Researchers at the University of Michigan have made a surprising discovery: people who have non-alcoholic fatty liver disease (NAFLD) and a normal body weight are more likely to have heart disease than people with NAFLD who are overweight or obese.
NAFLD is a condition where too much fat builds up in the liver cells, even though a person drinks little or no alcohol. It is a serious health issue because it can lead to liver problems like cirrhosis and also increase the risk of diabetes, heart disease, and kidney disease.
While NAFLD is more common in people who are overweight or obese, it can also happen in people with a normal body mass index (BMI).
Until now, little research has been done on how NAFLD affects people with normal weight. In this new study, researchers looked at the health records of more than 10,000 adults with NAFLD who were treated at the University of Michigan Hospital between 2012 and 2021.
They compared rates of liver scarring (cirrhosis), heart disease, metabolic conditions like diabetes, and kidney disease across four groups based on BMI: lean (BMI 18.5–24.9), overweight (BMI 25–29.9), class 1 obesity (BMI 30–34.9), and class 2-3 obesity (BMI 35–40).
They found that lean patients—those with normal weight—had fewer cases of cirrhosis, diabetes, high blood pressure, and abnormal cholesterol compared to heavier patients.
However, to their surprise, lean patients had a much higher rate of heart disease, including peripheral vascular disease (poor circulation in the limbs) and brain-vascular disease (problems with blood vessels in the brain).
The researchers had expected that people with normal weight would have fewer heart and metabolic problems. Instead, they found that having a normal BMI did not protect people with NAFLD from heart disease. In fact, lean people with NAFLD seemed to be at even greater risk for heart problems than heavier patients with the same liver condition.
Because of these unexpected results, the researchers urge doctors not to overlook heart disease risks in lean patients with NAFLD. They emphasize that having a normal weight does not mean a person with fatty liver disease is safe from serious health problems.
The team also plans to conduct more studies to follow these patients over time and find out why lean people with NAFLD might be more likely to develop heart disease.
If you have NAFLD, it’s important to take steps to protect your heart. Here are some ways to lower your risk of heart disease:
Maintain a healthy weight. Even if you are already at a normal weight, staying healthy with good lifestyle habits is important.
Eat a balanced diet. Focus on fruits, vegetables, whole grains, lean protein, and healthy fats like olive oil. Cut back on processed foods, added sugars, and unhealthy fats.
Exercise regularly. Aim for at least 30 minutes of moderate activity most days of the week.
Manage blood pressure and cholesterol. Work with your doctor to keep these numbers in a healthy range.
Quit smoking. Smoking greatly increases the risk of heart disease.
Manage other conditions. If you have diabetes or other health issues, proper management can help protect your heart.
Get regular check-ups. Seeing your doctor regularly helps catch any new problems early.
By following these healthy habits, you can help lower your risk of heart disease, even if you have NAFLD and a normal body weight.
If you’re interested in liver health, you might want to check out recent studies showing that dairy foods may be linked to liver cancer, while drinking coffee could lower the risk of liver cancer by half. For heart health, studies are also finding new ways to remove plaques from arteries and prevent heart attacks and strokes.
This study on NAFLD and heart disease was led by Karn Wijarnpreecha and his team.
If you care about liver health, please read studies that refined fiber is link to liver cancer, and the best and worst foods for liver health.
For more health information, please see recent studies about how to boost your liver naturally, and simple ways to detox your liver.
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