One in four Americans is at risk for fatty liver disease, but many remain undiagnosed

Increases in obesity and diabetes are fueling a little-known but life-threatening condition called fatty liver disease, with many people not even knowing they have it. In the most severe cases, fatty liver disease can progress to liver failure. To address this growing problem, the American Liver Foundation has announced a national screening and public awareness campaign, Think Liver Think Life, which will launch this summer to test high-risk children and adults in all 50 states over the next five years. (https://tinyurl.com/bctfhfy6)

People most at risk for fatty liver disease, also known as nonalcoholic fatty liver disease (NAFLD) and now called metabolic dysfunction-associated fatty liver disease or MASLD, include people with type 2 diabetes, those with high BMI or obesity, and the Hispanic and Asian communities. NAFLD is one of the most common causes of liver disease in the United States and the most common cause of liver disease worldwide.

Early signs of fatty liver - don't ignore these signals

Fatty liver, especially non-alcoholic fatty liver disease, is often "silent" in the early stage, and many patients may not have any obvious symptoms. However, as fat gradually accumulates in the liver, some early signs may appear quietly.

One of the most common early signs is fatigue and weakness. Studies have shown that patients with moderate and above fatty liver often feel persistent fatigue, which may be due to impaired liver function, affecting the body's energy metabolism. Secondly, mild discomfort or dull pain in the right upper abdomen may also be an early manifestation of fatty liver. This discomfort is usually not severe and can be easily mistaken for indigestion, but if it persists, it is worth being vigilant. In addition, weight gain or abdominal obesity is another key signal. More than one-third of adults in the United States are overweight or obese, and obesity is one of the biggest risk factors for fatty liver. Other possible signs include loss of appetite, nausea, and yellowing of the skin (mild jaundice), although the latter is more common when the disease progresses. For Americans, it is especially important to pay attention to these symptoms because a high-calorie diet culture (such as hamburgers, French fries, and sugary drinks) may accelerate the formation of fatty liver.

If you often feel tired, have abdominal discomfort, or continue to gain weight, especially if you have a family history of liver disease or diabetes, you may want to consult a doctor as soon as possible to get a blood test (such as a liver function test) or an ultrasound scan to rule out the possibility of fatty liver.

Prevention of fatty liver disease - start with lifestyle

In the United States, the prevalence of fatty liver disease is closely related to modern lifestyles, but the good news is that this disease can be largely avoided through scientific prevention methods.

First, controlling diet is the key to preventing fatty liver disease. Americans' diets often contain a lot of processed foods, saturated fats and added sugars, such as fast food and carbonated drinks, which are the "accomplices" of fatty liver disease. Experts recommend the Mediterranean Diet, which is rich in vegetables, fruits, whole grains, nuts and healthy fats (such as olive oil and fish oil), which has been shown to significantly reduce liver fat content.

Secondly, increasing physical exercise is another pillar. It is recommended to do at least 150 minutes of moderate-intensity aerobic exercise (such as brisk walking or cycling) per week, which not only helps to lose weight, but also improves fat metabolism in the liver. For sedentary white-collar workers or Americans who rely on cars to travel, even a 30-minute walk a day can bring significant improvements. In addition, limiting alcohol intake is crucial.

Finally, managing weight and chronic diseases cannot be ignored. Overweight or obese people should strive to lose 5%-10% of their body weight, which has been shown to reverse early fatty liver. In addition, controlling metabolic diseases such as diabetes and high cholesterol can also reduce risks.

Treatment for fatty liver disease - scientific response, regain health

Lifestyle intervention is the cornerstone of treatment and the most cost-effective way. Studies have shown that weight loss is the best non-drug means to improve fatty liver. This means that for overweight Americans, losing weight through a balanced diet and regular exercise (such as aerobic exercise 3-5 times a week) can not only improve fatty liver, but also improve overall health. In addition, quitting alcohol is particularly important for patients with alcoholic fatty liver.

For patients with more severe conditions, drug treatment may become an auxiliary option. Currently, the U.S. Food and Drug Administration (FDA) has not approved drugs specifically for non-alcoholic fatty liver disease, but some drugs have shown potential in clinical trials. For example, vitamin E (an antioxidant) and pioglitazone (a diabetes drug) are used to treat nonalcoholic steatohepatitis (NASH), with varying degrees of success in different patients.

In rare cases, if fatty liver disease progresses to cirrhosis or liver failure, surgery or a liver transplant may be a last resort.

However, these treatments are costly and risky and are usually reserved for patients in advanced stages. For most Americans, early intervention remains key to avoiding this step.

Summary:

Think Liver Think Life aims to help prevent and detect liver disease earlier, influence better management and treatment of liver disease, reduce the stigma associated with liver disease, address health inequities, and drive changes in federal policy and increase research funding. The program launched this summer in ten states, offering diagnostic testing, including liver testing, viral hepatitis antibody screening and assessments to help identify NAFLD/NASH and liver cancer.

The first ten states to screen this summer are: Alabama, Arizona, Florida, Kentucky, New Mexico, New York, Ohio, Pennsylvania, Texas and West Virginia, with ten more states to be added each year over the next five years.