5 ms·

Millions in west don't know they have aggressive fatty liver disease, study says

86 points by robaato 1y ago

abraxas 1y ago
This frankly scares me somewhat. I had a liver ultrasound where the radiologist warned me I had some signs of fat on the liver though not extensive yet. I weigh 72kg at 178cm height. At peak, when I got tested I weighed around 86kg. I was barely overweight and definitely not obese and yet...
- ABS 1y ago
  Knowing the weight alone is not enough though: you can be 72kg and fat or 86kg and very lean but also very muscular. E.g. I'm 178cm as well but when I was 71kg I was visibly "fat", or at least skinny fat to be charitable. I'm currently 67kg but very lean and somewhat muscular.
  - abraxas 1y ago
    At 86kg I had a bit of dad bod going on. Not a huge gut but somewhat pudgy here and there. Not hugely so and not overly visible as most of it was visceral fat. I haven't had an ultrasound since losing the weight. I hope the liver looks better now. I've been eating fewer calories, healthier calories and swimming. Hopefully that's enough to at least halt the damage done by my old lifestyle.
- prettyblocks 1y ago
  I had moderate NFLD and managed to get rid of it completely by just eliminating fried food, most dairy, and sugary snacks for about 6 months, I also almost never eat red meat. It's not so much about being overweight, but what you're eating.
  - SketchySeaBeast 1y ago
    You totally changed your diet and didn't lose weight?
    - prettyblocks 1y ago
      I did lose weight, but it wasn't crazy dramatic.
  - SlowTao 1y ago
    Yep, the dietary recommendations have been consistent for decades at this point. Dairy, meat, sugars and excessive oils are not great for us. A little in moderation is fine, that is a lot lower than what most people think. But it isnt pushed hard because it is difficult to steer the ship of humanity. Like how doctors will say "lose some weight" but they arent really expecting miracles on it as they know the battle that is.
    - bigbuppo 1y ago
      Not to mention, there's a good chance that your doctor is fatter than you are.
    - Amezarak 1y ago
      I eat enormous amounts of dairy and red meat and recently I had abdominal surgery and the doctor afterwards confirmed I was in very good shape and had no signs at all of fatty liver and very little visceral fat generally. I eat around a pound of beef a day, a gallon of yogurt a week, and almost everything (eg oatmeal) is made with copious amounts of butter. I think unless you know something specific about your genetics, just eat plain natural foods people have been eating for millennia and you will be perfectly fine. Basically, buy plain meat, vegetables, grains, and dairy and prepare them yourself. Don’t eat preservatives, corn syrups, or novel vegetable oils like canola. Maybe they’re fine but there’s no reason to risk it. Also do your best to make sure what you eat followed the same rule; eg my beef was grass fed and finished and was not fed skittles in a feedlot. Diet affects animal meat as well, just as it does us.
      - SlowTao 1y ago
        This is good advise to get behind. I do feel like a lot of the optimal dietary advice is far to hard lined and that a better path really is just whole foods in moderation.
    - nradov 1y ago
      Dietary recommendations have fluctuated widely for decades, and still differ substantially between sources. So far there is zero direct evidence that meat consumption causes fatty liver disease; I mean it's possible but we just don't know one way or the other. The only real data we have comes from low-quality observational studies (basically junk science). If someone wants to try limiting meat consumption as an "n=1" experiment to see how it affects their body composition and other biomarkers then go ahead. Just don't expect a major impact from that one factor.
- tryasimight 1y ago
  The two big ones are high fructose corn syrup and alcohol. I feel the hfcs is the bigger issue here because it is put in everything in the US, but moderating both of these will help. Look at labels and put back anything with hfcs. https://www.nih.gov/news-events/nih-research-matters/how-high-fructose-intake-may-trigger-fatty-liver-disease https://www.nih.gov/news-events/nih-research-matters/how-hig... https://pmc.ncbi.nlm.nih.gov/articles/PMC6549781/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6549781/
