Prolonged sitting, long hours on screens, less sleep can affect liver health

Q. Monsoon often triggers a spike in gastrointestinal infections. What are the most common liver-related complications observed during the season and how can those be prevented?
A. Monsoon results in an increase in subsoil ground water, which can be contaminated by sewage leaks and this contaminated water can be transported to the wells and sometimes to households through the pipe water supply. Hepatitis E virus and hepatitis A virus are endemic in India and are excreted through human excreta. It can contaminate drinking water as well as food processed by such water. These viruses are transmitted to humans orally through contaminated water and food causing acute hepatitis manifesting as jaundice due to liver dysfunction. They can be prevented by drinking boiled and then cooled water or after treatment by due process of chlorination. Avoid eating foods from street vendors and prepared in unhygienic conditions.
Q. As a leading hepatologist, what trends do you notice in liver disease prevalence over the last decade in India, particularly among the younger population?
The prevalence of alcohol induced liver damage and fatty liver disease are rapidly increasing in India. The two problems constitute more than three-fourth of overt clinically damaged liver presenting in various stages of liver dysfunction. More than half of the hospital beds in a gastroenterology unit or even many medical units, comprise of advanced and not infrequently life threatening complications of these two etiology-induced liver damage. Though hepatitis B and hepatitis C associated chronic liver disease is in decreasing trend, it continues to be a problem. These conditions can lead to chronic liver disease like cirrhosis and liver cancer which often compromise quality and quantity of human life. All of them can be prevented by awareness, HBV vaccination, avoiding alcohol consumption and foods which cause obesity (sweets, processed foods, aerated drinks, saturated and trans-fats). Younger people are suffering from these diseases due to increased alcohol consumption, lack of regular physical exercise to reduce cardio-metabolic risk factors like obesity, diabetes, dyslipidaemia and hypertension etc.
Q. NAFLD is now being called the silent epidemic. What factors are contributing to its rapid rise in urban and rural India?
Sedentary lifestyle, consumption of junk foods, rapid rise in prevalence of type-2 diabetes mellitus, along with even moderate alcohol consumption (which often accompanies snacking causing additional unwanted calories consumption) are causing more and more fatty liver disease as well as liver damage in people. It is often due to both fat and alcohol which is medically known as Met-ALD (metabolic dysfunction - met with alcoholic liver disease).
Q. How does NAFLD progress into more serious conditions like non-alcoholic steatohepatitis (NASH), cirrhosis, or even liver cancer and what early warning signs should people watch for?
A. About 70% to 80% of diabetics and about 30% to 50% of overweight and obese people (BMI > 23 to 25 with abdominal obesity) may have increased fat in the liver which can progress to more advance liver damage like NASH, now renamed as MASH - Metabolic dysfunction associated steatohepatitis. It indicates liver inflammation and damage often leading to fibrosis. At least, 10% to 25% of people, depending upon the presence of various other factors like dyslipidaemia, diabetes, and even infrequent alcohol consumption, lack of physical activity and consumption of high-risk foods may progress to serious liver damage in the next 10 years. Such people are also more prone to heart attacks, strokes and cancers.
Q. What are some under-discussed lifestyle factors, beyond alcohol and obesity that are damaging liver health these days?
Prolonged sitting, more time spent on screen watching, less sleep, more consumption of carbohydrates and sweets, fried foods, frequent consumption of painkillers and many unwanted complementary alternative medicines even un-indicated hepatotoxic antibiotics may be associated with liver damage.
Q. How do comorbidities like diabetes and hypertension worsen liver function or disease outcomes?
Diabetes and hypertension are manifestations of metabolic dysfunction of the body due to lifestyle changes and often are associated with fatty liver, cardiac dysfunction, renal complications and many other abnormalities. Their association with pre-existing fatty liver are well known synergistic factors for progression of liver disease.
