What makes a liver healthy?
A healthy liver is able to perform its essential functions properly. Among other things, the liver plays a role in processing and storing nutrients, regulating fats and glucose, and breaking down waste products.
One of the most common conditions affecting liver health is fatty liver disease, also known as hepatic steatosis. This occurs when more than a normal amount of fat accumulates in the liver cells.
A distinction is made between alcohol-related and non-alcohol-related fatty liver disease. The non-alcohol-related form, also known as NAFLD, is the most common and is often associated with metabolic factors such as insulin resistance and visceral fat.
Fatty liver disease does not occur in isolation. It is associated with an increased risk of conditions including type 2 diabetes and cardiovascular disease. Your liver health can therefore also provide insights into your broader metabolic health.
Why do you often not notice a fatty liver?
In many cases, fatty liver disease causes no noticeable symptoms for a long time. Fat can gradually accumulate in the liver without causing obvious pain or other specific symptoms.
This is partly due to the liver’s large functional reserve. The healthy part of the liver can often continue to perform its functions sufficiently. As a result, changes can occur without your body immediately giving clear warning signs.
Fatty liver disease is therefore sometimes discovered by chance. How you feel does not always provide a reliable indication of how healthy your liver actually is.
Because clear symptoms are often absent, it is important to also consider potential risk factors and indirect signs.
Fatty liver symptoms: what signs can occur?
Fatty liver disease often causes no clear symptoms. If symptoms do occur, they are usually not specific to fatty liver disease.
Some people may experience fatigue or a vague feeling of pressure or discomfort in the upper right abdomen. However, these symptoms alone do not mean that you have fatty liver disease, as they can have many different causes.
It is therefore not possible to determine whether you have a fatty liver based on symptoms alone.
Who is at greater risk of fatty liver disease?
The risk of fatty liver disease is higher with certain metabolic and lifestyle factors. In particular, visceral fat, being overweight, insulin resistance, type 2 diabetes, physical inactivity and alcohol consumption can play a role.
These are risk factors. Having one or more of them does not automatically mean that you have a fatty liver. Conversely, not having these risk factors does not completely rule out fatty liver disease.
Abdominal fat and fatty liver disease
A larger waistline can be associated with higher levels of visceral fat: fat stored around the organs in the abdomen. This type of abdominal fat is metabolically active and is associated with a higher risk of fatty liver disease.
Visceral fat can release fatty acids and inflammatory substances that travel through the bloodstream to the liver. This can contribute to the accumulation of fat in the liver.
This is why body weight and BMI do not tell the whole story about liver health. People with a normal weight or BMI can also have relatively high levels of visceral fat and develop liver fat. The distribution of body fat can therefore be just as relevant to your metabolic health as the number on the scale.
Read more about visceral fat and how it can affect your health.
Other known risk factors
In addition to visceral fat, several other factors are associated with a higher risk of fatty liver disease. These include:
- being overweight;
- type 2 diabetes;
- insulin resistance;
- physical inactivity;
- unhealthy eating habits;
- alcohol consumption.
These factors often occur together. However, having overweight or type 2 diabetes, for example, does not automatically mean that you have a fatty liver. Fatty liver disease can also occur in people without these known risk factors.
What happens if fatty liver disease is left untreated?
Simple fatty liver disease does not necessarily lead to liver damage, but in some people it can progress. The accumulation of fat may, for example, be accompanied by inflammation of the liver and, over time, lead to further liver damage. This is generally a gradual process that develops over years. Having fatty liver disease therefore does not automatically mean that serious liver damage will occur.
This gradual progression makes early detection particularly relevant. Once fatty liver disease has been identified, potential causes and modifiable risk factors can be addressed at an earlier stage.
How can fatty liver disease be diagnosed?
Whether you have fatty liver disease cannot be reliably determined based on symptoms, body weight or how healthy you feel. Objective testing is needed to diagnose fatty liver disease.
Blood tests can provide information about liver health and function, but do not always directly indicate the amount of fat in the liver. Liver abnormalities can also be detected using imaging techniques such as ultrasound, CT or MRI.
MRI can provide detailed images of the liver without the use of ionising radiation. It can provide insight into, among other things, the presence and amount of fat in the liver.
Measuring liver fat can also be useful for tracking changes over time. A follow-up measurement, for example, can show whether liver fat has changed after lifestyle adjustments.
Which type of examination is most appropriate depends on your individual situation and the reason for the examination.
Can you improve your liver health yourself?
Yes. Diet, body weight, physical activity and alcohol consumption can all influence liver fat and liver health.
What is beneficial depends on your individual situation. Small, sustainable adjustments can already make a difference.
Diet and weight
A healthy, varied diet can support your metabolic health and, in turn, your liver. For example, limit highly processed foods and products high in added sugars, and choose unprocessed or minimally processed foods more often.
If you are overweight, losing weight can help reduce liver fat. Aim for gradual weight loss rather than a crash diet, focusing on habits that are realistic to maintain.
Exercise and alcohol
Regular physical activity supports a healthy metabolism. This does not have to mean structured exercise: walking, cycling or simply moving more throughout the working day can also help.
Alcohol also affects the liver. Limiting alcohol consumption can reduce the strain on the liver.
The liver has a considerable capacity to recover. When contributing factors are addressed, fatty liver disease can improve in some people.
