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While globally linked to obesity and metabolic disorders, Non-Alcoholic Fatty Liver Disease (NAFLD)’s prevalence in India is further exacerbated by unique dietary habits, lifestyle patterns, and genetic predispositions
India’s traditional diet and evolving food habits have contributed significantly to the increasing burden of fatty liver disease
Fatty liver disease, particularly Non-Alcoholic Fatty Liver Disease (NAFLD)—now increasingly referred to as Metabolic Associated Fatty Liver Disease (MAFLD)—is emerging as a silent epidemic in India. While globally linked to obesity and metabolic disorders, its prevalence in India is further exacerbated by unique dietary habits, lifestyle patterns, and genetic predispositions. Experts warn that if left unchecked, fatty liver can progress to severe complications, including cirrhosis and even liver cancer.
India’s Unique Dietary and Lifestyle Risk Factors
India’s traditional diet and evolving food habits have contributed significantly to the increasing burden of fatty liver disease. Dr. Aravind Badiger, Technical Director, BDR Pharmaceuticals, highlights how dietary patterns, particularly excessive consumption of refined carbohydrates like white rice, wheat-based products, and processed sugars, contribute to insulin resistance and fat accumulation in the liver. The growing preference for fried snacks, fast food, and trans-fat-rich diets has only worsened liver health by promoting inflammation and fat deposition.
Additionally, many Indians follow a predominantly vegetarian diet, which, while rich in carbohydrates, often lacks high-quality protein sources. “A protein-deficient diet impairs hepatic metabolism and accelerates fatty liver progression,” Dr. Badiger explains. Furthermore, the widespread consumption of full-fat dairy products adds to the daily caloric intake, further contributing to liver fat accumulation.
Beyond diet, urbanization and a sedentary lifestyle play a major role in the disease’s progression. Dr Pavan Hanchanale, Hepatologist, Liver Transplant Physician, and Gastroenterologist at Ruby Hall Clinic, Pune, points out that reduced physical activity, combined with increased obesity, diabetes, and dyslipidemia, has led to a surge in fatty liver cases. He also highlights the impact of cultural eating patterns:
“Late-night dinners, excessive fasting followed by binge eating, and the overconsumption of sweets during festivals contribute to metabolic dysfunction,” he says. Furthermore, gut microbiota, influenced by India’s high-carb, spice-rich diet, plays a role in liver metabolism and inflammation.
The Growing Prevalence of Fatty Liver in India
Fatty liver disease occurs when more than 5% of liver tissue contains fat. Its prevalence in urban India is estimated between 16% to 32%, whereas in rural India, the numbers are currently around 10%. However, with rapid urbanization and changing food habits in rural areas, NAFLD cases are rising even in these regions.
Dr. Hanchanale warns that India’s genetic predisposition to metabolic diseases—coupled with increasing consumption of junk food, sugary beverages, and high-glycemic-index foods—has triggered a silent epidemic of obesity, diabetes, and liver disease. He emphasizes:
“Fatty liver disease can lead to liver scarring, which may progress to cirrhosis and, in some cases, even liver cancer. Regular check-ups, such as Fibroscan screenings, can help prevent fatty liver from developing into irreversible liver damage.”
Pharmaceutical and Medical Interventions
From a pharmaceutical standpoint, Dr. Badiger underscores the importance of early intervention with hepatoprotective agents, metabolic syndrome-targeting drugs, and nutraceuticals to manage fatty liver disease effectively. Raising awareness, promoting early screening, and advocating for lifestyle modifications should be a public health priority.
Given the increasing burden of MAFLD in India, a multi-faceted approach—including pharmacotherapy, dietary adjustments, and public health initiatives—is essential to curb its progression.
Preventing Fatty Liver: Key Takeaways
Adopt a balanced diet: Reduce refined carbohydrates and trans fats while incorporating high-quality proteins.
Increase physical activity: Regular exercise helps reduce fat accumulation in the liver.
Monitor liver health: Regular check-ups and early screenings (e.g., Fibroscan) help detect fatty liver at an early stage.
Limit processed foods and sugars: Avoid frequent consumption of sugary drinks, fast food, and high-glycemic foods.
Consult a liver specialist (Hepatologist): Early medical intervention can help manage and reverse fatty liver disease.
With India poised to face a growing number of fatty liver cases, the combined efforts of healthcare professionals, pharmaceutical advancements, and lifestyle changes are crucial to combating this emerging health crisis.
