A silent epidemic is gripping India—metabolic-dysfunction-associated fatty liver disease (MAFLD), previously known as non-alcoholic fatty liver disease (NAFLD). With rising cases linked to obesity and sedentary lifestyles, a new set of clinical guidelines from the Asian Pacific Association for the Study of the Liver (APASL) puts diet and exercise at the center of treatment. Published in Hepatology International, these are the first official guidelines from the expert body, and they emphasize structured lifestyle modifications as the primary approach.
How Diet and Exercise Can Reverse Fatty Liver Disease
Excess fat in the liver is reversible, and the key lies in sustainable weight loss. According to APASL, reducing body weight by 5–10% is crucial for improving liver health. Losing over 10% of body weight can significantly reduce liver fibrosis, a condition where scar tissue builds up due to chronic inflammation.
Patients are advised to:
- Reduce daily calorie intake by 500–700 kilocalories.
- Prioritize balanced nutrition with high-protein and fiber-rich foods.
- Avoid processed foods, sugary beverages, and trans fats.
“The idea is not just cutting calories but also ensuring a diet rich in nutrients that support liver function,” said one of the lead researchers involved in the study.
The Role of Structured Exercise in Liver Health
Exercise isn’t just about burning calories—it directly impacts liver metabolism. The new guidelines stress that regular physical activity can improve insulin sensitivity and reduce inflammation, two major contributors to fatty liver disease.
The recommended exercise regimen includes:
- 150–240 minutes per week of moderate-intensity aerobic exercise.
- Strength training at least twice a week to support metabolic function.
- A mix of activities such as brisk walking, cycling, swimming, and resistance training.
Even small changes, such as taking the stairs or engaging in short walking breaks, can contribute to better liver health over time.
Why These Guidelines Matter Now
India has seen a surge in MAFLD cases, with estimates suggesting that up to 38% of the population could be affected. The condition is linked to diabetes, obesity, and cardiovascular diseases, making it a ticking time bomb for public health. Unlike alcohol-related liver diseases, MAFLD is primarily driven by metabolic disorders, which means prevention and treatment require a lifestyle-first approach.
Previous treatments for fatty liver disease were often pharmaceutical-focused, but growing evidence shows that medications alone may not be as effective as lifestyle interventions. The APASL guidelines shift the focus toward long-term behavior changes.
A Closer Look: The Science Behind Weight Loss and Liver Recovery
To understand the relationship between weight loss and liver recovery, here’s a breakdown:
| Weight Loss (%) | Effect on Liver |
|---|---|
| 3–5% | Reduces liver fat |
| 5–10% | Improves liver enzyme levels and insulin sensitivity |
| >10% | Reduces liver fibrosis and inflammation |
These findings underscore the importance of gradual and consistent weight management. Crash diets or extreme workouts are not recommended, as they can do more harm than good.
The Road Ahead: Public Awareness and Policy Support
While individual lifestyle changes are essential, experts believe that government policies and healthcare interventions are necessary to curb the rise of MAFLD. Awareness campaigns, better nutritional labeling, and urban planning that encourages physical activity could play a role in reducing disease prevalence.
With these new guidelines, there is hope that more people will take preventive measures seriously. Structured weight loss programs, community fitness initiatives, and better education on diet and exercise can help reverse the trend.
As the first clinical guidelines of their kind, this marks a pivotal moment in the fight against fatty liver disease. The message is clear: the best medicine for a healthy liver is not found in a pill bottle but in daily lifestyle choices.