  - crazygringo 1y ago
    HFCS isn't any meaningfully different from sugar. It's basically chemically the same as honey. And no, they don't put it in everything. It's in soda and certain sweets (obviously) and sweet sauces, but it's not like it's creeping into unexpected places in some huge way. Yes, there may be foods with a hint of sweetness that have a hint of HFCS, but then it's a negligible amount anyways. HFCS isn't some kind of bogeyman. It's essentially just sugar. Treat it accordingly.
    - deleted 1y ago
      [deleted]
    - chris_va 1y ago
      Fructose is processed by the body quite differently than sucrose, in a way quite relevant here. And actually one of humanity's major evolutionary advances.
      - eurleif 1y ago
        HFCS is typically 42:58 or 55:45 fructose:glucose. Table sugar is 50:50. HFCS is only "high fructose" relative to unprocessed corn syrup, not relative to table sugar and other common sweeteners.
        Tallain 1y ago
        A small difference at small levels but one which obviously matters when it's shoved into countless foods without most people event realizing. It's not just in soda and candy; it's in bread, pasta, almost any processed food (crackers, ketchups and other sauces, canned fruit, applesauce, lunch meat, peanut butter, the list goes on) and many foods one might not considered processed. It makes sense to try to eliminate it even though it's "only" a small difference. Might as well remove the difference at all and look out for things with no HFCS shoved in it for no reason.
- wokkel 1y ago
  Bmi is one metric but you need to combine it with a measurement of your belly circumference. I had similar numbers but the weight was al in the belly and got diagnoses as type 2 diabetic with high cholesterol etc.
Theodores 1y ago
[flagged]
- chownie 1y ago
  Any answer that begins with "if everyone just-" is tantamount to doing nothing and those are the other options available, nothing except for weight loss drugs has managed to put a dent in widespread obesity.
  - shdjcnckcicnx 1y ago
    [flagged]
    - keybored 1y ago
      Are you ready to throw stones in glass houses? We can list a thousand sins of people with actual political power that dwarf the sin of “accommodating” so-called lifestyle choices. Then we can talk about how those same people abuse trust at every opportunity. Your buzzwords are useless.
    - JumpCrisscross 1y ago
      > It’s more a spiritual / moral decline of culture in the west It's not just the West. "Obesity in India has reached epidemic proportions in the 21st century, with morbid obesity affecting 5% of the country's population" [1]. (It's about 7% in America [2].) Meanwhile in China, "the incidence of overweight and obesity among school-age children...was 15.5% in 2010, rising to 24.2% in 2019 and soaring to 29.4% in 2022" [2]. Same story in Vietnam: "The prevalence of overweight among children aged under 5 years increased from 5.6% in 2010 to 7.4% in 2019. For overweight and obesity among children aged 5 to 19 years, prevalence rose from 8.5% and 2.5% in 2010 to 19% and 8.1% in 2020, respectively" [3]. OP is right. "If everyone just..." is shorthand for wishing upon a star that the world were different. It's not a serious solution for reality as it is. (To the degree there is a social trust variable at play, it's in folks doing mental gymnastics to reject the clinical data.) [1] https://en.wikipedia.org/wiki/Obesity_in_India https://en.wikipedia.org/wiki/Obesity_in_India [2] https://pmc.ncbi.nlm.nih.gov/articles/PMC10357130/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10357130/ [3] https://pmc.ncbi.nlm.nih.gov/articles/PMC9947684/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9947684/
lgleason 1y ago
I wonder who funded the study....
- n4r9 1y ago
  You don't need to wonder. It's in the Acknowledgements section of the paper. > JVL, HEM, and CJK acknowledge institutional support to ISGlobal from grant CEX2023-0001290-S, funded by MCIN/AEI/10.13039/501100011033, and the Generalitat de Catalunya, through the CERCA Programme. CDB is supported in part by the Southampton National Institute for Health and Care Research Biomedical Research Centre (NIHR 203319). Funding statement: This work was supported by Novo Nordisk and Echosens via a grant to ISGlobal. The funding sources had no role in the study design, writing of this manuscript, or decision to submit the paper for publication, but did carry out the data modelling. https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(25)00112-7/fulltext https://www.thelancet.com/journals/lanepe/article/PIIS2666-7...
