Liver Health

Updated 22 November 2019

Who gets non-alcoholic fatty liver disease?

People who are overweight or obese are more likely to get non-alcoholic fatty liver disease.

Long considered an occasional finding of little significance, non-alcoholic fatty liver disease (NAFLD) is now a major global health problem that’s closely linked to overweight and obesity. 

In recent years, the world has seen an increase in the non-alcoholic fatty liver disease (NAFLD) along with the growing obesity epidemic. For example, in the United States, the prevalence of NAFLD has risen from 18% in 1988–1991 to 31% in 2011–2012.

Estimates suggest that about 20-30% of the general adult population and 80-90% of obese people living in western countries have some degree of NAFLD – the most common liver problem worldwide. The highest prevalence is reported in the Middle East (31.8%) and South America (30.5%), with the lowest prevalence reported in Africa (13.5%).

Worldwide, the estimated prevalence of NAFLD is approximately 30-40% in men and 15-20% in women. Most people who are diagnosed with NAFLD are between the ages of 40 and 60.

Within the next decade, NAFLD is also expected to become the leading cause of liver disease and liver failure in children and teenagers across the western world. Although NAFLD have been reported in children as young as two years old, children usually present with the disease when they’re older than 10 years of age.

The estimated prevalence of NAFLD in people with type 2 diabetes is thought to be around 70%. What’s more, 10-30% of people with NAFLD have non-alcoholic steatohepatitis (NASH), which is the stage that could progress to cirrhosis and liver failure.

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.