
The rise of fast food businesses worldwide is linked to an increased risk of obesity and diabetes [1]. A recent study [2] has convincing evidence on why it is necessary to avoid fast foods. Published in the Clinical Gastroenterology and Hepatology, the study found that consuming fast food is associated with developing non-alcoholic fatty liver disease.
A systematic review and meta-analysis [3] showed that the prevalence of non-alcoholic fatty liver disease (NAFLD) in the overweight population is 70%. In comparison, the prevalence of non-alcoholic steatohepatitis (NASH) in the overweight population is 34%. The same review also found similar prevalence patterns in the obese population.
In the obese population, 75% have NAFLD, while 34% have NASH. The prevalence of NAFLD amongst the overweight population is highest in the US.
What is non-alcoholic fatty liver disease?
Non-alcoholic fatty liver disease refers to a range of conditions where the liver has an increased build-up of fats or fatty tissues. This disease is prevalent in obese or overweight people. In its early stages, NAFLD does not lead to severe symptoms or can cause significant harm. However, as NAFLD progresses, it can lead to cirrhosis and severe liver damage.
When you have high levels of fats in the liver, your risk of other severe health conditions also increases. Some of the health problems linked to NAFLD include the following:
- Diabetes
- Kidney disease
- High blood pressure
If you already have type 2 diabetes, developing NAFLD could increase your risk of cardiovascular disease.

Once detected early, NAFLD can be stopped from progressing and getting worse. The amount of fat in your liver could also reduce when managed during the early stage.
There are four stages of NAFLD:
- Steatosis or simple fatty liver- this stage is often harmless, with the liver cells accumulating fat and may be diagnosed only when tests are carried out for reasons other than diagnosing fatty liver.
- Non-alcoholic steatohepatitis (NASH)- at this stage, the liver becomes inflamed and is a more severe stage of NAFLD.
- Fibrosis- When inflammation becomes persistent, scar tissues begin to deliver throughout the liver and near blood vessels. However, the liver can still function normally, even with scar tissues.
- Cirrhosis is the most severe stage, which often develops after years of inflammation. The liver shrinks and becomes lumpy and scarred. The permanent damage to the liver can lead to liver failure when the liver no longer functions properly or stops working correctly. The risk of liver cancer is high when cirrhosis develops.
Since it can take years before cirrhosis or fibrosis develops, you must make lifestyle changes to prevent the condition from progressing.Â

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Who is at risk for NAFLD?
Individuals who are at increased risk of developing non-alcoholic fatty liver disease include the following:
- Are overweight or obese, particularly people who have the apple-like body shape where fats are concentrated in the waistline
- Have high blood pressure
- Have type 2 diabetes
- Have high cholesterol
- Have a condition that affects the body’s ability to use insulin
- Have insulin resistance, such as those suffering from a polycystic syndrome
- Are over the age of 50
- Have underactive thyroid
- Smokes
- Have metabolic syndrome (this is a combination of obesity, high blood pressure and diabetes)
It is noteworthy that NAFLD has been diagnosed in individuals who do not have any of the risk factors cited above. For example, there are children diagnosed with NAFLD. While NAFLD has similar signs and symptoms as alcohol-related liver disease, NAFLD is not caused by too much drinking of alcohol.
What are the symptoms of NAFLD?
- Weakness
- Unexplained weight loss
- Extreme tiredness
- Aching pain or dull pain in the lower right side of the ribs or the right part of the stomach
What does new research say about the link between fast food consumption and liver disease?
The study led by Kardashian [2], a medical doctor from the University of Southern California, analysed the results of the National Health and Nutrition Examination Survey (NHANES) conducted from 2017-2018. The study’s authors evaluated the impact of fast food consumption on the risk of liver steatosis in a nationally representative sample.
Findings indicated that individuals who have diabetes or are obese and consume at least 20% of their daily caloric needs from fast foods have fatty livers or extremely high levels of fats in the liver. In contrast, people who eat less or no fast food do not have fatty liver.
Similarly, people who eat fast food as part of their diet are also at increased risk of liver fat. Ani Kardashian, the study’s lead author, explained that “healthy livers contain a small amount of fat, usually less than 5%, and even a moderate increase in fat can lead to nonalcoholic fatty liver disease”. Kardashian continued, “the severe risk in liver fat in those with obesity or diabetes is especially striking and probably due to the fact that these conditions cause greater susceptibility for fat to build up in the liver.”Â