  - johnyzee 1y ago
    [flagged]
    - mixmastamyk 1y ago
      I was wondering why it didn't recommend reducing carbs and increasing vegetables; instead recommended drugs.
      - jplusequalt 1y ago
        Vegetables have carbs in them?
        mixmastamyk 1y ago
        Not many outside potatoes etc, hence the word "reducing."
- diggan 1y ago
deleted 1y ago
[deleted]
alecst 1y ago
For those who are curious, there's some anecdata online that extended fasting (days or weeks) can reverse this disease. I can't find much published research on it to be fair, but I think the science in this field is lagging behind people's personal experiences. If there's evidence to the contrary let me know, I'm not trying to spread misinformation. It's just one of the things I consistently recall reading over the years. Edit since I'm being downvoted: https://pmc.ncbi.nlm.nih.gov/articles/PMC6893587/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6893587/ (prolonged fasting, ~8 days) > The improvement of FLI correlated with the number of fasting days (r = −0.20, p < 0.0001) https://eglj.springeropen.com/articles/10.1186/s43066-021-00128-1 https://eglj.springeropen.com/articles/10.1186/s43066-021-00... (ADF rat model) > MSRDF rats showed cure of grade-1 NAFLD and significantly decreased LW than other groups and normalized HOMA-IR, HbA1C TC, LDL-C, ALT, and CRP. https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00538-1s43066-021-00128-1 https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)... (exercise + ADF, humans)
- cmrx64 1y ago
  https://www.nature.com/articles/s41467-024-45260-9 https://www.nature.com/articles/s41467-024-45260-9 this is the main thing I could find. https://prolonlife.com/ https://prolonlife.com/ sells a prepackaged fasting-mimicking diet. plenty of reviews online about the subjective effects on energy levels and soforth during the fast. I didn’t like it. day 2.5-3 will put me back into the headspace of food scarcity and even knowing that the next meal was sitting in the box and that this is temporary … it was a mental challenge for me. if you’ve never experienced food scarcity, it can be all-consuming and seriously warp your cognition and emotional baseline.
  - ty6853 1y ago
    Even cutting back a couple hundred calories a day can leave you absolutely exhausted, in my experience. Even just increasing exercise by a couple hundred calories a day without eating more is also incredibly exhausting, after a few weeks it becomes thought dominating second-by-second. Hunger is truly a powerful driver.
golemiprague 1y ago
[dead]
pama 1y ago
Lots of the numbers here are confusing in relation to other numbers… “The researchers found that just under 3% of people in the UK, France and Germany, and 4% of those in the US have MASH, but diagnosis rates were below 18%. That means about 20 million people in the US, UK, Germany and France are living with MASH but only 2.5 million people have a diagnosis, leaving more than three-quarters – about 16.7 million people – unaware they have the condition.” 2.5/20 is 12.5%, which is under 18% but a very weird and specifc way to put it; 16.7 is more than 3/4 of 20 indeed (by a lot), but adding 2.5 to 16.7 is about 19 not about 20. This just all seems randomly off in various ways that make little sense to me. Anyone has any good theory how such sentences escape editorial edits, or can find a simple typo or two that make this paragraph coherent again?
Qem 1y ago
I wonder, given the instances of common diseases that were discovered/strongly suspected recently to have a microbial component (eg. ulcers + heliobacter pylori, Guillain–Barré + cytomegalovirus, Alzheimer + HSV, Several cancers in men and women + HPV), what are the odds we'll eventually discover fatty liver disease is a symptom or is triggered by "hepatitis X" or something like that?
- owebmaster 1y ago
  That won't be the case for a disease that is almost 100% correlated to asedentary lifestyle, bad diet and alcoholism

