Medical experts are sounding the alarm bell over the increased risk of fatty liver disease among Filipinos who gained weight and developed unhealthy habits due to quarantine restrictions in the early days of the pandemic, according to Inquirer.
Philippine College of Physicians president Dr. Diana Alcantara Payawal warned on Thursday (Jun 16) that about 10 to 20 per cent of Filipinos have nonalcoholic fatty liver disease (NAFLD), part of the “silent epidemic” afflicting millions globally,
While this is within the range of the global rate of 15 to 30 per cent, “some of them may already have fatty liver disease but are unaware of it,” said Payawal in a webinar organized by the Hepatology Society of the Philippines.
“This is a growing concern,” she added.
There are two types of NAFLD, a condition caused by fat buildup in the liver: the nonalcoholic fatty liver, and the “more advanced” nonalcoholic steatohepatitis, or NASH, both of which can take years to develop.
The latter means the liver is already damaged. NASH can lead to serious problems, such as fibrosis, or persistent inflammation that causes scar tissue around the liver and nearby blood vessels, and cirrhosis.
In cirrhosis, the liver shrinks and becomes scarred and lumpy. This can lead to liver failure and liver cancer.
Health projects sidelined
Payawal noted that before the onset of the coronavirus, most of the World Health Organization's (WHO) strategies were aimed at noncommunicable diseases. However, these were sidelined by the limitations imposed by the pandemic.
This “definitely” affected clinical diagnosis and detection, said Payawal, pointing to the current crop of patients with uncontrolled metabolic disorders, such as liver diseases and cancer as well as diabetes and colon diseases.
Some 18 million Filipinos are considered obese and overweight, leaving them highly susceptible to NAFLD. However, those with preexisting illnesses such as diabetes, obesity and hypertension, are also at risk as fatty liver is a “multisystemic disease.”
For example, NAFLD increases the chance of developing heart ailments.
Former president of the Hepatology Society of the Philippines Dr. Edhel Tripon noted that aside from genetic factors, lifestyle plays a key role in developing fatty liver. Lifestyle changes and unhealthy habits developed during quarantine that resulted in weight gain may also contribute to this disease.
Tripon cited patients who are still within the normal weight categories, but gained 5-10 percent of weight from pre-pandemic times because of working from home and no longer exercising.
While there are usually no symptoms in the early stages of NAFLD, those with NASH or fibrosis may experience a dull ache in the top right of the stomach (over the lower right side of the ribs), extreme tiredness, and unexplained weight loss.
If cirrhosis develops, the more severe symptoms include jaundice or yellowing of the skin and the whites of the eyes, itchy skin, and swelling in the legs, ankles, feet or stomach.
Tripon added that a "comprehensive lifestyle approach” to preventing and managing fatty liver is cutting down on calories, sugar and alcohol, as well as increasing physical activity and consumption of black coffee, which has been found beneficial to liver health.