As cases continue to rise, the health sector is drawing attention to the prevalence of Non-Alcoholic Fatty Liver Disease in the country.

"The burden of liver diseases around the world is enormous, the coverage of the number of people suffering from liver disease can encompass the entire damage of Covid-19," said Dr. Jose Sollano, hepatologist and professor of Medicine at the University of Santo Tomas.

The Global State of Liver Health 2022 Report published by the Global Liver Institute suggests that one out of four people in the world are impacted by NAFLD, and in the Philippines alone, approximately 16,500 individuals die from liver disease complications per year.

Furthermore, in a previous webinar hosted by the Hepatology Society of the Philippines, Dr. Diana Payawal, immediate past president of the Philippine College of Physicians and Scientific Advisor to the Global State of Liver Health 2022, estimated that NAFLD affects about 10 to 20 percent of the Filipino population.

In the face of the severity of this disease, health officials and medical professionals are seeking ways to reduce the rapid pace of NAFLD risk nationwide. In the Philippines, one in 14 adults is living with diabetes and 38.6 percent of adults are overweight to obese, all of which are at risk for NAFLD.

"Despite the risk of NAFLD encompassing a significant portion of the Filipino population, public awareness around it remains alarmingly low. We need to guide our patients in navigating this potentially life-threatening disease, from understanding and early detection to active prevention," said Dr. Yvonne Ferrer, Sanofi Consumer Healthcare ASEA Medical head.

NAFLD covers a range of liver conditions caused by fat buildup, commonly seen in individuals who are overweight or obese. It is a disease more susceptible in those suffering from diabetes or cardiovascular diseases. NAFLD is an interplay of genetics, environment, diet and microbiota, so high cholesterol levels, sedentary lifestyle and inappropriate eating habits can also increase an individual's NAFLD risk, often leading to liver damage, disease or even liver failure.

"The difference between the Philippines and other countries is that we are an archipelago, where bodies of water separate us, making it harder [for the public] to consult with a specialist," said Dr. Payawal.

With this, medical practitioners are calling for the urgent need for standardized liver health information and resources, as well as guidelines in preventing the disease, especially in far-flung areas of the nation.

Available medications that have been explored for NAFLD treatment, such as fatty liver drugs and pioglitazone, only offer minimal effectiveness in managing the disease. So, by the time a patient's condition has reached a point where medication must be considered, the disease may still advance significantly, highlighting the importance of preventive techniques.

"Millions of people are suffering from chronic liver diseases brought about by alcohol, and now [we deal with] the metabolic syndrome but these diseases are preventable, curable and some [cases] can be controlled," Dr. Sollano said.

Prevention

Apart from the fact that there are no standardized guidelines geared towards managing NAFLD, there are also very few liver disease prevention techniques being recommended for the general population.

"The key factor to avoid NAFLD is to keep your metabolic parameters normal, keep your numbers normal, whether it's weight, cholesterol, etcetera," Dr. Payawal advised. "Since this is a mitochondrial and multi-factorial disease, you need to hit different aspects of the disease in order to control it."

Proper self-care, where individuals are intentional about maintaining their health in their day-to-day lives, is crucial to preventing NAFLD. Taking proactive steps that account for one's holistic well-being like exercising, developing healthy food habits and regularly consulting a doctor, is pivotal to reducing the risk of liver diseases.

However, should Filipinos find themselves at risk or in early stages of NAFLD, patients can still work towards reversing this disease as the liver is one of the organs that can regenerate. This comes with increased responsibility on lifestyle choices but several supplements also help boost liver regeneration.

"Embracing the practice of proactive self-care can positively impact liver health. By prioritizing proper nutrition, exercise and phospholipid intake, at-risk individuals can play an active role in reducing their NAFLD risk," Dr. Ferrer concluded.

Individuals have a responsibility to themselves and their loved ones to put their health in their own hands, and liver care is a little-known but prominent part of overall well-being. The more that people are aware of the effects of liver diseases like NAFLD, the more that they can be intentional in avoiding or treating it.