Around 20% of Spaniards have fatty liver, a disease associated with obesity and diabetes and that can be prevented, before it causes irreparable damage, by losing weight and eliminating the consumption of alcohol and junk food.
extreme concern of the doctors around to an almost unknown topic: fatty liver, a disease that is progressing unstoppably in Spain. A silent epidemic – already affecting 20% of the Spanish population – closely linked to obesity and diabetes and, in turn, sedentary lifestyle, to alcohol and junk food. A particularly alarming advance due to its incidence on liver cancer. This was stated today in Madrid by Dr. José Luis Callejapresident of the Spanish Association for the Study of the Liver (AEEH). The youngest eat worse and drink more alcohol. And it doesn’t help, he warned the expensiveness of the healthiest foods. “Today, in Spain, a liter of wine is cheaper than water and junk food is much cheaper than healthy food. Either the legislation is changed or the groups with fewer resources will be poorer and more sick,” denounced the doctor.
The Spanish Association for the Study of the Liver (AEEH) has started this Wednesday in Madrid its 48th Congress. More than 800 specialists and they will talk about fatty liver, liver cancer, hepatitis C, hepatitis Delta…Until Friday, several hundred studies and research carried out by Spanish hepatologists on prevention, screening and treatment will be presented of the different pathologies of the liver. Dr. Calleja, head of the Gastroenterology and Hepatology Service of the University Hospital Iron door (Madrid), began by calling attention to liver diseases. Still very unknown, he said, by society.
A national plan for fatty liver
The evolution of the prevalence of diseases liver disease is not a problem only in Spain. They are growing worldwide in terms of morbidity and mortality. They are one of the main causes of lost years of working life and quality of life. The number of deaths from cirrhosis in the world has gone from 1.9% to 2.4% between 2009 and 2016. And these figures will increase, warn hepatologists, because its impact is growing more and more and in young people, too in Spain. However, and outside the 2015 Hepatitis C Management Plan, there is no Reference Framework Document in the National Health System to start acting in a common way. That’s why, They ask for a National Plan on Pathologies of the Liver.
The advance of cases of fatty liver is closely linked to the epidemic of obesity and diabetes that exists in the population
Because, when going into detail, Dr. Calleja explains that, until 2015, the main cause of this type of ailment in our country was hepatitis C and -thanks to the appearance of medicines to cure the disease- in only 6 or 7 years has ceased to be a frequent cause. However, the specialist has warned, “at the same time that the incidence of hepatitis C was decreasing as a cause of cirrhosis, need for transplantation and liver cancerthe presence of fatty liver was increasing”. Closely linked, he added, “to the epidemic of obesity and diabetes that exists in the population”.
The unknown Metabolic Liver Disease (EHMet), better known as fatty liver, already affects 1 in 4 adults in Spain and is probably the silent pathology with the greatest potential risk to public health, due to its association with obesity and sedentary lifestyle, and with close to two thousand new diagnoses each year of people who are already in advanced stages of the disease. Right now, it is the third cause of this type of cancer, but experts consider it likely to be the first in a decade, given the advance of its prevalence.
Fatty liver, a silent disease
It is present, said the president of the hepatologists, in 20% of the Spanish population. And, although only a small part, will cause a more important picture -initially accompanied by inflammation and, later, by cirrhosis- in the end it will end up being the main cause of advanced liver disease. Dr. José Luis Calleja explained that, in United Statesthis sickness It is already the first cause of transplantation. “In Spain we are in the same dynamic,” she warned, alluding to the high rates of childhood obesity in children and adolescents.
Eight out of ten overweight people have fatty liver, and are at risk of developing cirrhosis at an early age
Therefore, the concern on fatty liver is double due to its impact on adolescents and young peoplea segment in which recent studies have estimated that up to eight out of ten people overweight already have fatty liver, and are at risk of developing cirrhosis at an early age. As has been said, obesity and overweight are, precisely, together with type 2 diabetes, cholesterol and high blood pressurethe main risk factors of Metabolic Liver Disease.
The change in patients with fatty liver
“In hospitals, we used to see middle-aged patients with hepatitis C infection, but now it’s an older patient with obesity and diabetes, and in that setting, he’s developed cirrhosis.” The specialist referred to the type of life we lead. And he asked the administrations for firmness and that they invest in prevention -most liver diseases are preventable-, but also, he stressed, asymptomatic, so that sometimes, when the damage is detected, It’s too late.
“The liver is very grateful. Even if you have a very significant injury, if the insult that is being done to that liver stops; if the patient loses weight, stop drinking alcohol, hepatitis C is treated…it heals quite well. That’s why we need a national liver disease prevention plan“said the specialist.
Less resources and more sick
The specialist spoke very loud and very clear. “In Spain there is a very easy consumption of alcohol. Just yesterday a study was published in which it was said that more than 50% of people under the age of 18 have tried alcohol and it’s creepy. Today, wine has a cheaper price than water, “he criticized. Society” has to know that, in any hospital, 50% of those admitted to digestive plants they are for alcohol problems“, he added.
But, in line with what many of his colleagues have been denouncing in recent months, it is not only worth talking about what should be done to maintain a healthy life. Rather, to provide people with resources so that they can have quality of life. For example, eating well. “Junk food, ultra-processed food, is much cheaper than healthy food. Either the legislation is changed or the groups with fewer resources will be poorer and sicker because we are going to put cheaper food available,” said the doctor.
In the absence of treatmentsthe doctors insist, it is even more necessary to optimize the strategies that have been shown to be efficient in preventing the progression of the disease: weight reduction and exercise. But for this, Multidisciplinary Units are needed, where there are specialists who can prescribe diet and physical exercise (Liver Rehabilitation Units) focused on achieving the desired results. It is there where the hepatologists return to put the accent. Regarding practice, recommending a healthy diet is easy, but there are many patients who currently cannot afford to buy healthy food due to its high cost..
If experts predict that fatty liver is going to become the main cause of liver cancer in less than a decade is because its presence has tripled in the last ten years in Spain. It is the second type of cancer that subtracts the most years of life from the population and every year 6,600 new cases are diagnosed in our country, half already in advanced stages, which reduces five times their chances of survival.
Liver cancer represents 2.3% of all tumors and the sixth in order of frequency, but the fear of specialists is that its prevalence will grow if not, as has been said, the epidemic of fatty liver linked to to obesity and diabetes. Hepatocellular carcinoma is the most frequent primary liver tumor, accounting for between 80-90 percent of the cases of this pathology, followed by cholangiocarcinoma.
The AEEH is already advancing on a draft strategy that it wants to present to the Ministry of Health in the coming months
The key to improving the results in relation to all these diseases is prevention and early diagnosis, the doctors insist. The AEEH is already making progress on a draft strategy that they want to present to the Ministry of Health in the coming months with the intention that it can be discussed with the autonomous communities and finally approved in the Interterritorial Health Council. The success of the 2015 Hepatitis C Plan is the model that we want to reproduce now, extended to other liver diseases and with special attention to precisely fatty liver.
Along with the need to improve preventionthe lack of simple and precise diagnostic tests, the absence of a common specific treatment for these diseases and the possibilities that personalized medicine opens up represent, according to the AEEH specialists, a huge challenge for the health system.