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Fatty liver disease

Key points

  • Fatty liver disease is when fat builds up in the liver.
  • Fatty liver disease can progress to more serious issues over time including cirrhosis, liver failure and liver cancer.
  • Reduce your risk of developing or progressing fatty liver disease by eating more whole plant foods, having less sugary drinks, eating less high fat and ultra-processed foods, being more active and avoiding alcohol.

Fatty liver graphic

What is fatty liver disease?

Fatty liver disease is when fat builds up in the liver.

When fatty liver disease is caused by metabolic dysfunction (when the body is not processing and distributing nutrients like fat and sugars correctly) it’s called metabolic dysfunction-associated fatty liver disease (MAFLD). MAFLD used to be known as non-alcoholic fatty liver disease (NAFLD).

How fatty liver disease affects health

While it doesn’t usually cause symptoms on its own, fatty liver can sometimes progress to more serious issues over time including cirrhosis, liver failure and liver cancer.

Metabolic associated fatty liver disease (MAFLD)

This is when fat has built up in the liver. MAFLD can be reversed with lifestyle changes.

Metabolic associated steatohepatitis (MASH)

This is a more advanced stage involving liver inflammation and cell damage. Over time this inflammation can cause fibrosis, which is when scar tissue forms in the liver. MASH is potentially reversible with lifestyle changes.

Liver cirrhosis

Cirrhosis is the most severe form of liver fibrosis. Cirrhosis may progress to liver failure or liver cancer.

As well as leading to further liver damage, fatty liver disease increases the risk of heart attack, stroke and cancers outside of the liver. In fact, these conditions are the leading causes of death in people with MAFLD.

Risk factors for MAFLD

Metabolic disorders

Certain metabolic disorders increase the likelihood of developing MAFLD. These include:

  • High blood sugar levels or type 2 diabetes
  • Insulin resistance
  • High blood pressure
  • High triglyceride level

Body weight

Higher body weight, defined as having a Body Mass Index (BMI) over 25, increases the risk of MAFLD. This is particularly true for those with a high waist circumference. However, it’s important to know that 1 in 5 people with MAFLD have a BMI under 25.

Food and movement patterns

Our food and movement patterns are very important. Low levels of physical activity, not having enough nutritious foods and drinks, and having too many ultra-processed ones, particularly sugary drinks or high fat foods, increase the risk of MAFLD.

Other risk factors

  • Polycystic ovary syndrome (PCOS)
  • Underactive thyroid
  • Certain medications
  • Age – risk increases with increasing age
  • Sex – men are more likely to develop MAFLD than women
  • Genetics

What can I do?

It’s estimated that around 30 per cent of adults in Australia have MAFLD. For most people, MAFLD is reversible to prevent more severe liver damage. However, as MAFLD rarely causes symptoms, it’s often only picked up during routine blood tests measuring liver function.

The recommendations below can help reduce the risk of developing MAFLD as well as stop it progressing to more serious damage. These strategies also decrease the likelihood of developing other conditions linked to fatty liver disease like heart disease and some cancers. Even small changes, done consistently, can make a big difference!

  • Eat more fibre-rich foods including beans, nuts, seeds, veg, fruit and wholegrain breads and cereals.
  • Have less added sugar, particularly from sugary drinks.
  • Replace saturated and trans fats with monounsaturated fats and omega-3s.
  • A Mediterranean-style diet can provide health benefits independent of weight loss. The Mediterranean diet emphasises vegetables, fruit, nuts, seeds, beans, wholegrains and olive oil. It includes moderate amounts of fish, dairy, eggs and chicken, and limited amounts of red meat and processed foods.

Selection of high fibre foods

Two women walk side by side in the park while one pushes a pram. Both are smiling.

For personalised advice, we encourage you to see your local GP. They may also be able to refer you to an Accredited Practising Dietitian. If you’re after more information, useful websites include the Liver Foundation, Health Direct and Eat for Health.