The risk factors for non-alcoholic fatty liver disease mirror those of heart disease—obesity, diabetes or pre-diabetes, high cholesterol or high triglycerides. (For Spectrum Health Beat)

Liver disease. That’s often associated with genetic conditions, high alcohol consumption or viruses like hepatitis, right?

It can be, but another type of liver trouble is also common—and many people aren’t even aware of it.

It’s called non-alcoholic fatty liver disease, an abnormal buildup of fat in the liver. Over time, the condition can damage both the liver and the heart.

About 1 in 4 adults worldwide have non-alcoholic fatty liver disease and may not even realize it, according to the American Heart Association.

As the name implies, non-alcoholic fatty liver disease affects people who drink little or no alcohol. The risk factors mirror those for heart disease: obesity, diabetes or pre-diabetes, high cholesterol or high triglycerides.

The prevalence of the disease does not surprise Thomas Boyden, MD, a preventive cardiologist at Spectrum Health.

“We’re not the healthiest society,” he said.

Unhealthy habits, such as overeating foods high in fat and low in nutrition, can change the body’s composition.

“We’re seeing people developing infiltration of fat in the liver,” Dr. Boyden said. “Too much can cause liver cancer or cirrhosis. So we have to take these things seriously.”

And it can hurt your heart.

Heart disease is the No. 1 cause of death for people with non-alcoholic fatty liver disease.

“All these things that put you at risk of fatty liver disease are the things that tip people over the edge for heart disease,” Dr. Boyden said.

And they don’t just add to your risk, they multiply it, he said.

Balance the scale

While obesity can increase your risk of developing non-alcoholic fatty liver disease, “your weight is not as important as your habits,” Dr. Boyden said.

Eating too many processed foods and simple carbohydrates, for example, can increase glucose and blood sugar levels. This creates fat tissue that can infiltrate the liver.

By improving your health habits, you’re more likely to reduce the risk of developing liver disease in the first place—but it can also rid this workhorse organ of harmful fats.

Patients who make healthier choices may also find they sleep better, as well as noticing improvements in blood pressure and overall health.

Dr. Boyden said he recommends the Mediterranean diet, rich in leafy greens, vegetables, fruits, whole grains and beans.

Plant-based foods provide plentiful complex carbohydrates and fiber.

“When you eat a lot of plant-based foods, you’re getting a lot of nutrients and not a lot of empty calories,” he said.

The Mediterranean diet doesn’t require giving up all dairy and animal-based protein, which can make the diet appealing to those who would like to continue eating these types of foods.

Targeted approach

Some people may not realize they have non-alcoholic fatty liver disease, because they don’t show symptoms.

“It’s often picked up incidentally when we’re looking for something else,” Dr. Boyden said.

An ultrasound for abdominal pain, for instance, may reveal fatty deposits in the liver.

Dr. Boyden recommends a targeted approach rather than blanket screening.

Patients with conditions such as diabetes or high cholesterol can talk to their doctor about steps they can take to avoid developing non-alcoholic fatty liver disease. Consulting a dietitian may also help.

Armed with this information, patients can make changes that may help keep their liver—and their heart—healthy.