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According to Kardashian, past studies have established an association between obesity and diabetes and fast food. However, the present study is one of the first to demonstrate that eating fast food or having 20% of one’s diet composed of fast food can affect liver health and lead to fatty liver.
The study’s findings likewise revealed that even a modest amount of fast food could hurt the liver. For example, if individuals eat only one meal of fast food a day but if the meal equals 20% of their daily caloric intake, this can increase the risk of liver disease.
In the study, fast food meals include pizza, burgers and other typical fast food meals. The investigators performed fatty liver measurements in 4,000 adults in the study. These measurements were then compared with their consumption of fast food.

More than half, or 52%, of those surveyed, had consumed some fast food. Of those who have eaten fast food, 29% consumed 20% of their daily caloric needs from fast food. Only this subgroup of the sample population experienced increased fat levels in their liver.
When 20% or one-fifth of one’s diet is made up of fast food, this can increase the risk of liver steatosis, regardless if the individual has or does not have diabetes or is obese or has average body mass index (BMI).
The findings prompted Kardashian to state that their study’s results are alarming since fast food consumption has increased in the last fifty years, regardless of the individual’s socioeconomic status.
The authors of the study recommended offering patients more education on nutrition, especially those with diabetes or obesity and at higher risk of developing a fatty liver from eating fast food.
Improving one’s diet is the only way to treat early-stage NAFLD or liver steatosis. Apart from avoiding fast food, some strategies can help prevent NAFLD.
A diet that can prevent fatty liver
- Plant-based protein diet. Getting protein from plants or consuming less red meat has reduced the risk of obesity and type 2 diabetes mellitus. Further, a plant-based protein diet can increase longevity and health span.
- Diet rich in complex carbohydrates. Complex carbohydrates, such as vegetables, legumes and nuts, can ward off heart diseases and fatty liver disease.
- Diet high in fish content. Eating fish has been shown to reduce the risk of cardiovascular diseases since fishes are rich in omega-3 fatty acids, proteins and nutrients. Unlike red meat or fatty meat, fish do not contain animal fats that can increase cholesterol deposits in the blood vessel walls.
- Diet rich in fruits and vegetables. Fruits and vegetables are rich sources of nutrients, vitamins and minerals. They are also excellent antioxidants and can promote longevity and delay cellular ageing. Further, fruits and vegetables can help the liver to be healthy and reduce the risk of developing fatty liver disease.
Besides a healthy diet, being physically active can also reduce body fats and fats in the liver. The World Health Organisation recommends at least 150 minutes of moderate to vigorous-intensity physical exercise every week, regardless of age and gender.
Strength training and aerobic exercises can lower cholesterol levels and the risk of fatty liver disease. Reducing cholesterol levels in the blood can also help prevent the risk of cardiovascular disease and obesity, which are risk factors for NAFLD.
In addition, individuals can also undergo intermittent fasting or periodic fasting. Intermittent fasting happens when individuals abstain from food for at least 12-16 hours a day, while periodic fasting goes without food for 24-48 hours every month or periodically. Researchers have found that regular fasting can increase longevity and reduce the risk of obesity and cardiovascular diseases, the risk factors of fatty liver disease.
Take home message
Fast foods are readily available and can save cooking time for those who dine in restaurants that offer these types of food. Further, fast foods are cheap, which makes these foods highly accessible. However, eating fast foods or having one-fifth of your diet composed of fast foods can significantly increase your risk of NAFLD.
Adopting healthy eating habits and incorporating more fruits and vegetables in your diet could help reduce the risk of fatty liver. You can choose to make homemade meals since these are healthier compared with fast foods and ward off the risk of NAFLD.Â

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[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196377/
[2] https://www.cghjournal.org/article/S1542-3565(22)01137-5/fulltext
[3] https://www.thelancet.com/journals/langas/article/PIIS2468-1253(22)00317-X/fulltext