The Growing Epidemic of Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease is a growing concern in both adults and young people, as its prevalence and severity have increased in tandem with the rise in obesity. While alcohol was once the primary cause of fatty liver disease, the number of cases of non-alcoholic fatty liver disease has been on the rise in recent years. In fact, recent domestic health examinations have shown a prevalence of 16-33% for non-alcoholic fatty liver disease diagnosed by abdominal ultrasound.
The Impact on Children and Adolescents
The increase in non-alcoholic fatty liver disease is not limited to adults, as it has also been a major problem for children and young people. The condition is closely associated with metabolic syndrome, including abdominal obesity, dyslipidemia, hypertension, insulin resistance, and impaired glucose tolerance in children and adolescents. Factors such as lack of exercise, excessive use of smart devices, and the consumption of processed and convenience foods contribute to the development of fatty liver in young people.
The Health Implications
Research shows that non-alcoholic fatty liver disease is prevalent in 60-80% of obese individuals, and 25-40% of patients with this condition may progress to non-alcoholic steatohepatitis. Additionally, 5-18% of patients with nonalcoholic steatohepatitis may develop cirrhosis, with an estimated annual incidence of hepatocellular carcinoma at 2.6%.
Treatment and Prevention
Lifestyle improvements, treatment of metabolic syndrome, medication for steatohepatitis or liver fibrosis, and management of complications such as cirrhosis are the mainstays of treatment for non-alcoholic fatty liver disease. Lifestyle modifications such as weight loss through diet and exercise are particularly emphasized as an effective primary treatment method. According to the Korean Liver Association, proper diet and increased exercise are key to curing non-alcoholic fatty liver disease.
Exercise therapy can help improve insulin resistance and metabolic syndrome, thereby reducing the incidence of non-alcoholic fatty liver disease. The association between exercise and a decrease in the occurrence of non-alcoholic fatty liver disease has been observed in studies among individuals undergoing health examinations in Korea.
The Scope of the Issue
Non-alcoholic fatty liver disease is not just a liver disease, but a systemic condition that affects various metabolic organs in the body. It is a concern for an increase in liver cirrhosis, hepatocellular carcinoma, cardiovascular disease, and metabolic complications. Lifestyle modification, particularly in terms of healthy eating and physical activity, is crucial in addressing this issue.
A Call for Action
The government should play a role in increasing access to healthy food, regulating unhealthy food marketing, and promoting healthy eating and physical activity. Moreover, the establishment of diagnostic criteria for binge eating, guidelines for broadcasts and advertisements encouraging binge eating, and a monitoring system is essential to address the issue of non-alcoholic fatty liver disease. Strengthening recommended daily sugar intake limits and implementing warnings are also urgent measures that need to be taken.
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Entered 2023.12.10 15:00 Views 1 Entered 2023.12.10 15:00 Modified 2023.12.10 14:53 View 1
The prevalence and severity of non-alcoholic fatty liver disease not only in adults but also in children and young people has recently become a major problem as it has been increasing along with the increase in obesity. [사진=게티이미지뱅크]There is a ‘funny’ joke that in order to cure fatty liver disease (fatty liver), all you need to do is move from a rural area to a big city like the Seoul metropolitan area. In the past, alcohol was the biggest cause of fatty liver disease, where fat builds up in the liver, but over the past few years, the number of cases of non-alcoholic fatty liver disease has been increasing. The prevalence of non-alcoholic fatty liver disease diagnosed by abdominal ultrasound among recent domestic health examinations was 16-33%.
According to the ‘Korean Liver Disease White Paper 2023’ published by the Korean Liver Association, the prevalence and severity of non-alcoholic fatty liver disease not only in adults but also in children and young people has been increasing recently along with the increase in obesity, emerging as a major problem. Nonalcoholic fatty liver disease in children and adolescents is also closely associated with metabolic syndrome such as abdominal obesity, dyslipidemia, hypertension, insulin resistance, and impaired glucose tolerance. Not having enough time to exercise due to excessive studying and dependence on smart devices, and frequent consumption of processed foods and convenience foods, are also linked to the development of fatty liver.
