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Liver Health Q1 2022

How to stop the NAFLD domino effect

iStock / Getty Images Plus / JuliarStudio

Yiannoula Koulla

Leader of NAFLD/NASH Working Group, European Liver Patients’ Association

Dr Teresa Casanovas M.D

Scientific Committee Leader, European Liver Patients’ Association (ELPA)

In recent years, non-alcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease.

Based on the official studies, NAFLD affects one in four adults and one in 10 children/adolescents in Europe1. The prevalence and incidence of the condition are expected to increase worldwide as the global obesity epidemic spreads and the trend in developing countries toward the Western lifestyle continues.

NAFLD can cause what is called the ‘domino effect’ and together with co-morbidities such as obesity, hypertension and hypertriglyceridemia can be the cause of cirrhosis and hepatocellular carcinoma. COVID-19 pandemic measures may have played an essential role in the global increase of the NAFLD ‘domino effect’ as most individuals needed to change how they live, work, study and socialise.

Pandemic changes in lifestyle

In combination with the isolation measures, these sudden changes influenced emotional and psychosocial wellbeing, as well as food habits. The pandemic has affected our lives and contributed to increasing the time we spend in front of a screen, maybe eating while watching, paying less attention to the size of the portion, or the quality of food. In addition, this means greater exposure to advertising of unhealthy products and decreased physical activity. In addition, an increase in harmful alcohol use has been reported.

It is also clear how health care systems must be improved to fight inequalities across Europe and not leave some people behind. 

New working group needed

The European Liver Patients Association (ELPA) strongly believes that 2022 is crucial to frame a set of specific action steps the EU and stop the ‘domino effect’ of the disease. A specific working group has been created within ELPA members to work precisely in that direction.

Recently, the working group, together with the ELPA Scientific committee coordinator, Dr Teresa Casanovas, has organised a survey which in the first phase aimed to:

  1. Find out the knowledge level of the disease among the general population.
  2. Uncover the unmet needs of people living with this disease.

The survey was translated into seven different languages, and the final results will be announced in September 2022.

International NASH day

Another critical step ELPA is taking in fighting the ‘domino effect’ is gathering all stakeholders, and discussing important, framing issues related to NAFLD patients on June 9, 2022 – international NASH day.

These two actions are essential because citizens need health literacy and updated scientific information. Politicians should introduce changes in legislation related to food and alcohol labels. It is also clear how health care systems must be improved to fight inequalities across Europe and not leave some people behind.

We are aware that liver diseases have a significant public health component and many liver diseases might be preventable; NASH is one of them.

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