

Remember, it is essential to work closely with your healthcare team, including doctors, dietitians, and other specialists, to develop a comprehensive management plan tailored to your specific needs. They can provide personalised guidance and support throughout your journey with NAFLD.

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