The liver is one of the most important vital organs; it maintains metabolic homeostasis and is a principal detoxifying organ. Liver diseases are a worldwide medical problem and are rising exponentially. Apart from a viral infection, liver functions get hampered by diabetes, alcohol abuse, drug abuse and change in the metabolic behaviours like regular consumption of processed foods, high-fat red meat, soft drinks, sedentary lifestyle and over-eating ultimately lead to hepatic steatosis or Non-alcoholic fatty liver diseases (NAFLD) which generally doesn’t show symptoms in earlier stages.

Non-alcoholic fatty liver disease (NAFLD) has taken us by storm globally. Kashmir is in the middle of an epidemic of metabolic syndrome. It’s all because of bad eating styles and less awareness about our regular diet. Non Alcoholic Fatty Liver Disease (NAFLD) results from fat depositions in the liver which is unrelated to alcohol and viral cause. Three out of five affected individuals with metabolic syndromes like obesity, Hypertension, Diabetes, Hyperglycaemia, Hyperlipidaemia are diagnosed with NAFLD.

Liver metabolize various compounds and produces wide range of free radicals which cause hepatic-oxidative stress. Most of the chronic liver diseases are almost characterized by increase oxidative stress within Liver Cells (hepatocytes). Overtime fat in hepatocytes is vulnerable, because fatty acid becomes unstable and reacts with the free radicles (Oxygen reacting molecules) and forming a chain of free fatty acyl radicle formation. This terminating reaction damages lipid membrane, mitochondrial dysfunction and cell death. Cell death generates information and eventually the process of steatosis and in the absence of alcohol, causes non-alcoholic fatty liver disease.

NAFLD also cause Hepatic infiltration of neutrophils (one of the immune cells) in liver and finally cause chronic steatosis and activations of stellate cells (type of liver cell) to lay down fibrotic tissue thereby causing fibrosis. As the fibrosis continues, the scares are formed in the liver tissue and is classified as cirrhosis (Total damage of liver). Hepatocytes damage can increase liver enzyme in the blood stream, such as aspartate transaminase(AST) and alanine transaminase(ALT). Diagnosis can be made with Liver function test, Ultrasound, CT-scan and MRI, to look for fatty infiltrates. Additionally, biopsy can be used to diagnose and asses the severity of the disease as per doctor’s recommendations.

NAFLD usually causes no signs and symptoms. When it does, they may include:

·         Fatigue.

·         Pain or discomfort in the upper right abdomen.

If NAFLD is prolonged, then possible signs and symptoms is advanced scarring (cirrhosis) that include:

·         Abdominal swelling (ascites).

·         Enlarged blood vessels just beneath the skin's surface.

·         Enlarged spleen.

·         Red palms.

·         Yellowing of the skin and eyes (jaundice).

 Some important awareness tips in prevention of NAFLD (FATTY LIVER) disease.  As it is said “Prevention is better than cure”.

 Restore antioxidants: One method of restoring antioxidants is to consume natural compounds with antioxidant capacity, because this will only play the key role in preventing liver disease and also help decreasing the concentration of free radicals inside the body.

 Green tea: Green tea is fully of antioxidants and will help you to reduce various free radicals inside the body and also help in decreasing triglyceride ratio in blood. One dose of hot green tea cup without milk and sugar in a day is better.

 Lemon juice: Lemon juice contains Vitamin C which is potent antioxidant, one lemon extract in 250 ml of water without sugar is recommended per day.

 Mix Fruit and veggies: You can add mix fruits and veggies in your daily diet, which not only are good for liver but for overall health.

 Silymarin/Extract of Milk thistle plant: It is one of the best proven antioxidant for fatty liver diseases. Available in the form of supplements (Doctor advice is needed).

 Intermediate Fasting and Calorie Restriction:  Study evidence suggests that intermittent fasting can strongly effects on body weight and metabolic parameters, which may link obesity, non-alcoholic fatty liver disease (NAFLD) and major chronic diseases. One can also take enormous benefits from the month of Ramadhan (fasting month of Muslims) by taking small meals at sheri of iftayri. Small meals means less amount of carbohydrates and addition of key ingredients like proteins and vitamins.  

 Calorie restriction: Reducing your daily calorie intake causes weight loss and can be the corner stone therapy of non-alcoholic fatty liver disease (NAFLD). Intermittent fasting and calorie restriction has shown favourable effects on body weight (BW) and relevant indicators of NAFLD in several reports.

 Advice: Count Your Daily Calories (as per your body weight and height) then reduce 600 calories in your daily recommended calorie (calorie deficit). Stop consuming high energised foods like: Red meat, Excessive Dairy products, Soft drinks, Too much dry fruits, large bowls of rice, and high processed foods.

 Daily activity or physical exercise: Increasing prevalence of obesity has made non-alcoholic fatty liver disease (NAFLD) the most common liver disease in Kashmir.  Many studies suggest that physical inactivity is related to the severity of fatty liver disease irrespective of body weight, supporting the hypothesis that increasing physical activity through exercise can improve fatty liver disease. In the liver, exercise increases fatty acid oxidation, decreases fatty acid synthesis, and prevents mitochondrial and hepatocellular damage through a reduction of the release of damage-associated molecular patterns. Physical exercise is a proven therapeutic strategy to improve fatty liver disease along with calorie restricted diet. Your weekly reduction in body weight is directly proportional to overall improvement in metabolism.

 (The author is a fitness enthusiast. He can be reached on:  kwajid40@gmail.com)