A silent epidemic is sweeping across the globe, affecting millions—many of them young adults in their 20s—without their knowledge. Non-alcoholic fatty liver disease (NAFLD), now also referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), is emerging as one of the most deadly and underdiagnosed health threats of our time. Recent research published in The Lancet Regional Health Europe reveals that nearly 20 million people across the US, UK, Germany, and France are living with this condition, yet only a fraction have been formally diagnosed. Even more concerning: three-quarters of those affected have no idea they are at risk.

Once thought to be a disease of the middle-aged and overweight, NAFLD is now increasingly seen in young, seemingly healthy individuals, many of whom are asymptomatic. New research reveals that nearly 20 million people across the U.S., UK, Germany, and France are living with NAFLD—with only 2.5 million actually diagnosed. That means three out of four people have no idea they’re living with a condition that, left untreated, could progress to cirrhosis or even liver cancer.

NAFLD is often called a “silent” disease for good reason. It develops quietly, often without any symptoms, and can go undetected for years. In many cases, it is only discovered incidentally—when a patient undergoes imaging studies for unrelated health issues. This stealthy progression is what makes NAFLD so dangerous. According to experts, it is now estimated that nearly one in three adults worldwide may have some form of fatty liver disease, and the numbers are rising among younger populations.

In MASH, the liver becomes inflamed due to fat deposits. Inflammation and scarring (fibrosis) may eventually lead to cirrhosis, liver failure, or liver cancer. What makes NAFLD particularly concerning is how quietly it progresses. In many cases, it is only discovered incidentally—through imaging tests done for unrelated health issues.

Dr. Joseph Salhab, a leading gastroenterologist, describes NAFLD as “the most deadly yet underdiagnosed condition.” He stresses that most people with fatty liver have no signs or symptoms, and up to 50% may even have normal lab tests. This makes routine screening and awareness all the more critical.

What Is Non-Alcoholic Fatty Liver Disease?

NAFLD occurs when more than 5% of the liver’s weight is made up of fat, in individuals who consume little to no alcohol. This distinguishes it from alcohol-related fatty liver disease. The condition is closely linked to metabolic dysfunction, including obesity, type 2 diabetes, high cholesterol, and high blood pressure, but it can also affect people who have none of these risk factors.

NAFLD exists on a spectrum. The earliest and least severe stage is “simple fatty liver,” where fat builds up in the liver cells but there is little or no inflammation or damage. However, the disease can progress to a more serious form called metabolic dysfunction-associated steatohepatitis (MASH). In MASH, the liver becomes inflamed due to fat accumulation, which can lead to scarring (fibrosis), cirrhosis, liver failure, and even liver cancer.

Red Flag Symptom You Shouldn’t Ignore

According to Dr. Joseph Salhab, a gastroenterologist who has observed hundreds of patients with fatty liver disease, there is one symptom that often stands out—fatigue.

“Fatigue is probably one of the most commonly reported symptoms in people with fatty livers,” says Dr. Salhab. “We think it’s linked to metabolic dysfunction in the liver and poor sleep regulation.”

He also notes that pain in the upper right quadrant of the abdomen—especially discomfort after eating—is another early sign of liver inflammation. But the most troubling symptom of all may be no symptom at all.

“NAFLD is a sneaky disease,” he emphasizes. “Around 50% of people with fatty liver can even have normal lab results. You can’t rely on symptoms alone.”

Why Young Adults Are Now at Risk?

What’s particularly alarming is the growing number of younger adults—even those in their 20s—being diagnosed with NAFLD. This trend aligns with the global rise in obesity, sedentary lifestyles, and diets high in processed foods, all of which are risk factors.

Historically, NAFLD was seen primarily in middle-aged or older adults. However, the rise in obesity, sedentary lifestyles, and poor dietary habits has led to an alarming increase in cases among people in their 20s and even teenagers. The modern diet—high in processed foods, sugars, and unhealthy fats—combined with decreased physical activity, is fueling this trend.

Recent data show that more than 15 million people in the US, UK, Germany, and France are unaware they have the most aggressive form of fatty liver disease. And while being overweight, having type 2 diabetes, or high cholesterol increases the risk, NAFLD can—and does—affect people without any of these conditions.

How Is NAFLD Diagnosed?

Because symptoms are often absent, NAFLD is frequently discovered during routine bloodwork or imaging scans, such as ultrasounds or CT scans, conducted for other reasons. In some cases, a liver biopsy may be required to assess the level of inflammation and scarring. NHS Inform and Mayo Clinic list the following signs that may warrant further investigation:

• Persistent fatigue
• Abdominal discomfort (especially upper right quadrant)
• Itchy skin
• Abdominal swelling or fluid retention
• Swelling in legs
• Spider veins, red palms, and in advanced stages, jaundice

The real danger of NAFLD lies in its potential to progress. For some, simple fatty liver remains relatively benign. But for others, the disease advances to MASH, causing inflammation and scarring. Over time, this can lead to cirrhosis (permanent liver damage), liver cancer, or even liver failure—conditions that are often fatal without a transplant.

