How Poor Diets And Obesity Contribute To Non-alcoholic Fatty Liver Disease

Non-Alcoholic Fatty Liver Disease (NAFLD), now redefined as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), has become the most prevalent liver disease in India, currently affecting nearly 30% of the adult population. In individuals with risk conditions such as diabetes and obesity, the incidence may rise to 50–90%, according to various studies. MASLD is characterized by the accumulation of fat in liver cells in individuals who do not consume alcohol. It has emerged as a serious public health issue, driven primarily by poor dietary habits and the rising burden of obesity.

This article is authored by Dr. V S Gaurav Narayan, Consultant, Gastroenterologist: Yashoda Medicity

Impact of Urbanization and Dietary Changes on the Rising MASLD Cases in India

India's rapid urbanization and changing food patterns over the past three decades have significantly contributed to the surge in MASLD cases. Traditional, balanced diets have been increasingly replaced by calorie-dense, nutrient-poor foods, with high intakes of refined carbohydrates, saturated fats, and hidden sugars. A major contributor is fructose, especially in the form of high-fructose corn syrup, which is widely used in processed foods and beverages. Fructose is metabolized in the liver and plays a key role in liver fat accumulation.

Central or abdominal obesity is one of the primary drivers of MASLD. It promotes insulin resistance, a condition where the body's cells respond poorly to insulin, leading not only to elevated blood sugar levels but also to increased fat deposition in the liver. Importantly, MASLD is not exclusive to obese individuals—it is increasingly seen in those with normal body weight, a condition termed "lean MASLD", indicating that poor dietary patterns and metabolic imbalances can independently contribute to the disease.

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Childhood MASLD and Disease Progression

Alarmingly, MASLD is also being detected in children, with studies showing that up to 30% of kids may be affected due to sedentary lifestyles and unhealthy eating habits.

If left unaddressed, MASLD can progress from simple liver fat accumulation to non-alcoholic steatohepatitis (NASH)—a more severe form of liver inflammation that may lead to fibrosis, cirrhosis, and liver cancer. Furthermore, patients who have MASLD and also consume alcohol face a more rapid progression and worsening of liver disease.

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