Dr Anil Arora, DM(Gastro), AIIMS, FRCP(EDINBURG), FRCP(LONDON)
Director
Institute of Liver Gastroenterology & Pancreatic Biliary Sciences
Sir Ganga Ram Hospital
Visiting Fellow
Queen Elizabeth Hospital, Birmingham (U.K.)
An Interview published in Indian Express 10.06.2025, on World Liver Day
In today’s fast-paced world, one of the most overlooked yet rapidly rising threats to our health is not a virus or a cancer — it’s fat. But not the kind you see on a weighing scale — we’re talking about fatty liver disease, a quiet disruptor that can progress to life-threatening conditions if ignored. We sat down with one of India’s foremost liver experts, Dr. Anil Arora, to understand how our food, lifestyle, and choices are shaping the fate of our livers — and what we can do to take control.
Q: Dr. Arora, why is fatty liver disease suddenly getting so much attention?
A: That’s a great question — and an important one. The truth is, fatty liver disease has become a modern epidemic. It used to be something we saw in people with chronic alcohol use. But now, non-alcoholic fatty liver disease (NAFLD) is on the rise — especially among young, seemingly healthy individuals. Poor diets, sedentary lifestyles, rising obesity, stress, and even sleep deprivation all contribute. What’s scary is that the liver suffers in silence. By the time symptoms appear, damage may already be advanced.
Q: What exactly is fatty liver disease? And why should the average person care?
A: Fatty liver is what it sounds like — excess fat buildup in the liver cells. Normally, a healthy liver has little to no fat. When fat exceeds 5% of the liver’s weight, it becomes a concern. If left unchecked, it can progress to inflammation, scarring (fibrosis), cirrhosis, and even liver cancer. The general public needs to care because this is preventable. It’s not something that happens overnight — it’s a reflection of long-term habits. And if caught early, it’s completely reversible.
Q: So, who’s most at risk?
A: Anyone with obesity, type 2 diabetes, high cholesterol, or metabolic syndrome and even those with polycystic ovary syndrome (PCOS) is at increased risk. But we’re now seeing it in individuals who are not overweight or fat, too — especially those who consume excess sugar, processed foods, or have poor physical activity levels. Children and teenagers, especially in urban settings with poor physical activity and poor diet, are increasingly being diagnosed. So it’s not limited to a specific age or gender anymore. It’s no longer a disease of the middle-aged — it’s a warning sign of our lifestyle.
Q: You mentioned it’s silent. How does one know if they have it?
A: Most people with fatty liver feel absolutely fine — no pain, no discomfort. It’s often caught incidentally on an ultrasound or through elevated liver enzymes in a blood test. That’s why routine health checks are crucial, especially if you fall into a risk group. Once fibrosis begins, symptoms like fatigue, weakness, and abdominal discomfort may appear — but that’s late.
Q: Let’s talk food. What’s the connection between our diet and liver health?
A: The liver is your body’s metabolic engine — everything you eat, drink, or swallow passes through it. Unfortunately, we’re consuming high-calorie, low-nutrient, ultra-processed foods, sugary drinks, and excess fat. Over time, this overwhelms the liver’s ability to process fats and sugars, leading to fat accumulation. The liver becomes inflamed, insulin resistance kicks in, and damage begins.
But the good news? Just as the liver can be damaged by food, it can also be healed by food.
Q: What are some liver-friendly foods you recommend?
A: I encourage a Mediterranean-style diet. This includes:
- Plenty of vegetables and fruits (especially berries, green leafy vegetables, and citrus fruits)
- Whole grains
- Lean proteins like fish, poultry, tofu, paneer and legumes
- Healthy fats — especially monounsaturated fats from olive oil, nuts, and avocados
- Coffee (yes, coffee!) — in moderation, it’s rich in antioxidants and has been shown to reduce liver fibrosis
- Green tea — has anti-inflammatory and antioxidant properties
Switch to whole foods — home-cooked meals with fresh ingredients, spices like turmeric and garlic, and oils like olive or mustard seed oil can help. Avoid refined flour, fried items, and excessive salt. In India, even seemingly healthy dishes become problematic when they are deep-fried or overly salty. Small, frequent meals with controlled portion sizes work best for most people.
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Q: Interesting! So coffee is good for the liver?
A: Surprisingly, yes — several studies now show that 2–3 cups of black coffee per day can reduce the risk of liver fibrosis and even liver cancer. Of course, this doesn’t mean you can drink coffee and eat junk all day. It has to be part of a healthy pattern.