Alarmingly, the vast majority of those with NAFLD have no idea their liver is under threat. According to the research, only 2.5 million out of 20 million people with the disease have received a diagnosis. This means millions are at risk of severe complications without knowing it.

Can NAFLD Be Reversed?

NAFLD is reversible, especially in its early stages. The primary treatment isn’t medication—it’s lifestyle modification, and the most effective step is weight loss.

According to Dr. Chris Boettcher, a physician advocating for liver health awareness, “Just losing 7–10% of your body weight can reverse fatty liver in up to 90% of patients.”

The Mayo Clinic supports this, noting that even 3–5% weight loss can significantly reduce liver fat, while 10% or more can reverse inflammation and fibrosis. Key steps to reversing NAFLD include:

• Adopting a Mediterranean-style diet rich in vegetables, whole grains, lean proteins, and healthy fats
• Exercising regularly, with a focus on both cardio and strength training
• Managing blood sugar, cholesterol, and blood pressure
• Avoiding alcohol and unnecessary medications that stress the liver

With 1 in 3 adults potentially affected, NAFLD represents a looming public health crisis. Yet the condition remains underdiagnosed, and awareness is critically low—even among healthcare providers.

Dr. Boettcher calls it “the most deadly yet underdiagnosed condition,” warning that if the current trend continues, NAFLD could soon overtake hepatitis as the leading cause of liver transplants.

The medical community is now urging health systems to incorporate early screening for at-risk groups and raise awareness of subtle symptoms.

What You Can Do Right Now To Protecting Your Liver?

Whether you’re in your 20s or your 60s, now is the time to take charge of your liver health. Here’s how to start:

• Get a routine check-up—especially if you have any metabolic risk factors.
• Ask your doctor about a liver ultrasound or fibrosis scan if you experience unexplained fatigue or abdominal discomfort.
• Track your weight, blood sugar, and cholesterol regularly.
• Eliminate excess sugar, saturated fats, and alcohol from your diet.
• Prioritize movement—even 30 minutes of walking a day makes a difference.

NAFLD is a global health crisis hiding in plain sight—affecting millions, including people in their 20s, with most unaware of their risk. Fatigue is the one symptom that should not be ignored, but the absence of symptoms does not mean the absence of disease. Routine screening, especially for those at risk, is essential.

As Dr. Chris Boettcher, a physician and advocate for NAFLD awareness, emphasizes: “Just losing 7-10% of your bodyweight reverses non-alcoholic fatty liver disease in up to 90% of people. It directly burns liver fat, lowers inflammation, and reduces insulin resistance.”

Recognizing fatigue or unexplained abdominal pain might just be the red flag you need to start asking questions and demand screening.

Glaucoma is an umbrella term for a group of eye diseases that create pressure inside your eyeball, which can damage delicate, critical parts at the back of your eye, including the optic nerve.

While most of the diseases are progressive, meaning they gradually get worse and eventually cause permanent vision loss and blindness. In fact, glaucoma is the second-leading cause of blindness worldwide and is the leading cause of blindness for people over 60 years old.

Dr Niteen Dedhia, Medical Director, Ojas Maxivision Eye Hospital tells Business Standard: "Glaucoma slowly and quietly causes damage to the optic nerve. Changes in eye pressure, blood flow and nerve fibres occur over time, while the brain often compensates for the loss.

"As a result, symptoms go unnoticed, and by the time vision loss becomes apparent, the damage is usually permanent."

Many forms of glaucoma have no warning signs and the effect is extremely gradual, to the point that you may not notice a change in vision until the condition is in its late stages.

Here are some symptoms that mid-age people need to keep an eye out for:

1. Gradual loss of circumferential vision

One of the earliest symptoms of glaucoma is damage and subsequent loss of peripheral vision. Dr Dedhia noted: “Glaucoma starts by damaging the peripheral vision but doesn’t affect the centre (front) vision."

If you seem to struggle with spotting objects approaching from the side or bump into things more often, you may be experiencing early stages of the disease and not merely experiencing normal ageing.

2. Difficulty seeing or reading in the dark or low light settings

3. Frequent changes in eye power

Dr Neeraj Sanduja, Ophthalmologist, Eye Surgeon at Viaan Eye Centre, Gurgaon told the publication: "Needing frequent prescription changes or feeling that glasses 'never feel quite right' may reflect subtle visual field changes caused by glaucoma rather than simple refractive error progression."

4. Eye pressure or unusual discomfort

Open-angle glaucoma, the most common form of the condition that causes patchy blind spots in your side vision, is often painless or limited to a mild sense of pressure or heaviness in the eyes.

