eISSN: 2373-6372 GHOA

Gastroenterology & Hepatology: Open Access
Volume 4 Issue 1 - 2016
Fatty Liver: A Pure Harvest of Sedentary Life or Something Else?
Pezhman Alavinejad*
Department of Gastroenterology, Ahvaz Jundishapur University of Medical Sciences, Iran
Received: January 3, 2016 | Published: January 29, 2016
*Corresponding author: Pezhman Alavinejad, Gastroenterologist, Hepatologist, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Tel: +989161115880; E mail:
Citation: Alavinejad P (2016) Fatty Liver: A Pure Harvest of Sedentary Life or Something Else?. Gastroenterol Hepatol Open Access 4(1): 00086. DOI: 10.15406/ghoa.2016.04.00086


Currently nonalcoholic fatty liver disease (NAFLD) is one of the major and rapidly growing public health problems worldwide [1-3]. In recent years, its prevalence has increased continuously [4-7] and it is currently estimated that as high as one billion people be involved with NAFLD [8]. This condition is one of the most common liver diseases among western countries, currently 2 to 3 times more prevalent than hepatitis B, C and or alcohol related liver disorders and consider as the most common reason of disturbed liver function tests [9,10]. Its prevalence has been reported to be about 10 to 24% in general population and up to 75% among obese subjects [11-13]. Recent surveys in eastern countries have also revealed an increasing incidence of fatty liver due to changes in life style, tendency toward sedentary life, low physical activity, central obesity and diabetes Mellitus type 2 and population based studies estimated its prevalence about 15 to 30% of community and comparable to western countries [14-19]. The epidemiologic studies have proved the important role of the sedentary life style in accumulating fat in liver and introducing fatty liver disease [8, 20,21] and based on important role of life style in different stages of fatty liver, the most fundamental step in management of NAFLD is treating the risk factors through life style modification [22-24].

The huge burden of urbanization and reducing physical activity has begun since more than 50 years ago [25,26] and even in recent years, there is more focus on correcting the life style and encouraging general population to maintain some degrees of physical activity [27-29]. So it could be simplification of story to pertain all of the NAFLD pandemic to just sedentary life style and maybe it is the time for a little bit more thinking about it. It could handle a big question that is there any other culprit else?

And we should keep in mind the story of celiac disease and its increasing prevalence in recent years. Researchers reported that the prevalence of undiagnosed celiac disease increased 4-fold during the past half century [30]. Another study found similar results by comparison of 50-year-old frozen serum samples from healthy recruits in the US Air Force with samples collected recently from sex-matched subjects [31]. During the past decades, wheat has gained alterations that increased production, pest resistance, and baking properties. These changes altered the macronutrient profile (particularly of protein and immunogenic peptides), and increased the speed of wheat-flour processing, eliminating fermentation before baking. These changes might have contributed to the increased prevalence of celiac disease in the past few decades. May be the wheat story is also happening for other food products including poultry and meat. If this immunogenic and structural changes prove about these food products, then an allergic and or immunogenic base could be supposable for fatty liver and its rapid spreading. And maybe it’s time to revise and think that “are industrial revolution and nutritional advances necessarily useful for human health?”