86 points by robaato 1y ago

This frankly scares me somewhat. I had a liver ultrasound where the radiologist warned me I had some signs of fat on the liver though not extensive yet. I weigh 72kg at 178cm height. At peak, when I got tested I weighed around 86kg. I was barely overweight and definitely not obese and yet...

ABS 1y ago
Knowing the weight alone is not enough though: you can be 72kg and fat or 86kg and very lean but also very muscular. E.g. I'm 178cm as well but when I was 71kg I was visibly "fat", or at least skinny fat to be charitable. I'm currently 67kg but very lean and somewhat muscular.
- abraxas 1y ago
  At 86kg I had a bit of dad bod going on. Not a huge gut but somewhat pudgy here and there. Not hugely so and not overly visible as most of it was visceral fat. I haven't had an ultrasound since losing the weight. I hope the liver looks better now. I've been eating fewer calories, healthier calories and swimming. Hopefully that's enough to at least halt the damage done by my old lifestyle.
prettyblocks 1y ago
I had moderate NFLD and managed to get rid of it completely by just eliminating fried food, most dairy, and sugary snacks for about 6 months, I also almost never eat red meat. It's not so much about being overweight, but what you're eating.
- SketchySeaBeast 1y ago
  You totally changed your diet and didn't lose weight?
  - prettyblocks 1y ago
    I did lose weight, but it wasn't crazy dramatic.
- SlowTao 1y ago
  Yep, the dietary recommendations have been consistent for decades at this point. Dairy, meat, sugars and excessive oils are not great for us. A little in moderation is fine, that is a lot lower than what most people think. But it isnt pushed hard because it is difficult to steer the ship of humanity. Like how doctors will say "lose some weight" but they arent really expecting miracles on it as they know the battle that is.
  - bigbuppo 1y ago
    Not to mention, there's a good chance that your doctor is fatter than you are.
  - Amezarak 1y ago
    I eat enormous amounts of dairy and red meat and recently I had abdominal surgery and the doctor afterwards confirmed I was in very good shape and had no signs at all of fatty liver and very little visceral fat generally. I eat around a pound of beef a day, a gallon of yogurt a week, and almost everything (eg oatmeal) is made with copious amounts of butter. I think unless you know something specific about your genetics, just eat plain natural foods people have been eating for millennia and you will be perfectly fine. Basically, buy plain meat, vegetables, grains, and dairy and prepare them yourself. Don’t eat preservatives, corn syrups, or novel vegetable oils like canola. Maybe they’re fine but there’s no reason to risk it. Also do your best to make sure what you eat followed the same rule; eg my beef was grass fed and finished and was not fed skittles in a feedlot. Diet affects animal meat as well, just as it does us.
    - SlowTao 1y ago
      This is good advise to get behind. I do feel like a lot of the optimal dietary advice is far to hard lined and that a better path really is just whole foods in moderation.
  - nradov 1y ago
    Dietary recommendations have fluctuated widely for decades, and still differ substantially between sources. So far there is zero direct evidence that meat consumption causes fatty liver disease; I mean it's possible but we just don't know one way or the other. The only real data we have comes from low-quality observational studies (basically junk science). If someone wants to try limiting meat consumption as an "n=1" experiment to see how it affects their body composition and other biomarkers then go ahead. Just don't expect a major impact from that one factor.
tryasimight 1y ago
The two big ones are high fructose corn syrup and alcohol. I feel the hfcs is the bigger issue here because it is put in everything in the US, but moderating both of these will help. Look at labels and put back anything with hfcs. https://www.nih.gov/news-events/nih-research-matters/how-high-fructose-intake-may-trigger-fatty-liver-disease https://www.nih.gov/news-events/nih-research-matters/how-hig... https://pmc.ncbi.nlm.nih.gov/articles/PMC6549781/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6549781/
- crazygringo 1y ago
  HFCS isn't any meaningfully different from sugar. It's basically chemically the same as honey. And no, they don't put it in everything. It's in soda and certain sweets (obviously) and sweet sauces, but it's not like it's creeping into unexpected places in some huge way. Yes, there may be foods with a hint of sweetness that have a hint of HFCS, but then it's a negligible amount anyways. HFCS isn't some kind of bogeyman. It's essentially just sugar. Treat it accordingly.
  - deleted 1y ago
    [deleted]
  - chris_va 1y ago
    Fructose is processed by the body quite differently than sucrose, in a way quite relevant here. And actually one of humanity's major evolutionary advances.
    - eurleif 1y ago
      HFCS is typically 42:58 or 55:45 fructose:glucose. Table sugar is 50:50. HFCS is only "high fructose" relative to unprocessed corn syrup, not relative to table sugar and other common sweeteners.
      - Tallain 1y ago
        A small difference at small levels but one which obviously matters when it's shoved into countless foods without most people event realizing. It's not just in soda and candy; it's in bread, pasta, almost any processed food (crackers, ketchups and other sauces, canned fruit, applesauce, lunch meat, peanut butter, the list goes on) and many foods one might not considered processed. It makes sense to try to eliminate it even though it's "only" a small difference. Might as well remove the difference at all and look out for things with no HFCS shoved in it for no reason.
wokkel 1y ago
Bmi is one metric but you need to combine it with a measurement of your belly circumference. I had similar numbers but the weight was al in the belly and got diagnoses as type 2 diabetic with high cholesterol etc.

