What is Metabolic-associated Fatty Liver Disease? Risks, tips to avoid ‘silent epidemic’
MANILA, Philippines — When one talks about Fatty Liver, the common association is alchohol consumption.
It may not be entirely the case, though, as other factors, such as unhealthy food intake and a sedentary lifestyle, may be at play.
Doctors and experts gathered late last year in Bonifacio Global City to raise awareness on a “silent epidemic” that is considered a growing health concern in the country.
Metabolic-associated Fatty Liver Disease (MAFLD) is previously known as Non-alcoholic Fatty Liver Disease (NAFLD). It is characterized by the build-up of excess fat in the liver, often without any noticeable symptoms in its early stages.
Hepatologist and professor at the Faculty of Medicine and Surgery of the University of Santo Tomas Dr. Jose Sollano said that risk factors for MFLAD are obesity, high cholesterol, high triglyceride, high blood sugar, and a big waistline.
“All these excesses, that this immuno-metabolic system, that this disorder can drive fat deposition in the liver, we call it Metabolic Fatty Liver Disease, because there's also fatty liver disease that can be secondary to alcohol use,” Dr. Sollano explained.
The doctor said that the Philippines’ current statistics on Fatty Liver Disease varies between 10% to about 18% in the latest data. He said that most of those with non-alcoholic Fatty Liver Disease are basically on the population of patients who have metabolic disorders.
Filipino diet, sedentary lifestyle
Dr. Angelo Lozada, President of the Hepatology Society of the Philippines, said that the Metabolic Syndrome is a constellation of different illnesses. These include Hypertension, obesity, high Triglycerides or Dyslipidemia or bad cholesterol, and big waistline.
The doctor said that since most of the time these are ignored or people tend to focus on Hypertension or cholesterol, they tend to forget that these factors have an effect on the liver, making it fatty.
Both doctors observed that in the case of many Filipinos, their diet play an important factor in MAFLD.
“First of all, the answer is the diet of the Filipino is basically high carbohydrates and high in salt. You can ask all these people here. That's what your basic food that you have grown up with, and both are bad. High in sugar, fatty liver, high in salt, cancer. The other one, of course, is because of the way that we live our lives today, the tendency for less exercise and more eating drives people to be obese. And the basic substrate of fatty liver basically is obesity. And there's a rising obesity in this country in the last 30 years,” Dr. Sollano said.
Apart from food intake, Dr. Lozada also underscored Filipinos’ lack of physical activities. He compared Filipinos’ physical activity to those of their neighbors in other Asian countries.
“Physical activity is actually very essential, very important to the treatment of the fatty liver… Compared to, for example, other Asian countries, Japan or Korea or Hong Kong or Taiwan, when you go there, you do a lot of walking. You get to complete your 10,000 steps a day, but here in the Philippines, we have very little physical activity, and all that physical activity counts.
“For example, labas tayo ng hotel, we ride a car, going to the next block. So those things, those little factors that we do not have or lack in our society actually also contribute to this particular problem because physical activity is very important to the treatment of fatty liver and prevention of the fatty liver. So that's one asset of the lifestyle that we Filipinos have. Intrinsically, we do not have a lot of physical activity in our daily activities or our daily movements,” Dr. Lozada said.
No symptoms
Dr. Sollano said that Fatty Disease is the biggest liver disease in the world, but ironically it is considered a silent disease.
Many do not know that they have it because this disease has no symptoms. “What we see in the clinics are actually innocent individuals who come in to you because they had an innocent ultrasound. They did the blood test that was directed to you by colleagues, by relatives, or by sometimes doctors. And there are some abnormalities.”
The doctor said that the most common scenario they encounter is the patient being handed a report from blood tests that has elevated values and that they are told that they have fatty liver.
Drs. Sollano and Lozada ended by saying that diet and exercise are key in preventing and treating Fatty Liver Disease.
“Ibig sabihin, mura ang gamot sa fatty liver— healthy kang kumain, mag-exercise — which is true!” Dr. Sollano said.
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