There is growing concern over fatty liver disease in India, with discussions highlighting its impact on public health.
Introduction to Non-Alcoholic Fatty Liver Disease (NAFLD)
Non-alcoholic fatty liver disease (NAFLD) is a condition where excess fat accumulates in liver cells. This is not due to alcohol consumption but rather lifestyle factors. NAFLD is becoming increasingly common, affecting about 25% of the global population and up to 33% in India. It is particularly prevalent in urban areas due to sedentary lifestyles and obesity.
NAFLD can progress to more severe conditions like liver inflammation, fibrosis, cirrhosis, and even liver cancer. The condition often shows no symptoms initially, making early detection crucial. Factors such as diabetes and obesity increase the risk of developing NAFLD. In India, the prevalence varies significantly, with some regions reporting higher rates due to genetic predispositions and lifestyle choices.
The condition is not limited to obese individuals; a phenomenon known as “lean NAFLD” or “TOFI” (Thin Outside, Fat Inside) is increasingly observed, where people with normal body mass index (BMI) develop fatty liver. This highlights the complexity of the disease and the need for comprehensive awareness and preventive measures.

Impact and Prevention
NAFLD is a silent epidemic in India, with every third person potentially affected. It is more common among women than men, with genetic factors like the PNPLA3 gene variant playing a significant role, especially in South Asian populations. The disease is no longer confined to older adults; it is now common among younger individuals, including those in their twenties and thirties.
Prevention and reversal of NAFLD are possible through lifestyle changes. A low-carb diet and intermittent fasting have been effective in reducing liver fat and improving overall health. Physical activity is also crucial in managing and reversing the condition. Early detection is vital to prevent progression to more severe liver diseases.
India has taken steps to address NAFLD by integrating it into the National Programme for Prevention and Control of Non-Communicable Diseases. This move aims to enhance awareness and provide better healthcare services for those affected.

Public Health Concerns and Future Directions
The rising prevalence of NAFLD poses significant public health challenges. It is essential to raise awareness about the risks associated with sedentary lifestyles and obesity. Urban regions, in particular, need targeted interventions to reduce the incidence of NAFLD.
As India continues to grapple with this health issue, there is a growing need for comprehensive strategies that include education, early detection, and lifestyle interventions. The integration of NAFLD into national health programs is a step in the right direction, but more needs to be done to address the genetic and environmental factors contributing to its spread.
Question: What do you think are the most effective ways to combat the rising incidence of NAFLD in urban India, and how can awareness be increased among younger populations?