Those suffering from open-angle glaucoma may notice a dull ache after prolonged screen time or reading that improves with rest. Frequently mistaken as regular eye strain, it is often ignored, however, may indicate subtle increases in eye pressure that require professional evaluation.

5. Frequent headaches with eye strain

Frequent headaches, especially when accompanied by eye strain or blurred vision, should not be ignored as migraine pain as it may signal rising eye pressure or early glaucoma changes, Dr Dedhia warns.

Who Is at Risk for Glaucoma?

Certain groups of people have a higher than normal risk of getting glaucoma which includes those who:

• have high eye pressure
• are farsighted or nearsighted
• have had an eye injury
• use long-term steroid medications
• have corneas that are thin in the center
• have thinning of the optic nerve
• have diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body
• are over age 40
• have family members with glaucoma
• are of African, Hispanic, or Asian heritage

Abnormal sleeping patterns, whether excessive or brief, can significantly increase your risk of developing chronic liver disease, an EMJ study suggests.

Sleep duration has previously been linked to worsening your chances of Type 2 diabetes; obesity; cardiovascular diseases including hypertension, stroke, heart attack; mental disorders such as depression, anxiety; weakened immune system and potentially contributing to neurological conditions such as dementia.

However, researchers have now also found that sleep disruption may intensify existing stress on the liver which can worsen metabolism and pave the way for disease progression.

The authors noted that poor sleeping habits may influence liver health for multiple reasons including by altering glucose metabolism, increasing inflammation and disrupt circadian rhythms that regulate liver function.

"Participants who reported consistently short sleep duration were more likely to have elevated liver enzymes and higher fibrosis risk scores compared with those reporting moderate sleep duration. Long sleep duration was also associated with adverse liver markers, though the relationship was weaker than that observed for short sleep," the study noted.

Despite discovering links, the involved researchers noted that the study only highlighted sleep as a potential factor that could worsen liver function along with other lifestyle reasons and did not act as a clear cause.

Why Is Chronic Liver Disease A Concern?

Once a rare condition, non-alcoholic fatty liver disease (NAFLD) now affects one in three Indians. A JAMA study has now found that about 40 percent of the global population is now suffering from NAFLD, with abdominal obesity identified as its single biggest risk factor.

Researchers found that nearly 70 percent of people with Type 2 diabetes and about 80 percent of those with obesity are affected by NAFLD. They also discovered that NAFLD prevalence is higher in men than in women, with rates of 15,731 per 100,000 population in men compared with 14,310 in women.

READ MORE: This Deadly Liver Disease Is Affecting People In Their 20s And This One Symptom Is The Red Flag

Between 2010 and 2021, India recorded a 13.2 percent increase in age-standardized prevalence, ranking just behind China at 16.9 percent and Sudan at 13.3 percent. Additionally, the disease peaks earlier in men, between 45 and 49 years of age, while women show the highest prevalence between 50 and 54 years.

NAFLD, now called as metabolic dysfunction-associated steatotic liver disease (MASLD), is when excess fat builds up in the liver, unrelated to heavy alcohol use, due to obesity, Type 2 diabetes, high blood pressure and cholesterol.

It ranges from simple fat accumulation to inflammation and damage, which can progress to fibrosis, cirrhosis or liver cancer, The disease often has no symptoms and is managed with lifestyle changes such as diet and weight loss.

Why Is NAFLD on the rise?

Poor diets (high carbs/sugar), sedentary habits and rising obesity are some of the key reasons why an uptick in NAFLD cases has been seen pan-India. Increased intake of refined carbs, sugary drinks, processed foods and unhealthy fats can increase the risk of obesity, diabetes, hypertension and high cholesterol which can pave the way for this liver disease.

Experts also note that working long hours at desks without any proper physical activity can lead to weight gain and fat accumulation in the liver.

According to the Union Health Ministry, the prevalence of the condition could be in the range of 9-53 percent. Multiple other health studies also suggest nearly 40 percent of urban Indians may have some form of fatty liver disease

Hepatologist Dr Cyriac Abby Philips, popularly known as LiverDoc on social media, noted on X that many patients do not realize that timely lifestyle changes can completely reverse the condition. “All it takes is being in charge of your body and health. No shortcuts—go slow and steady,” he wrote.

If left untreated, NAFLD can progress to Non-Alcoholic Steatohepatitis (NASH), where liver inflammation begins. Over time, this inflammation can lead to scarring of the liver, known as fibrosis. Advanced fibrosis results in cirrhosis, which severely affects liver function.

NAFLD can also increase the risk of chronic liver disease, liver failure and hepatocellular carcinoma. Many patients diagnosed with liver cancer have a history of untreated fatty liver.

