Nationwide Study Reveals 40% of Indian Adults Affected by Fatty Liver Disease
A comprehensive nationwide study published in The Lancet Regional Health Southeast Asia has uncovered a significant public health concern in India. The research indicates that approximately 40% of Indian adults—equivalent to about 4 in 10 people—are living with metabolic dysfunction-associated steatotic liver disease (MASLD), commonly referred to as non-alcoholic fatty liver disease.
Research Methodology and Key Findings
The study analyzed data from 7,764 adults across 37 Council of Scientific and Industrial Research (CSIR) laboratories located in 27 different Indian cities. This extensive sampling provides a robust overview of the condition's prevalence across the nation.
Obesity emerged as the most significant contributing factor, with many participants also presenting three or more cardiovascular risk factors. In metropolitan regions like Bengaluru, the age-adjusted prevalence of MASLD was found to range between 37% and 42%.
An alarming discovery from the study is that 4% of individuals, particularly older adults with pre-existing conditions such as diabetes, hypertension, abnormal cholesterol levels, or obesity, already exhibit signs of liver fibrosis. This progression significantly increases the risk of developing cirrhosis, a serious and potentially life-threatening liver condition.
Clinical Observations Suggest Even Higher Prevalence
When consulted about these findings, hepatologists in Bengaluru indicated that the actual outpatient figures for MASLD in most hospitals might be substantially higher—potentially reaching 50–60%.
Dr. Naveen Ganjoo, senior consultant in hepatology and integrated liver care at Aster RV Hospital, shared insights from a local study: "We conducted our own research among 700 IT professionals in Bengaluru, and nearly 71% of them were diagnosed with fatty liver. The primary causes appeared to be poor lifestyle habits including irregular eating patterns, night shifts, lack of physical activity, and disrupted circadian rhythms."
Dr. Ganjoo further noted that while the condition is more common among individuals with diabetes and those who are overweight, there is a growing risk among lean individuals with familial diabetes—a phenomenon sometimes termed 'lean metabolic dysfunction.'
Detection Patterns and Demographic Shifts
Dr. Sunil S. Bohra, consultant in internal medicine at Apollo Hospitals, Seshadripuram, explained that most MASLD cases are identified during routine health check-ups or pre-employment medical examinations. "If an ultrasound indicates fatty changes, we proceed with liver screening and, if necessary, assess fibrosis levels. Fibrosis becomes more common after age 45 and may worsen with alcohol consumption," he stated.
Medical professionals are observing an increasing incidence of MASLD among younger adults aged 20–45. Dr. Ravindra Nidoni, consultant liver transplant and HPB surgeon at Gleneagles BGS Hospital, described a concerning case involving a 21-year-old weighing approximately 100kg who was diagnosed during a pilot fitness evaluation, despite no history of alcohol use. "Severe sedentary behavior, frequent fast food consumption, and high intake of sugary drinks were key contributors in his case. This demonstrates that fatty liver is now largely driven by poor diet, physical inactivity, and metabolic risk factors," Dr. Nidoni emphasized.
The Silent Progression and Management Strategies
Dr. Sandeep Satsangi, lead consultant in hepatology and transplant hepatology at Manipal Hospital Old Airport Road, highlighted a major concern: "Fatty liver is typically asymptomatic in its early stages. Nearly 90–95% of patients experience no symptoms, and about 10% may silently progress to fibrosis and cirrhosis."
He explained that liver fibrosis is classified from F0 (normal) to F4 (cirrhosis). The intermediate stages, F1 to F3, can often be reversed with appropriate interventions:
- Medication as prescribed by healthcare providers
- Calorie-deficit diets tailored to individual needs
- Improved nutrition with better protein and fiber balance
- Reduced sedentary behavior and increased physical activity
Lifestyle correction plays a crucial role in significantly improving treatment outcomes, according to Dr. Satsangi.
Understanding MASLD and Preventive Measures
MASLD is a condition characterized by excess fat accumulation in the liver, primarily due to factors such as obesity, diabetes, high blood pressure, or abnormal cholesterol levels, rather than alcohol consumption.
To prevent, manage, or potentially reverse MASLD, medical experts recommend the following measures:
- Avoid sugar and refined carbohydrates while increasing protein and fiber intake in your diet
- Stay physically active and reduce prolonged periods of sitting or screen time
- Maintain a healthy weight and effectively manage diabetes, blood pressure, and cholesterol levels
- Avoid alcohol entirely if diagnosed with fatty liver disease
- Schedule regular health check-ups for early detection and prevention of disease progression
This study underscores the urgent need for increased public awareness and proactive health management to address the growing prevalence of fatty liver disease across India's diverse population.