Theodores 1y ago

[flagged]

chownie 1y ago
Any answer that begins with "if everyone just-" is tantamount to doing nothing and those are the other options available, nothing except for weight loss drugs has managed to put a dent in widespread obesity.
- shdjcnckcicnx 1y ago
  [flagged]
  - keybored 1y ago
    Are you ready to throw stones in glass houses? We can list a thousand sins of people with actual political power that dwarf the sin of “accommodating” so-called lifestyle choices. Then we can talk about how those same people abuse trust at every opportunity. Your buzzwords are useless.
  - JumpCrisscross 1y ago
    > It’s more a spiritual / moral decline of culture in the west It's not just the West. "Obesity in India has reached epidemic proportions in the 21st century, with morbid obesity affecting 5% of the country's population" [1]. (It's about 7% in America [2].) Meanwhile in China, "the incidence of overweight and obesity among school-age children...was 15.5% in 2010, rising to 24.2% in 2019 and soaring to 29.4% in 2022" [2]. Same story in Vietnam: "The prevalence of overweight among children aged under 5 years increased from 5.6% in 2010 to 7.4% in 2019. For overweight and obesity among children aged 5 to 19 years, prevalence rose from 8.5% and 2.5% in 2010 to 19% and 8.1% in 2020, respectively" [3]. OP is right. "If everyone just..." is shorthand for wishing upon a star that the world were different. It's not a serious solution for reality as it is. (To the degree there is a social trust variable at play, it's in folks doing mental gymnastics to reject the clinical data.) [1] https://en.wikipedia.org/wiki/Obesity_in_India https://en.wikipedia.org/wiki/Obesity_in_India [2] https://pmc.ncbi.nlm.nih.gov/articles/PMC10357130/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10357130/ [3] https://pmc.ncbi.nlm.nih.gov/articles/PMC9947684/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9947684/

lgleason 1y ago

I wonder who funded the study....