Q. Given the rise in poly-pharmacy, especially in middle-aged individuals, how concerning is drug-induced liver injury (DILI)?
DILI is another problem compounding the liver disease. Drugs for tuberculosis, anti-cancer drugs, complementary alternative medicines, some antibiotics, painkillers and many other drugs can cause liver damage. Therefore, close monitoring of liver functions is needed during such medications.
Q. Is there a role for routine liver function screening even in asymptomatic individuals, especially among those with sedentary lifestyles or obesity?
Definitely. All risk factors, if present in any individual, without symptoms should be evaluated for liver, cardiac and renal dysfunction. Occurrence of hypertension, increase in uric acid, compromised bone density and presence of polycystic ovaries in females should also be looked into. Even fat infiltration to muscles can be there causing increased fatigue and relative muscle loss. Fat in the liver easily detected by an abdominal ultrasound indicates a generalised metabolic dysfunction of the whole body. The human body and its organs evolutionarily have substantial reserves and therefore metabolic dysfunction associated organ damage can be asymptomatic. Therefore, individuals with risk factors like obesity, diabetes, hypertension and alcohol abuse should be screened for presence of abnormalities in various organs. If diagnosed early, all of these abnormalities are completely reversible.
Q. Is there a connection between immunity, gut health, and liver function that people need to be more aware of, particularly during seasonal changes like the monsoon?
The human body should be assessed holistically. Organ cross talk is a naturally evolved process. Gut microbiome is an important determinant of our immune competence and is a barrier against environmental infection. They can enhance liver damage in fatty liver disease and can get altered in presence of diabetes, alcohol consumption and various other bowel as well as systemic illnesses. Diet (vegetarian and non-vegetarian) can alter gut microbiome affecting human health in susceptible individuals. However, monsoon per se cannot be blamed solely for gut health. Rather, it is diet and types of diet, alcohol, presence of uncontrolled diabetes, frequent consumption of antibiotics, bowel habits etc which can influence gut microbiome.
Q. What is your take on hepatitis A and B vaccination rates in India? Are we doing enough to prevent these preventable liver diseases?
Hepatitis B virus immunisation by vaccination starting at birth is already a part of the universal immunisation programme of the Government of India and is being implemented in all states. However, I think Hepatitis A virus vaccination should be given to all children starting at the age of around two years, because hepatitis A-virus induced acute hepatitis is on the rise in all states and often is causing severe liver disease in children and young adults.
Q. Do you believe India needs a national liver health programme or policy, similar to its initiatives on diabetes and heart disease and why?
Yes. Fatty liver disease prevalence is around 30% to 40% in the Indian population. Alcohol consumption is on the rise. More and more DILI are being documented. Substance use is on the rise. Liver due to its huge reserve remains often asymptomatic despite having damage due to various etiologies. When clinically liver dysfunction becomes overt, often disease is in an advanced stage and may be difficult to get corrected needing liver transplant.
Q. How can primary care physicians and public health workers be better trained or equipped to detect liver-related diseases early?
Awareness, availability of liver function tests, ultrasound screening of liver and regular training of doctors and health professionals about various tests and screening methods are necessary to encourage identification and screening of high risk persons prone to develop liver disease.
Q. As liver diseases do not discriminate between vegetarians or non-vegetarians and alcoholic or non-alcoholic, what would be your liver care tips for the common man?
I think regular exercise, nil alcohol consumption, less consumption of foods with high glycaemic index, control of diabetes and dyslipidaemia, if present, avoidance of un-indicated medication, avoiding red meat consumption, saturated and trans-fat, aerated drinks and processed food will be helpful to all in not only preventing liver disease but also promoting good health in general. Further, since smoking aggravates all diseases and it should be completely avoided.

