How dangerous is a fatty liver (hepatic steatosis)?
For most people a fatty liver is stable for the time being, but it substantially raises the risk of cardiovascular disease, diabetes and liver disease; losing weight is so far the only proven way to limit the damage.
A fatty liver is by far the most common liver disease in the world: roughly one in four adults has it. In the United States the figure is almost one in three. Most people notice nothing at first, but the disease is anything but harmless. Cardiovascular disease is the most common cause of death in people with a fatty liver, not the liver itself. Cancer outside the liver ranks second. Liver disease comes only after that. This means a fatty liver puts the entire body at risk, even when the liver itself has not yet been seriously damaged. There is also a strong interaction with type 2 diabetes and chronic kidney disease: the conditions reinforce one another. In some people the fatty liver progresses to a more serious stage, one that involves inflammation and cell damage. Well over 66% of people above the age of 50 with diabetes or severe obesity already have such an advanced stage. Twenty percent of those with this more serious stage eventually develop liver cirrhosis, in which the liver consists largely of scar tissue. This is irreversible, and the condition is on track to become the most common reason for a liver transplant. Notably, liver cell cancer can also develop before cirrhosis is present, in up to half of NAFLD-related cases. The more scar tissue already present in the liver, the greater the risk of dying, both from liver disease and from other conditions. The severity of fibrosis is therefore the most important measure of prognosis. The only approach with proven effects on scar tissue formation is losing weight and adopting a healthier lifestyle. The more weight you lose, the greater the improvement. There is no approved medication specifically for a fatty liver. Some agents such as vitamin E or certain diabetes medications are being investigated, but their effect is modest and they have not been officially approved for this condition.
This answer is based on multiple systematic reviews and a meta-analysis. The meta-analysis covers dozens of studies on global prevalence and mortality figures. On most points the evidence is solid and consistent; the figures on progression to more serious stages are estimates with some uncertainty, because large long-term studies in humans are difficult to conduct and most data come from selected patient groups.
How harmful are trans fats, exactly?
Industrial trans fats are demonstrably harmful to your heart and blood vessels, even in small amounts. Avoid them by checking ingredient lists for 'partially hydrogenated oil'.
How dangerous is belly fat?
Belly fat is a serious risk factor for cardiovascular disease, heart failure, and premature death, and the risk increases the longer it remains elevated. A combination of a Mediterranean diet and regular physical activity is the best-supported approach for reducing it.
Is atrial fibrillation dangerous, and what can I do about it?
Atrial fibrillation substantially increases your risk of death, heart failure, and stroke, and requires active treatment. Discuss blood thinners for stroke prevention with your doctor, as well as which lifestyle changes are worthwhile in your specific situation.
How bad is eating a lot of salt for me?
Eating a lot of salt is clearly harmful to your blood pressure and your heart, and the risk grows with the amount consumed. Eating more vegetables and fruit helps to temper the effect, but does not replace reducing salt intake.
How healthy are my blood vessels / what is my vascular age?
For a first impression of your vascular health, an ApoB blood test is the simplest and most accessible step; a CAC scan adds the most value when your risk remains unclear after blood testing.
How healthy is olive oil and what is it good for?
Olive oil, and extra-virgin olive oil in particular, is well supported as protective for the heart and blood vessels, especially when used in place of butter and as part of a varied, plant-based diet.