The 4 Stages of Nonalcoholic fatty liver disease (NAFLD)
NAFLD may seem like it has similarities with Alcoholic Liver Disease (ALD) but it’s different because ALD comes from heavy drinking and family history, while NAFLD is associated with being overweight and other symptoms [2]. NAFLD progresses in 4 stages [3]:
Stage 1: Simple fatty liver (Steatosis)
Hepatic steatosis is when more than 5% of fat builds up in the liver cells because the amount of fat in the diet exceeds the amount of fat the body can handle. It is considered harmless because there are usually no symptoms. You may only know from doing a thorough health check-up.
Stage 2: Non-alcoholic steatohepatitis (NASH)
Rarely people with simple fatty liver will go to stage 2 of NAFLD, called non-alcoholic steatohepatitis (NASH). You may feel some pain in the lower right side of your ribs and sometimes there won’t be any symptoms at all. NASH is when your liver becomes inflamed and it shows that your liver might be damaged and some of your liver cells are dying. It’s more common in women than men between ages of 40-60 [4].
Stage 3: Fibrosis
Over time, the inflammation of your liver could eventually lead to fibrosis. Fibrosis is the build up of scar tissues. These fibrous tissues will replace some of the healthy liver tissue until the liver becomes harder. But your liver can still function normally if there are enough healthy tissues left.
Stage 4: Cirrhosis
If your liver has progressed to this stage, it is serious because the damage has become permanent. Cirrhosis is when your liver shrinks and become lumpy because all your liver tissues has been scared. This stage of NAFLD leads to liver failure and maybe even liver cancer. People with type 2 diabetes are at greater risk of cirrhosis.
Who are at risk?
You are at risk if you:
- Are overweight or obese
- Have a poor diet and do little or no exercise
- Are a smoker
- Have fasted for long periods of time
- Have Metabolic syndrome
- Have underwent rapid weight loss
- Have high cholesterol levels
- Have type 2 diabetes
- Have hypertension (high blood pressure)
- Have hyperlipidaemia (too much cholesterol and triglyceride in your blood)
- Have polycystic ovaries
What are the symptoms?
Generally NAFLD has no symptoms but there are reports of discomfort in the right abdomen, fatigue, nausea, trouble concentrating and loss of appetite and weight [5].
How is it diagnosed?
You can only find out if your have NAFLD from a blood test, an ultrasound and a biopsy. Your blood test might show abnormal levels of certain enzymes, while the ultrasound might show your liver looking enlarged.
How to do you treat NAFLD?
There are no direct treatments for nonalcoholic fatty liver disease so far, so doctors can only prescribe treatments for the other risk factors that might have caused NAFLD such as obesity, diabetes and more. Changing your lifestyle by exercising more and eating healthier is one way to lower your cholesterol level.
- Eat plenty of fruits and vegetables; aim for five a day
- Avoid salty and fatty foods
- Eat smaller portions and choosing the low-fat options
- Go for lean cuts of meat
- Try grilling, baking or poaching your food instead of frying
- Stay away from crash diets and rapid weight-loss programmes
- Reduce and stop drinking alcohol
Taking dietary supplements might help too. Fat-soluble antioxidants, such as vitamin E (>800IU/day) have been shown to be effective in a large clinical trial of non-diabetic patients with NAFLD. Antioxidants also work to reduce oxidative stress which helps lower inflammatory factors that can damage liver cells. Taking Omega-3 fatty acids may reduce further development of a fatty liver by reducing the build-up of fat in the liver.
You might be prone to NAFLD if you suddenly undertake a diet without preparing your body for it beforehand because your body will be in shock of the sudden changes. So to prevent NAFLD, it all comes down to living a healthier lifestyle, eating less junk, high cholesterol food and more exercise to maintain a healthy liver!
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