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Fatty liver: 10 everyday foods that can trigger this liver condition without you realizing it

Time of India

3 hours ago

Time of India

Fatty liver: 10 everyday foods that can trigger this liver condition without you realizing it

Let's start with a fact that might shake you up a little: fatty liver disease affects nearly 1 in 3 adults globally—and many of them don't even know they have it. You might be going about your day, powering through deadlines, sipping your usual cup of chai or coffee, feeling a little bloated maybe, but otherwise fine—and meanwhile, your liver might be struggling under layers of fat. It doesn't scream. It doesn't throw a tantrum. It just quietly starts failing. And unless you catch it early, that quiet damage can turn into something loud, scary, and irreversible. Fatty liver, or hepatic steatosis, happens when too much fat builds up in your liver cells. Your liver is supposed to have some fat—it's a normal part of its structure. But when fat makes up more than 5–10% of the liver's weight, it starts becoming a problem. There are two main types: Non-Alcoholic Fatty Liver Disease (NAFLD) – Not caused by alcohol, but linked to diet, weight, and lifestyle. Alcoholic Fatty Liver Disease (AFLD) – Caused by heavy drinking. We'll mostly talk about NAFLD here—because even non-drinkers are showing up with it in growing numbers. It's become a modern lifestyle epidemic. 10 foods that can trigger this liver condition without you realizing it 1. White bread and refined grains Let's start with the basics. White bread, pizza bases, and anything made with maida (refined flour) spike your blood sugar fast. Your body ends up storing that extra glucose as fat—some of it in your liver. Whole grains are a much kinder choice. 2. Sugary breakfast cereals They may scream 'fortified with vitamins!' on the box, but flip it over and check the sugar content. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Your Finger Shape Says a Lot About Your Personality, Read Now Tips and Tricks Undo Many cereals are basically dessert disguised as breakfast. Your liver can't handle that much sugar first thing in the morning. 3. Soda and sweetened beverages This one's a liver killer. Sodas, energy drinks, iced teas, and even those fancy bottled fruit juices are packed with high-fructose corn syrup or added sugar. Fructose goes straight to your liver—and too much of it gets converted into fat. 4. Packaged snacks (chips, crackers, and namkeens) Crunchy, salty, and hard to stop eating—most processed snacks are loaded with refined carbs, trans fats, and preservatives. These things are a nightmare for your liver and offer zero nutritional value. 5. Red meat (especially processed) We're talking bacon, sausages, salami, and even that juicy steak if it's a regular on your plate. Red meat is high in saturated fat, which adds to the liver's fat burden and inflammation. Swap it for lean proteins or plant-based options more often. 6. Pastries and cakes Sure, they're fun for birthdays. But when pastries, muffins, donuts, and cakes become an everyday treat, your liver takes a hit. These are full of sugar and bad fats that encourage fat storage right in the liver. 7. Fried foods Whether it's fries, pakoras, or fried chicken, deep-fried goodies are heavy on trans fats. Your liver struggles to break them down, and over time, it starts storing the excess as fat. Even 'air-fried' versions aren't always innocent—watch the oil and batter. 8. Full-fat dairy (especially flavored versions) Whole milk, full-fat cheese, creamy yogurts, and sweetened lassis might be comforting, but they're also full of saturated fat and added sugars. And that combo? Not your liver's best friend. 9. Fast food and takeout Burgers, noodles, pizzas, and that 'just one bite' of biryani can add up fast. Most fast food meals are high in sugar, salt, and unhealthy fats—all of which overwhelm the liver when eaten too often. 10. Artificial sweeteners and diet foods Yep, even diet soda isn't totally safe. Some studies suggest that artificial sweeteners might mess with your metabolism and gut bacteria, indirectly contributing to fatty liver. 'Low-fat' or 'sugar-free' labels don't always mean liver-friendly. So how do you know if you have it? Especially when it's so silent in the early stages? Let's break it down in simple, real-life terms. Fatty liver: Sneaky symptoms that often go unnoticed Fatty liver doesn't usually show up with big, obvious signs—especially in the early days. But if you listen carefully, your body is talking. Here's how: 1. You're always tired for no reason Ever feel like you just wake up tired? Even on days you sleep enough? Chronic fatigue is one of the earliest signs. Your liver is a detox engine, and when it's not working efficiently, toxins build up—and you feel the drag. 2. Your belly feels heavy, bloated, or uncomfortable Some people describe it as a 'full' feeling on the right side of their belly, especially after eating. Others feel like they're carrying an invisible balloon in their stomach. It's not always painful, but it's definitely not pleasant. 3. Your liver enzymes are high in your blood test—but you feel fine This is a classic. A routine blood test might show elevated ALT or AST levels. If your doctor casually mentions 'your liver enzymes are a bit high,' don't ignore it. That might be fatty liver waving hello. 4. You have insulin resistance or are prediabetic NAFLD is tightly linked to insulin resistance. If you've been told you're borderline diabetic, have PCOS, or carry a lot of weight around your midsection, your liver might already be absorbing the consequences. 5. You're gaining weight without changing much Especially if the weight is piling up around your belly and waistline. The liver is closely tied to fat metabolism, and when it's out of sync, your weight becomes harder to manage—even if you're eating reasonably well. The weird-but-true signs that sometimes show up These aren't textbook symptoms, but many people with fatty liver report them: Brain fog or poor memory Skin issues like acne or dark patches (especially on neck or underarms) Bad breath that won't go away Mild depression or anxiety that feels unexplainable Again, none of these scream 'your liver's in trouble!'—but when you connect the dots, it's worth getting checked. What causes it (even if you don't drink)? Here's the kicker: you don't have to drink a drop of alcohol to develop fatty liver. In fact, some of the most common culprits are things we encounter every day—often without even realizing the damage they're doing. One major trigger is a diet high in sugar and refined carbs. Think white bread, pasta, packaged snacks, sugary cereals, and those sweetened drinks that sneak into your daily routine. Your liver turns excess sugar into fat, and over time, that fat starts to build up where it shouldn't. Then there's the sedentary lifestyle factor. Even if you're hustling mentally at your desk job, your liver suffers when your body doesn't move much. Long hours of sitting without any physical activity can slow down your metabolism and lead to fat accumulation—not just in your belly, but in your liver too. Being overweight or obese also plays a key role, especially if you carry that extra weight around your midsection. A high BMI and expanding waistline are red flags that your liver might be under stress. How to start healing your liver Cut back on added sugar and processed foods. Your liver hates sugary cereals, soft drinks, and baked goods. Start there. Move your body every day. You don't need a gym. Brisk walks, yoga, or dancing in your living room helps. Lose 5–10% of your body weight. Research shows that even 5% weight loss can reduce liver fat significantly. Eat more real, whole foods. Leafy greens, cruciferous veggies, lentils, berries, garlic, and omega-3 fats are liver-friendly. Get enough sleep. Nightly rest resets your metabolism and liver function. You don't need to panic. But you do need to pay attention. If your body is whispering—through fatigue, bloating, or weird lab results—don't wait for it to shout. Fatty liver might be common, but it's not harmless. The good news? You have more control than you think. So go on. Show your liver some love. It's been quietly working for you all along. One step to a healthier you—join Times Health+ Yoga and feel the change