n4r9 1y ago
You don't need to wonder. It's in the Acknowledgements section of the paper. > JVL, HEM, and CJK acknowledge institutional support to ISGlobal from grant CEX2023-0001290-S, funded by MCIN/AEI/10.13039/501100011033, and the Generalitat de Catalunya, through the CERCA Programme. CDB is supported in part by the Southampton National Institute for Health and Care Research Biomedical Research Centre (NIHR 203319). Funding statement: This work was supported by Novo Nordisk and Echosens via a grant to ISGlobal. The funding sources had no role in the study design, writing of this manuscript, or decision to submit the paper for publication, but did carry out the data modelling. https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(25)00112-7/fulltext https://www.thelancet.com/journals/lanepe/article/PIIS2666-7...
- johnyzee 1y ago
  [flagged]
  - mixmastamyk 1y ago
    I was wondering why it didn't recommend reducing carbs and increasing vegetables; instead recommended drugs.
    - jplusequalt 1y ago
      Vegetables have carbs in them?
      - mixmastamyk 1y ago
        Not many outside potatoes etc, hence the word "reducing."
diggan 1y ago

deleted 1y ago

[deleted]

alecst 1y ago

For those who are curious, there's some anecdata online that extended fasting (days or weeks) can reverse this disease. I can't find much published research on it to be fair, but I think the science in this field is lagging behind people's personal experiences. If there's evidence to the contrary let me know, I'm not trying to spread misinformation. It's just one of the things I consistently recall reading over the years. Edit since I'm being downvoted: https://pmc.ncbi.nlm.nih.gov/articles/PMC6893587/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6893587/ (prolonged fasting, ~8 days) > The improvement of FLI correlated with the number of fasting days (r = −0.20, p < 0.0001) https://eglj.springeropen.com/articles/10.1186/s43066-021-00128-1 https://eglj.springeropen.com/articles/10.1186/s43066-021-00... (ADF rat model) > MSRDF rats showed cure of grade-1 NAFLD and significantly decreased LW than other groups and normalized HOMA-IR, HbA1C TC, LDL-C, ALT, and CRP. https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00538-1s43066-021-00128-1 https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)... (exercise + ADF, humans)

cmrx64 1y ago
https://www.nature.com/articles/s41467-024-45260-9 https://www.nature.com/articles/s41467-024-45260-9 this is the main thing I could find. https://prolonlife.com/ https://prolonlife.com/ sells a prepackaged fasting-mimicking diet. plenty of reviews online about the subjective effects on energy levels and soforth during the fast. I didn’t like it. day 2.5-3 will put me back into the headspace of food scarcity and even knowing that the next meal was sitting in the box and that this is temporary … it was a mental challenge for me. if you’ve never experienced food scarcity, it can be all-consuming and seriously warp your cognition and emotional baseline.
- ty6853 1y ago
  Even cutting back a couple hundred calories a day can leave you absolutely exhausted, in my experience. Even just increasing exercise by a couple hundred calories a day without eating more is also incredibly exhausting, after a few weeks it becomes thought dominating second-by-second. Hunger is truly a powerful driver.

golemiprague 1y ago

[dead]

pama 1y ago

Lots of the numbers here are confusing in relation to other numbers… “The researchers found that just under 3% of people in the UK, France and Germany, and 4% of those in the US have MASH, but diagnosis rates were below 18%. That means about 20 million people in the US, UK, Germany and France are living with MASH but only 2.5 million people have a diagnosis, leaving more than three-quarters – about 16.7 million people – unaware they have the condition.” 2.5/20 is 12.5%, which is under 18% but a very weird and specifc way to put it; 16.7 is more than 3/4 of 20 indeed (by a lot), but adding 2.5 to 16.7 is about 19 not about 20. This just all seems randomly off in various ways that make little sense to me. Anyone has any good theory how such sentences escape editorial edits, or can find a simple typo or two that make this paragraph coherent again?

Qem 1y ago

I wonder, given the instances of common diseases that were discovered/strongly suspected recently to have a microbial component (eg. ulcers + heliobacter pylori, Guillain–Barré + cytomegalovirus, Alzheimer + HSV, Several cancers in men and women + HPV), what are the odds we'll eventually discover fatty liver disease is a symptom or is triggered by "hepatitis X" or something like that?

owebmaster 1y ago
That won't be the case for a disease that is almost 100% correlated to asedentary lifestyle, bad diet and alcoholism