Fatty Liver Disease Increasingly Affects Young Adults, Lifestyle Changes Crucial
Cases of fatty liver, known as metabolic dysfunction-associated steatotic liver disease (MASLD), are increasingly found in younger age groups, especially those in their 30s. Widya Khairunnisa Sarkowi, a lecturer at the Faculty of Medicine and Nutrition (FKGiz) of IPB University, explained that fatty liver occurs due to fat accumulation in the liver linked to metabolic disorders. She noted the disease is often dubbed a ‘silent killer’ because it develops slowly without clear clinical signs and can lead to permanent liver damage.
“Many people feel healthy, but when examined via ultrasound or liver enzyme tests, fatty liver is already present. Individuals with obesity, diabetes mellitus, or other metabolic disorders have a higher risk of developing fatty liver,” Widya said in a statement on Saturday (20/6).
Globally, the prevalence of fatty liver is estimated at around 30 per cent and continues to rise. Meanwhile, according to the 2023 Indonesian Health Survey (SKI), the prevalence of obesity in adults increased from 21.8 per cent in 2018 to 23.4 per cent in 2023. The prevalence of central obesity among the population aged over 15 years reached 36.8 per cent.
According to Dr Widya, these high figures are a strong signal of increasing metabolic problems in society, such as obesity, central obesity or abdominal fat, diabetes, high cholesterol, hypertension, high-sugar and high-calorie diets, and lack of physical activity.
Nevertheless, she stated that fatty liver does not only affect overweight individuals. People with normal body weight can still develop fatty liver if they have abdominal obesity, insulin resistance, diabetes, a high-sugar diet, or insufficient physical activity.
Widya added that fatty liver is not merely a liver organ issue but a marker of metabolic disorders throughout the body. She therefore urged the public not to be easily tempted by instant solutions such as supplements, detox products, or herbs claimed to “cleanse the liver”.
“Medication alone is insufficient without accompanying healthy lifestyle changes. Scientific evidence shows that lifestyle modification remains the most effective way to prevent and manage fatty liver,” she said.
As preventive measures, Widya conveyed five key educational messages aligned with World Health Organisation (WHO) recommendations. First, lose weight gradually. A weight reduction of around 5 to 10 per cent is known to reduce liver fat, inflammation, and the risk of fibrosis.
Second, reduce consumption of sugary drinks such as sweet tea, high-sugar milk coffee, bubble tea, soda, packaged beverages, and syrups, which are sources of liquid sugar with high calories. “WHO recommends free sugar consumption of less than 10 per cent of total daily energy needs, ideally below 5 per cent,” she stated.
Third, adopt a balanced diet with half the plate consisting of vegetables and fruit, a quarter protein, and a quarter carbohydrates. The public is also advised to limit ultra-processed foods, fried foods, sweet foods, and high-calorie snacks.
Fourth, engage in regular physical activity. WHO recommends moderate-intensity physical activity for 150 to 300 minutes per week, or about 30 minutes per day five times a week. Weight training twice a week is also recommended to increase muscle mass and insulin sensitivity.
Fifth, undergo periodic risk factor checks, including waist circumference measurement, body mass index (BMI), blood sugar levels, lipid profile, blood pressure, and liver function tests and abdominal ultrasound if necessary.
Furthermore, Widya emphasised that fatty liver prevention should ideally begin in childhood. The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) recommends screening for fatty liver in obese children starting at age 9 to 11, especially if accompanied by additional risk factors such as insulin resistance, diabetes, dyslipidaemia, or a family history of fatty liver.
“Children need to be accustomed to consuming healthy foods, increasing outdoor activities, reducing screen time, getting adequate sleep, and limiting consumption of sugary drinks and ultra-processed foods,” she said.
For adolescents, education needs to be linked to modern lifestyles, such as consumption of trendy drinks, fast food, late-night habits, lack of movement, and stress, which can increase the risk of obesity and metabolic disorders.
Meanwhile, for young adults, the public is advised to start routinely monitoring body weight, waist circumference, blood pressure, blood sugar, and lipid levels, especially if there is a family history of diabetes, obesity, or heart disease. For those over 40, early detection needs to be pursued more actively as the risk of various metabolic diseases increases.
Widya also reminded the public not to normalise a diagnosis of mild fatty liver. According to her, the condition can progress to liver inflammation, fibrosis, cirrhosis, and even liver cancer if not properly managed. She stressed the importance of cross-sector collaboration.
“Preventing fatty liver requires collaboration from all parties because it will be difficult for the public to adopt a healthy lifestyle if high-sugar and high-fat foods are more accessible, cheaper, and more heavily promoted than healthy options,” she concluded.