Although the results of each study are slightly different, in general, 60-80% of obese people have non-alcoholic fatty liver disease, and 25-40% of patients with non-alcoholic fatty liver disease progress to steatohepatitis non-alcoholic. In addition, 5-18% of patients with nonalcoholic steatohepatitis progress to cirrhosis, and the annual incidence of hepatocellular carcinoma in patients with cirrhosis associated with nonalcoholic steatohepatitis is estimated to be 2.6%.
Treatment of non-alcoholic fatty liver disease is generally divided into lifestyle improvement, metabolic syndrome treatment, drug treatment for steatohepatitis or liver fibrosis, and treatment of complications such as cirrhosis associated with fatty liver disease. non-alcoholic. For most patients, the most important and cost-effective primary treatment method is lifestyle modification, such as weight loss through diet and exercise. In the treatment of non-alcoholic fatty liver disease, it is important to manage insulin resistance, obesity and accompanying hyperlipidaemia. In order to treat these concomitant diseases, drug treatment for each is important, but above all, it is important to correct eating and exercise habits at the same time.
The white paper on liver disease consistently emphasizes that weight loss through proper diet and increased exercise can cure non-alcoholic fatty liver disease. In the treatment of non-alcoholic fatty liver disease, reducing total energy intake is most important in dietary control, and control of carbohydrate and fat intake is particularly important. Research results on whether a low-carbohydrate or low-fat diet is more important in the treatment of non-alcoholic fatty liver disease are inconsistent, but carbohydrate control is more important given the domestic dietary pattern where carbohydrate intake has a relatively higher proportion of total calories than fat. .
Exercise therapy helps improve insulin resistance and metabolic syndrome. Exercise therapy was associated with a reduction in the incidence of nonalcoholic fatty liver disease regardless of abdominal obesity and insulin resistance among 3,718 people who underwent health examinations in Korea. Additionally, in the same study, when 1,373 people continued to exercise by maintaining or increasing exercise intensity, the incidence of non-alcoholic fatty liver disease decreased regardless of abdominal obesity and insulin resistance. Aerobic exercise and muscle strengthening exercise are helpful, and can be particularly effective if you have abdominal obesity or sarcopenia.
The obese population in Korea accounts for about 30-40% of the total population. Of these, 25-30% have non-alcoholic fatty liver disease. About 30% of all non-alcoholic fatty liver disease patients have type 2 diabetes. In particular, non-alcoholic fatty liver disease is not limited to liver disease, but is a systemic disease associated with with all the metabolic organs of the body (brain, fat tissue, muscle tissue, pancreas, small and large intestine, blood vessels, thyroid gland, gonads, etc.). In the white paper, the Society for Liver Studies repeatedly warns, “There are concerns about an explosive increase in liver cirrhosis, hepatocellular carcinoma, cardiovascular disease, and metabolic complications caused by nonalcoholic fatty liver disease. “
The first step in treating non-alcoholic fatty liver disease is lifestyle modification. The government must increase people’s access to healthy food, protect people from unhealthy food marketing, and encourage healthy eating and physical activity. In addition, it should be considered to reflect medical fees in lifestyle education for non-alcoholic fatty liver patients.
Eating foods high in calories together with overeating and drinking too much increases the risk of obesity and non-alcoholic fatty liver disease. It will be necessary to develop diagnostic criteria for binge eating, guidelines for broadcasts and advertisements that encourage binge eating, and establish a monitoring system. Foods subject to mandatory nutrition labeling should be expanded to enable consumers to check calorie and carbohydrate content (especially sugars) so they can choose healthy foods. What is most urgent is to significantly strengthen the recommended daily sugar intake and set warnings.
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