Fatty liver, also known as non-alcoholic fatty liver disease (NAFLD), is a buildup of fat in the liver that is not related to alcohol consumption.
According to specialist doctor Lam Nguyen Thuy An, University of Medicine and Pharmacy Hospital, Ho Chi Minh City - branch 3, many studies show that about 10-20% of people with fatty liver have a thin body, with a completely normal body mass index (BMI).
Consuming a lot of saturated fat, sugar, and processed foods can increase fat accumulation in the liver, although it does not cause significant weight gain. ILLUSTRATION: AI
Lack of sleep and irregular eating increase the risk of disease
Dr. Thuy An said that in reality, there are many patients with normal weight, even BMI is only about 18-19, but liver enzymes are increased or ultrasound detects fatty liver. The common points seen in them are:
- Have a family history of liver disease, diabetes, or metabolic disorders.
- Thin but sedentary, does not exercise regularly.
- Unbalanced diet: High in sugar, high in starch but low in protein (for example, the habit of consuming a lot of milk tea, sweets, white starch).
- Prolonged stress, lack of sleep, irregular eating: These are also factors that contribute to increasing the risk of fatty liver disease.
- Some have undetected dyslipidemia or insulin resistance.
“In Vietnam, the risk is even higher due to specific genetic factors, plus the Vietnamese body often accumulates visceral fat, small bone structure, so BMI sometimes does not reflect the true level of risk. Therefore, many people are still subjective, leading to serious disease complications,” Dr. Thuy An added.
Why do people with normal weight still have fatty liver?
According to Dr. Thuy An, the following reasons make people with normal weight still susceptible to fatty liver.
Visceral fat and abnormal metabolism : Visceral fat is the type of fat that accumulates around the liver, blood vessels, and intestines. It can easily cause metabolic diseases, even in people with thin bodies. Normally, the liver converts sugar into energy. If the body lacks sugar (due to inadequate diet or excessive weight loss), the liver is forced to use fat instead. The amount of fat accumulated in the liver over time will cause accumulation and disease.
Genetics and metabolic disorders : Some people have genes that make them susceptible to fat metabolism disorders, increasing their risk of fatty liver.
Diabetes and insulin resistance : High blood sugar makes the liver more susceptible to fatty deposits, even in people who are not overweight.
Unbalanced diet : Consuming a lot of saturated fat, sugar, and processed foods can increase fat accumulation in the liver, without causing significant weight gain.
Unscientific vegetarianism or excessive abstinence : Causes the body to lack essential nutrients, causing imbalance in fat metabolism.
Lack of exercise : People who are thin but sedentary are also at risk of fat metabolism disorders, leading to fatty liver.
Side effects of drugs and other factors : Some drugs such as corticosteroids, tamoxifen, amiodarone derivatives can increase fat accumulation in the liver. Smoking and drinking a lot of alcohol, even if not fattening, can also damage the liver and cause fat accumulation.
Eat lots of green vegetables, beans, fish, whole grains, and protein to reduce the risk of fatty liver. PHOTO: AI
Actively protect the liver in all subjects
“Thin people often think they are not in the risk group so they do not go for check-ups or screening. When detected, the disease has progressed to non-alcoholic steatohepatitis (NASH), causing cirrhosis, liver failure, and even liver cancer. Some studies show that the rate of serious complications in thin people is equal to, or even higher than, that of obese people,” Dr. Thuy An warned.
From there, Dr. Thuy An recommends that everyone should proactively protect the liver and prevent fatty liver disease by:
Maintain a healthy diet : Eat lots of green vegetables, beans, fish, whole grains, and protein. Limit sugar, soft drinks, milk tea, processed foods, fried foods, animal fats, and alcoholic beverages.
Increase physical activity : Exercise at least 30 minutes a day and do not take more than 2 days off. Adults should spend about 150 minutes a week doing simple exercises, maintaining exercise habits to support more effective fat metabolism.
Control underlying diseases : If you have diabetes, lipid disorders, high blood pressure, control them closely according to your doctor's instructions. You should check liver enzymes, blood lipids, and have an abdominal ultrasound at least once a year.
Avoid risk factors : Do not smoke, limit alcohol. Be careful when using drugs that can harm the liver and always consult your doctor.
Distinguishing between fatty liver due to obesity and fatty liver due to metabolic or genetic disorders
According to specialist 2 Lam Nguyen Thuy An, fatty liver often has no obvious symptoms in the early stages. Some cases may include: Prolonged fatigue, feeling of heaviness, discomfort in the upper right abdomen.
In obesity-associated fatty liver disease (MASLD), the “classic” condition:
Often found in overweight, obese people, increased waist circumference.
Age of onset: Usually 30-40 years old, or in obese children.
Comorbidities: Type 2 diabetes, hypertension, “metabolic type” dyslipidemia (increased TG, decreased HDL, LDL - C may be normal or increased).
Extrahepatic manifestations: Often associated with metabolic syndrome (cardiovascular, renal…).
In inherited/metabolic fatty liver (IEM), a rare disease:
Often found in thin people with normal BMI.
Age of onset: Children, adolescents, thin young adults, or any age with severe symptoms.
Comorbidities: Family history of premature liver disease, systemic disease, “strange” dyslipidemia (LDL can be very high or very low).
Extrahepatic manifestations: Nervous, muscular, digestive, pulmonary, eye… depending on the type of genetic disease.