The NHS is urging millions of people across the UK to take vitamin D to support overall health, but experts say certain symptoms should not be ignored. In a post shared on X, an NHS spokesperson said: “From October to March we can’t make enough vitamin D from sunlight, so to keep bones and muscles healthy, it’s best to take a daily 10 microgram supplement of vitamin D. You can get vitamin D from most pharmacies and retailers.”

While health professionals agree that vitamin D supplementation is important for many people, especially during the colder months, they stress that it should be taken carefully.

Why Does Sunlight Matter For Vitamin D Production?

Sunlight plays a crucial role in how the body makes vitamin D. UVB rays trigger a reaction in the skin that converts a compound called 7-dehydrocholesterol into vitamin D3. This form of vitamin D is essential for absorbing calcium, maintaining strong bones, and supporting the immune system.

As sunlight in the UK is not strong enough between autumn and early spring, the government advises everyone to consider taking a daily supplement of 10 micrograms, or 400 IU. Relying on food alone is often not enough to meet daily needs during this period.

Expert Warns Too Much Vitamin D Can Backfire

Biomedical scientist Tobias Mapulanga, who co-founded Repose Healthcare, has warned that some people may be taking more vitamin D than their bodies can handle. He explained that as winter advice circulates, many people add tablets, sprays, or gummies without realising they are doubling up.

He said that symptoms such as constant thirst, needing the toilet more often, nausea, stomach discomfort or constipation, headaches, mental fog, and new aches or cramps can appear soon after increasing vitamin D intake. These signs are often mistaken for winter illnesses, when they may actually point to excess supplementation.

“The message is simple,” he added. “The right dose helps, but taking too much can leave you feeling worse, not better.”

High-Dose Supplements Raise Safety Concerns

Research shows that 42% of UK adults reported taking vitamin D supplements in the past year. However, an investigation by Which? found some vitamin D products on sale contained doses as high as 12.5 times the recommended safe upper limit.

NHS England also logged 42 incidents over a two-year period where high-strength vitamin D was given more often than intended. Some of these cases led to hospital treatment for hypercalcaemia, a condition caused by too much calcium in the blood, according to reports from Bristol Live.

Stop Taking Vitamin D If You Notice These Warning Signs

1. Ongoing thirst and frequent trips to the toilet

If you suddenly feel unusually thirsty or find yourself urinating more often after starting vitamin D, it may be a sign you’re overdoing it. Cut back to a single 10 microgram tablet and stop using any additional vitamin D products if this happens.

Too much vitamin D can disrupt fluid and salt balance in the body, leaving you dehydrated and running to the bathroom. Check labels carefully and remove multivitamins, sprays, gummies, and fortified foods or drinks that also contain vitamin D.

Keep water close by and sip regularly while your body settles. Stay well below the upper limit of 100 micrograms, keep just one product visible, and put the rest out of sight to avoid accidental doubling.

2. Nausea, excessive burping, or stomach discomfort

Feeling sick, bloated, or dealing with an upset stomach after taking vitamin D suggests it isn’t agreeing with you. Try taking your supplement with a full meal and switch from sprays or gummies to a plain D3 tablet if symptoms persist.

Food helps protect the stomach lining, while sprays and gummies often contain sweeteners or flavourings that can irritate digestion. Choose a simple cholecalciferol tablet with minimal ingredients and reduce the dose to 10 micrograms.

Avoid fortified shakes or energy drinks until your stomach feels normal again.

3. New muscle cramps or bone aches

If you notice more aches in your bones or frequent muscle cramps after starting vitamin D, take it as a signal to reassess. Lower your dose and focus on staying well hydrated while eating mineral-rich foods.

Excess vitamin D can interfere with mineral balance, which muscles rely on, and dehydration can make cramping worse. Drink water with meals and include yoghurt, leafy greens, beans, and bananas in your diet.

Gentle stretching and short walks can ease stiffness. Stick to one 10 microgram supplement and avoid adding anything else until symptoms improve.

4. Brain fog or headaches

Trouble concentrating or recurring headaches can be signs that your vitamin D intake is too high. Replace multivitamins or high-strength products with a single 10 microgram D3 tablet.

High doses can raise calcium levels, and extra additives found in combined supplements may affect clarity of thought. Choose a product that contains only cholecalciferol and basic fillers.

Take it with food at the same time each day for consistency and better digestion. Avoid combined vitamin A and D products and focus on one simple supplement.

To prevent accidental overuse, review everything you take that contains vitamin D. Spread out all tablets, sprays, gummies, and fortified foods, and read each label carefully. Convert IU to micrograms by dividing by 40 to make totals easier to track.

Discard any extras and stick to one daily 10 microgram source. Keep a note of symptoms such as thirst, frequent urination, stomach upset, cramps, or mental fog to see how they relate to your intake.