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Non-alcoholic fatty liver disease (NAFLD), recently renamed to metabolic dysfunction-associated steatotic liver disease (MASLD), is a condition where excess fat builds up in the liver of people who drink little to no alcohol. It is the most common form of chronic liver disease worldwide and ranges from simple steatosis (fatty liver) to non-alcoholic steatohepatitis (NASH), which involves inflammation and liver cell damage. If left untreated, it can progress to fibrosis, cirrhosis, and liver failure.
Common symptoms
Fatigue or extreme tiredness
General feeling of being unwell (malaise)
Dull ache or discomfort in the upper right abdomen
Unexplained weight loss
Swelling in the abdomen (ascites) in advanced stages
Swelling in the legs, ankles, or feet (edema)
Yellowing of the skin and eyes (jaundice)
Itchy skin
Easy bruising or bleeding
Possible causes
Overweight or obesity, especially central (abdominal) fat
Insulin resistance or type 2 diabetes
High levels of fats (cholesterol and triglycerides) in the blood
Metabolic syndrome
High blood pressure
Polycystic ovary syndrome (PCOS)
Underactive thyroid (hypothyroidism) or pituitary gland
Medical treatment
Gradual weight loss (target of 7-10% of total body weight)
Adopting a healthy diet, such as the Mediterranean diet, low in simple sugars and saturated fats
Regular physical activity (at least 150 minutes of aerobic exercise per week)
Managing underlying conditions like diabetes and high cholesterol
Avoiding alcohol and certain medications that may stress the liver
Pharmacological options for NASH (e.g., resmetirom/Rezdiffra, Vitamin E, or pioglitazone in specific cases)
Liver transplantation for end-stage cirrhosis
Ayurvedic perspective
In Ayurveda, NAFLD is categorized as a Santarpanajanya Vyadhi (disease of over-nutrition) and a Yakrit Vikara (liver disorder). The condition begins with Agnimandya (impaired metabolic fire), specifically at the Jatharagni and Dhatvagni levels. This weakness in digestion leads to the formation of Ama (metabolic toxins), which obstructs the Srotas (microchannels). The Kapha dosha and Meda Dhatu (fat tissue) subsequently accumulate in the Yakrit (liver), which is the seat of Ranjaka Pitta and the root of Raktavaha Srotas (blood channels). If untreated, the progression moves from Kaphaja (steatosis) to Pittaja (inflammation/NASH) and eventually Vataja (fibrosis/cirrhosis).
Ayurvedic dietary guidelines
Consume Laghu (light) and Ruksha (dry) foods such as Yava (barley) and millets
Include Tikta (bitter) vegetables like Karavellaka (bitter gourd) and Patola (pointed gourd)
Incorporate buttermilk (Takra) seasoned with roasted cumin and ginger
Avoid Abhishyandi (clogging) foods like heavy dairy, refined flour, and sweets
Restrict intake of high-fructose fruits and saturated fats
