While many of us associate alcohol with liver diseases, there's one insidious condition that experts fear is fast becoming a silent epidemic.
The lesser-known Non-Alcoholic Fatty Liver Disease (or NALFD) is perhaps a hidden illness you have never come across before - and one in three of us are already developing it.
NALFD is a catch-all term for a number of conditions triggered by a build of fat in your liver. The condition isn't caused by alcohol but drinking can make it worse.
Back in 2016, NALFD’s profile skyrocketed after a coroner’s report listed it as among the causes of death for pop superstar George Michael, who passed away at just 53. When this illness merges with other causes of liver ailments (infections such as hepatitis or drinking more than the recommended 14 units a week), it puts liver disease as the biggest killer of adults in their 30s and 40s.
The British Liver Trust chief executive officer Pamela Healy says many don't realise how weight can be a risk factor: “The liver is just as vital an organ as the heart but people often fail to appreciate the importance of keeping it healthy. There are also lots of myths surrounding it.
"For example, many people believe you need to be an alcoholic to develop liver disease, whereas one in five of us are drinking at a level that puts our liver at risk. Many also fail to realise that being overweight is a major risk factor.”
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Liver disease is mostly preventable, with the organ being highly resilient and the only one in the human body that can regenerate.
So why does carrying a few extra pounds – not even necessarily being obese – raise such a red flag? Basically, a healthy liver should contain little or no fat. Yet poor diet and extra weight means up to one in three people in the UK is now in the early stages of NAFLD.
Essentially this means they already have small amounts of fat in their liver which may not yet be causing them a problem, but as the levels rise will increase the risk of high blood pressure, kidney complaints and diabetes.
Initially the build-up of fat causes no symptoms, but left unchecked can transform into a more serious condition called non-alcohol steatohepatitis, or NASH, where the liver becomes inflamed. As time goes by, this inflammation scars both blood vessels and the liver. The unwitting sufferer would still have no clue as the liver is able to function normally.
The NHS says some people may experience symptoms such as:
Problems usually became clear much further down the line once cirrhosis sets in, where years of inflammation causes the liver to get lumpy and reduce in size. At this stage symptoms include:
- yellowing of the skin and the whites of the eyes
- itchy skin
- swelling in the legs, ankles, feet or tummy
The damage is often irreversible and the chances of liver failure and liver cancer increase dramatically.
Because this illness is so creeping and often goes unnoticed, experts stress it is vital to make lifestyle changes earlier in life.
Professor Jonathan Fallowfield, head of liver research at the University of Edinburgh, says “The 5 per cent who get NASH is expected to increase to 7 per cent by 2030.
“By and large most people don’t know they have a fatty liver. These are often people who are thin on the outside and fat on the inside. They tend to carry visceral fat around the abdomen and rarely have any symptoms other than fatigue.”
Prof Fallowfield says although NAFLD is not strictly related to booze, there is a major overlap with liver disease that is caused by alcohol. Essentially, people who drink too much are more likely to have a poor diet and lifestyle.
The professor says the very best treatment for NAFLD is simply to lose weight.
“You only have to lose about 10 per cent of your body weight to reverse it and possibly even reverse liver fibrosis too, boosting your quality of life”, he says.
