You might want to reconsider hitting the drive-thru.
In another stunning rebuke of a fast-food diet, researchers find it puts us at increased risk for nonalcoholic fatty liver disease (NAFLD)—even among otherwise healthy people.
While we’ve long known that an unhealthy lifestyle—including a chronically unhealthy diet and lack of exercise—can lead to NAFLD, the new research from Keck Medicine USC quantifies the risk, more tangibly, and breaks it down to a specific behavior: our cheeseburger and French fry habit.
Researchers discovered that people with obesity or diabetes who eat fast food for 20% or more of their daily calories have significantly higher levels of fat in their liver than those who eat less or no fast food. That’s not all. Even the general population has moderate increases in liver fat when fast food accounts for one-fifth or more of their diet.
I applaud the USC researchers for conducting such pivotal research that holds the mirror up on specific lifestyle decisions we make. Without it, real change may never come. Liver disease leads to 2 million deaths per year, worldwide. Additionally, the incidence of liver disease is rising at staggering rates.
While the clinical community is acutely aware of the high prevalence and cost burden of liver disease, many consumers don’t know much about liver health or the risks of liver disease. Increasing education is key and studies like this are the building blocks of that effort.
But let’s not fool ourselves; education alone is not enough. We can’t continue down this pathway, unless we’re truly okay with the high death rate and the $100 billion spent per year on liver disease. As a clinical community, it’s time to do more and think differently to drive meaningful change. It’s time to increase access to liver disease screening across all social economic groups. Better access entails expanded screening across at-risk populations and expanded screening at the primary care level.
Early screening is crucial to reversing disease progression. NAFLD currently affects approximately 37% of adults, is asymptomatic and is infrequently diagnosed in primary care clinics. Yet when NAFLD is detected and properly managed in its early stages, lifestyle changes can stop the progression of the disease and even reduce the amount of liver fat present. That’s why non-invasive liver tests need to be adopted earlier in the patient pathway. In fact, because of this, the American Association for the Study of Liver Diseases (AASLD) just recently updated its practice guidance calling for expanded use of noninvasive liver evaluations for earlier detection of NAFLD and NASH. Their actionable recommendation for the use of such evaluations earlier in the clinical care pathway speaks volumes to the tremendously positive impact such noninvasive technology can have on the prevention of advanced disease and reducing its tremendous cost burden on our healthcare system.
By implementing this type of technology earlier in the diagnosis process, endocrinologists and primary care clinics can best identify high-risk NAFLD patients and connect them with gastroenterology or hepatology specialists to manage patients at risk of NASH or cirrhosis.
Primary care physicians should play a central role in identifying patients who are at risk for NAFLD. Preventive screenings will also be especially important in order to prevent an influx of patients overloading liver specialists when therapeutical treatment options become available.
Enhanced clinical feedback helps support lifestyle changes. The science is well documented that lifestyle changes take time and require supportive feedback. Non-invasive liver tests provide an accessible means for healthcare providers to monitor the positive effects of patient lifestyle changes over time, reinforcing the positive behaviors that lead to improved liver health – halting or even reversing the progression of liver disease. In many patients, a 5-7% decrease in body weight is associated with a reduction in liver fat and inflammation.
Easy, fast and painless options are available. Point-of-care exams can directly measure physical properties of liver stiffness and liver fat within 10 minutes. These painless, non-invasive tests are able to generate reproducible results and allow for both diagnosis and monitoring. Such quantifiable information can improve individual health outcomes and lessen the burden on the healthcare system by avoiding expensive, invasive interventions, such as painful liver biopsies.
My challenge to you is this: We have to make liver screening as easily accessible as visiting the drive-thru, and I believe it’s possible. The first step is expanded screening. I’m asking you to join the growing number of physician groups and hospital systems introducing liver health management programs that include non-invasive testing as part of an overall evaluation of liver health. We owe it to the patients and the communities we serve to embrace a highly cost-effective way to curb the staggering cost of liver disease on our healthcare system and stem the tide of this silent epidemic.
Photo: Dilok Klaisataporn, Getty Images