You might have fatty liver and not even know it—here's how to tell

Time of India

3 hours ago

Time of India

You might have fatty liver and not even know it—here's how to tell

Fatty liver disease: Common signs and symptoms you must not ignore

India.com

a day ago

India.com

Fatty liver disease: Common signs and symptoms you must not ignore

Fatty liver disease: Common signs and symptoms you must not ignore Fatty liver disease, better known as Non-Alcoholic Fatty Liver Disease (NAFLD), has been dubbed the 'silent epidemic' because it develops slowly and without significant warning signs. It is important to understand that while there are no serious clinical warning signs during the early stages of fatty liver disease, the body will exhibit some mild signs of liver impairment, especially at night, which can be detected. By spotting these signs here at the onset of liver impairment, one can limit the likelihood of the chronic, progressive damage that can cause complications such as cirrhosis or failure of the liver. The serious symptoms of fatty liver disease you should watch for are: Pain in the Abdomen (Especially at Night): Pain or fullness in the upper right quadrant of the abdomen is one of the more common symptoms of fatty liver disease. Many people will describe the pain as becoming intense at night, which can interrupt a sound sleep. Loss of Appetite During Dinner Time: During evening meals, a decline in appetite may be a sign of a dysfunctional liver. If the loss of appetite persists, an individual can eventually end up with weight loss that may lead to malnutrition. Unusual Weight Loss: When someone begins to lose weight without dietary or exercise changes, it can possibly be a sign of the liver failing to metabolize and maintain weight. Swollen Legs and Feet: Edema due to water retention caused by liver dysfunction may also manifest in the lower extremities (lower legs and feet) of the body. One can recognize the sign by slight leg swelling, boots or shoes not seeming to fit. Physical Fatigue and Weakness: Unlike ordinary fatigue, this type of fatigue is debilitating and persistent. As we stated previously, the liver is not functioning correctly leaving the body unable to clean itself, leading to fatigue and weakness. Insomnia: The inability to get to sleep or the inability to stay asleep is prevalent. Insomnia is commonly caused by pain, inflammation, and/or blood sugar fluctuations that result when the liver is not functioning properly. Insomnia: The inability to get to sleep or stay asleep is prevalent. Insomnia is commonly caused by pain, inflammation, and/or blood sugar fluctuations that occur when the liver is not functioning correctly. Itchy skin (without rash): itching and irritation can occur from bile salts that accumulate in the skin, even if there is no itch rash, as is sometimes present in liver disease. Yellowing of the skin and/or eyes: This is an obvious symptom and if observed, the liver has had extensive damage. Bilirubin is a waste product from the breakdown of red blood cells that accumulates in the body and causes yellow coloring of both the skin and eyes.