  1. Sanyal AJ (2011) NASH: a global health problem. Hepatol Res 41(7): 670-674.
  2. Cohen JC, Horton JD, Hobbs HH (2011) Human fatty liver disease: old questions and new insights. Science 332(6037): 1519-1523.
  3. Cao HX, Fan JG (2011) Fatty liver disease: a growing public health problem worldwide. Journal of digestive diseases 12(1): 1-2.
  4. Kojima S, Watanabe N, Numata M, Ogawa T, Matsuzaki S (2003) Increase in the prevalence of fatty liver in Japan over the past 12 years: analysis of clinical background. J Gastroenterol 38(10): 954-961.
  5. Angulo P (2007) GI epidemiology: nonalcoholic fatty liver disease. Aliment Pharmacol Ther 25(8): 883-889.
  6. Williams R (2006) Global challenges in liver disease. Hepatology 44(3): 521-526.
  7. Fan JG, Farrell GC (2009) Epidemiology of non-alcoholic fatty liver disease in China. J Hepatol 50(1): 204-210.
  8. Loomba R, Sanyal AJ (2013) The global NAFLD epidemic. Nat Rev Gastroenterol Hepatol 10(11): 686-690.
  9. Neuschwander-Tetri BA, Caldwell SH (2003) Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology 37(5): 1202-1219.
  10. Bellentani S, Saccoccio G, Masutti F, Crocè LS, Brandi G, et al. (2000) Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med 132(2): 112-117.
  11. Ludwig J, Viggiano TR, McGill DB, Oh BJ (1980) Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 55(7): 434-438.
  12. Sheth SG, Fredric DG, Sanjiv C (1997) Nonalcoholic steatohepatitis. Annals of internal medicine 126(2): 137-145.
  13. Targher G, Bertolini L, Padovani R, Rodella S, Tessari R, et al. (2007) Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes care 30(5): 1212-1218.
  14. Park HS, Han JH, Choi KM, Kim SM (2005) Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents. The American journal of clinical nutrition 82(5): 1046-1051.
  15. Jamali R, Jamali A (2010) Non-alcoholic Fatty Liver Disease. Journal of Kashan University of Medical Science 14(2): 169-181.
  16. Jamali R, Khonsari M, Merat S, Khoshnia M, Jafari E, et al. (2008) Persistent alanine aminotransferase elevation among the general Iranian population: prevalence and causes. World J Gastroenterol14(18): 2867-2871.
  17. Park SH, Jeon WK, Kim SH, Kim HJ, Park DI, et al. (2006) Prevalence and risk factors of non‐alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol 21(1): 138-143.
  18. Fan JG, Farrell GC (2009) Epidemiology of non-alcoholic fatty liver disease in China. Journal of hepatology 50(1): 204-210.
  19. Amarapurkar D, Kamani P, Patel N, Gupte P, Kumar P, et al. (2007) Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol 6(3): 161-163.
  20. Erickson, Sandra K (2009) Nonalcoholic fatty liver disease. Journal of lipid research 50(Suppl): S412-S416.
  21. Cave M, Deaciuc I, Mendez C, Song Z, Joshi-Barve S, et al. (2007) Nonalcoholic fatty liver disease: predisposing factors and the role of nutrition. J Nutr Biochem 18(3): 184-195.
  22. Harrison SA, Day CP (2007) Benefits of lifestyle modification in NAFLD. Gut 56(12): 1760-1769.
  23. Barrera F, George J (2014) The role of diet and nutritional intervention for the management of patients with NAFLD. Clinics in liver disease 18(1): 91-112.
  24. Gerber LH, Weinstein A, Pawloski L (2014) Role of exercise in optimizing the functional status of patients with nonalcoholic fatty liver disease. Clin Liver Dis 18(1): 113-127.
  25. Barry MP (1999) Urbanization, lifestyle changes and the nutrition transition. World Development 27(11): 1905-1916.
  26. United States (1996) Department of Health, and Human Services. Physical activity and health: a report of the Surgeon General. Diane Publishing, USA.
  27. Jacoby E, Goldstein J, López A, Núñez E, López T (2003) Social class, family, and life-style factors associated with overweight and obesity among adults in Peruvian cities. Preventive medicine 37(5): 396-405.
  28. Lawrence DF, Engelke PO (2001) The built environment and human activity patterns: exploring the impacts of urban form on public health. Journal of Planning Literature 16(2): 202-218.
  29. Al-Hazzaa HM, Musaiger AO, Arab Teens Lifestyle Study Research Group (2010) Physical activity patterns and eating habits of adolescents living in major Arab cities. The Arab Teens Lifestyle Study. Saudi Med J 31(2): 210-211.
  30. Catassi C, Kryszak D, Bhatti B, Sturgeon C, Helzlsouer K, et al. (2010) Natural history of celiac disease autoimmunity in a USA cohort followed since 1974. Ann Med 42(7): 530-538.
  31. Riddle MS, Murray JA, Porter CK (2012) The incidence and risk of celiac disease in a healthy US adult population. Am J Gastroenterol 107(8): 1248-1255.
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