Non-alcoholic Fatty Liver Disease (NAFLD)
Our livers are responsible for fat and glucose regulation. When functioning properly the liver stores excess glucose as glycogen and it breaks down fats from a meal. If those fats are not needed for energy they are stored in our normal fatty deposit areas such as our bottoms, arms, thighs and legs (1). However as we continue to gain extra weight, the body can no longer store fat in these areas and is instead stored in intra-abdominal adipose tissue (around our organs) and inside our muscles and our liver. This type fat is called ectopic fat.
NAFLD is the most common liver disease in developed countries and it starts with the benign build-up of this ectopic fat in the liver cells (steatosis) with about 5-33% of the liver being fatty. This is the stage that is completely reversible by making changes to nutrition / lifestyle and is suggested to be present in 30% of UK adults and in >70% of those with T2D. If left unaddressed then over a further 8-13 years about 50% of people will go on to develop NASH (non-alcoholic steatohepatitis), which is steatosis with inflammation. Early NASH may also respond to nutrition and lifestyle interventions (2).
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(1) Chait A, den Hartigh LJ. Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease Front Cardiovasc. Med 2020;7:22 - doi: 10.3389/fcvm.2020.00022