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Liver Health

Updated 20 July 2018

Risk factors for non-alcoholic fatty liver disease

It is mostly several unhealthy lifestyle factors that will put you at risk for non-alcoholic fatty liver disease.

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Lifestyle issues such as an unhealthy diet and physical inactivity may put you at risk for overweight/obesity and, consequently, non-alcoholic fatty liver disease (NAFLD). Research shows that the prevalence of NAFLD steeply increases with increased body mass index (BMI) and waist circumference.

If you’re already insulin resistant or have diabetes, high blood pressure, high blood fat levels and/or the metabolic syndrome, you’re also at increased risk for NAFLD.

If you have a family member with NAFLD, it’s worth talking to your doctor about your risk. Studies among twins have shown that both simple fatty liver (hepatic steatosis) and the formation of an abnormally large amount of scar tissue in the liver (fibrosis) are heritable traits.

Ethnicity also plays a role. The prevalence of NAFLD in African Americans appears to be lower than in other population groups in the United States, with the burden of disease highest among Hispanics. In South Africa, the African population group seems to be at lower risk than the Indian, Mixed-Ancestry and Caucasian populations.

  • The major risk factors for advanced disease include:
  • Age (older than 45 years of age)
  • Overweight/obesity
  • Insulin resistance (this counts for young, non-obese individuals too)
  • Ethnicity

Reviewed by Dr Mark Sonderup, B Pharm, MB ChB, FCP (SA). Senior Specialist, Division of Hepatology, Department of Medicine, University of Cape Town and Groote Schuur Hospital. July 2018.