Q: And what foods should we avoid for liver health?
A: Anything that’s processed, sugary, or salty. That includes:
- Sugary beverages (colas, energy drinks)
- Refined carbs (white bread, pastries)
- Fried and fast food
- Packaged snacks high in sodium and additives
- High-fructose corn syrup — one of the worst offenders
Also, alcohol — in excess — is a major toxin for the liver. Even small amounts can be harmful if you already have fatty liver.
Q: So is alcohol off the table for everyone?
A: Not necessarily. Moderation is key. For most people, the occasional drink — say, 1-2 per week — may be acceptable. But if you already have liver disease, or if you’re on medications that affect the liver, it’s best to avoid alcohol completely. The liver doesn’t have a “pause” button — once damage starts, it’s hard to reverse.
Fatty Liver: The Silent Epidemic – A Conversation with Dr. Anil Arora
Q: Let’s shift to lifestyle. Apart from food, what else can people do to protect their liver?
A: Three things:
- Exercise regularly — Even 30 minutes of brisk walking daily can reduce liver fat.
- Maintain a healthy weight — Just 5-10% weight loss can significantly improve liver function.
- Stay hydrated — Water supports detoxification and overall metabolism.
Also, avoid unnecessary medications, overuse of painkillers like paracetamol, and always consult your doctor before taking supplements or herbal remedies.
Q: What role does exercise play in prevention or reversal?
A: A massive role. Physical activity enhances insulin sensitivity and helps mobilize fat from the liver. Studies have shown that even without weight loss, regular exercise — whether it’s walking, cycling, yoga, or strength training — can reduce liver fat. Ideally, a combination of aerobic and resistance training is best. For those short on time, even 20 minutes of high-intensity interval training (HIIT) three times a week shows significant benefits. Movement is medicine.
Q: You mentioned supplements. Are there any that help with liver health?
A: Some do, but with caution. Milk thistle, turmeric (curcumin), and omega-3 fatty acids have been studied for their benefits in liver disease. However, not all supplements are created equal — and many can harm the liver. I always tell patients: natural doesn’t mean safe. Talk to your doctor before taking any supplement.
Q: Is fatty liver reversible? That’s the big question.
A: Absolutely — and that’s the silver lining. If caught early, and if you take corrective action — change your diet, lose weight, become active, reduce alcohol, manage diabetes or cholesterol — fatty liver can be reversed. But once it becomes cirrhosis, the damage is permanent.
Q: One last question — what’s your message to the average reader who may think, “I feel fine, I don’t need to worry about my liver”?
A: I’d say — don’t wait for symptoms. The liver is resilient, but it’s not invincible. Respect it. If you care about your future — energy levels, weight, metabolism, immunity, even mental health — protect your liver now. You don’t need to go on a “detox diet” or buy expensive pills. Just start with better food, daily movement, and regular check-ups. Your liver will thank you — quietly, but profoundly.
[Conclusion]
Fatty liver is no longer a condition for specialists alone to worry about — it’s a public health issue. But unlike many diseases, this one is within our control. With awareness, food wisdom, and small daily choices, we can protect one of the most vital organs in our body. As Dr. Arora says, “The liver never complains — until it’s too late. Let’s not wait that long.”
Quick Guide: Do’s and Don’ts for a Healthy Liver
| Do’s (Recommended) | Don’ts (To Avoid) |
| Eat a Mediterranean-style diet rich in vegetables, fruits, whole grains, and healthy fats | Avoid sugary drinks like soda and packaged fruit juices |
| Consume lean proteins like fish, poultry, legumes, and tofu | Avoid refined carbohydrates like white bread and pastries |
| Drink 2–3 cups of black coffee per day (if no contraindications) | Avoid highly processed and fried foods |
| Include antioxidant-rich foods like berries, green tea, garlic, and turmeric | Limit intake of high-fructose corn syrup and junk food |
| Exercise regularly — at least 30 minutes of moderate activity daily | Avoid excessive alcohol consumption |
| Aim for 5–10% weight loss if overweight | Don’t rely on ‘detox diets’ or unverified supplements |
| Stay well hydrated — drink at least 2.5 liters of water daily | Don’t take multiple medications without consulting a doctor |
| Use supplements like milk thistle or curcumin only under medical guidance | Avoid taking maximum doses of paracetamol with alcohol |
| Go for regular health checkups and liver function tests | Don’t wait for symptoms to appear before taking action |
| Use medications cautiously, especially painkillers and herbal remedies | Avoid excess salt and packaged salty snacks |
