What is NASH/NAFLD?

Non-alcoholic fatty liver disease (NAFLD)

NAFLD, non-alcoholic fatty liver disease, is a condition where there is too much fat built up in the liver. If left untreated, it can lead to serious liver problems.

Non-alcoholic Steatohepatitis (NASH)

NASH is caused when that extra fat turns into inflammation (swelling in the liver) and fibrosis (scarring) of the liver. If severe enough, that can lead to cirrhosis or liver cancer, potentially requiring a liver transplant.

Could I have NAFLD or NASH?

NAFLD and NASH can affect people of any age, including children. It is more common in people who live with certain conditions, including obesity (BMI >30) and conditions that may be related to obesity, such as type 2 diabetes, high blood pressure, or high cholesterol.

While NAFLD/NASH occurs in all populations, it is more common in Hispanic, Asian, and White populations than black. Further research supports that Hispanic individuals of Mexican origin have one of the highest incidences. In Europe, NAFLD affects 1 in 4 people with some differences according to geography and different socio-economic and ethnic groups.

What are the signs and symptoms of NASH?

Many individuals do not display symptoms in the early stages. Once prominent damage to the liver has occurred, signs of NASH may become more obvious.

Individuals with NASH can report:

  • Fatigue (tiredness that does not resolve with rest)
  • Changes to skin color (yellowing)
  • Abdominal pain

Cirrhosis is advanced liver disease and can be caused by NASH. If it develops, these symptoms may be observed:

  • Jaundice (yellowing of the skin and whites of eyes)
  • Itchy skin
  • Swelling of the abdomen
  • Dark urine

How is NAFLD/NASH diagnosed?

NAFLD and NASH can have very few observable symptoms in the early stages. There are several tests to diagnose NAFLD/NASH. These tests include:

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General clinical history/exam

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Blood tests

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Imaging tests
(e.g., ultrasound, MRI)

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Liver biopsy

How can I reduce my risk for NAFLD/NASH?

The amount of fat in the liver can be reduced through nutrition (similar to a Mediterranean diet), physical activity, maintaining a healthy weight, and adequate sleep. This can help prevent and treat NAFLD and NASH.

Nutrition

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Read the nutrition labels to look for hidden fat, sugar, and sodium.

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Have a goal of 5 portions of fruit and vegetables a day.

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Eat foods high in fiber including whole grains.

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Use extra virgin olive oil as main added fat.

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Consume fish 2-3 times per week.

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Switch sugary drinks and sodas for water or low-calorie beverages.

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Avoid oversized portions. Different products have different serving sizes.

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Avoid processed food and fast food.

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Avoid saturated fatty acid.

Activity

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Aim for 60 minutes of physical activity a day.

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Sleep matters. Have a regular bedtime to ensure enough sleep.

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Reduce screen time by limiting media use and device type.

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