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The-Urban-Liver-Crisis:-Tackling-Lifestyle-Diseases-Through-City-Level-Policies-The-Aaretry-Chronicles-TAC
Image Source: Wikimedia Commons
The-Urban-Liver-Crisis:-Tackling-Lifestyle-Diseases-Through-City-Level-Policies-The-Aaretry-Chronicles-TAC
Image Source: Wikimedia Commons

The Urban Liver Crisis: Tackling Lifestyle Diseases Through City-Level Policies

Introduction

The modern amenities in life have led most of the population in developing countries to the biggest and most addictive habit-The sedentary lifestyle!! This has contributed to a rise in conditions such as high blood pressure, diabetes, obesity, heart disease, and chronic liver disorders. Chronic liver disease refers to the progressive decline in liver functions, including the production of clotting factors, removal of toxins, and bile excretion, for at least six months. According to Stanford Health Care, major chronic liver conditions include cirrhosis, the 12th leading cause of death in the US, and liver fibrosis, where normal liver tissue is replaced by scar tissue that may eventually cause cirrhosis.

Alcoholic and Non-Alcoholic liver conditions

Apart from alcohol, which is a known cause of fatty liver disease and cirrhosis, another category of chronic liver conditions is non-alcoholic fatty liver disease (NAFLD), which has become highly prevalent worldwide. Liver function tests such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) are commonly used non-invasive markers of dysfunction. Each enzyme is typically elevated in specific liver conditions. Low levels of adiponectin, an adipokine with anti-inflammatory and lipid-regulating activity, are a known risk factor for NAFLD and liver dysfunction. Interestingly, some studies suggest that consuming coffee may help increase adiponectin, potentially reducing the risk of NAFLD.

Causes of chronic liver disease

  • Alcoholism

  • Sedentary lifestyle

  • Increase in junk food consumption

  • Overweight

  • Obesity

  • Stress

  • Environmental factors

Treatment

According to Johns Hopkins Medicine, treatment options for chronic liver disease include:

  • Following a low-sodium and calorie-controlled diet

  • Avoiding excessive fatty food consumption

  • Eliminating alcohol intake

  • Managing associated symptoms such as easy bruising and vitamin deficiencies

Early detection and lifestyle modifications are key to preventing progression of liver disease. Regular monitoring through liver function tests can help track improvements and guide treatment.

Global policies for liver diseases

Several initiatives worldwide aim to raise awareness and promote early detection of liver diseases:

  • India: The country has integrated NAFLD into its National Program for Prevention and Control of Non-Communicable Diseases (NCDs).

  • World Liver Day: Celebrated annually on April 19, this day promotes liver health and educates the public about liver disease prevention.

  • Europe: The LiverScreen Project works to increase awareness, early detection, and prevention of liver disease across European countries.

City level policies for lifestyle diseases

Lifestyle diseases such as diabetes, hypertension, and fatty liver disease are often reversible with proper diet and regular physical activity. City-level policies can play a crucial role in reducing their prevalence.

Key measures include:

  • Awareness campaigns and health education programs

  • Early screening programs for NAFLD and other lifestyle diseases

  • Urban planning that encourages active lifestyles, such as parks, walking paths, and cycling lanes

  • Stricter alcohol regulations, including higher taxes, reduced advertising, and raising the legal drinking age

A study conducted in Chennai found that 61.5% of participants screened positive for NAFLD, with higher body mass index significantly increasing the risk. Men were slightly more prone to develop the condition than women, and age was also a predictor. Reducing alcohol consumption and promoting healthier lifestyles are essential to lowering the urban liver disease burden.

Conclusion

Alcoholic and non-alcoholic fatty liver diseases are reversible if detected early. To reduce the global burden of liver diseases and hepatocellular carcinoma, coordinated policies at both global and local levels are needed. Reducing alcohol consumption and addressing lifestyle-related risks remain central to prevention.

Call To Action

Addressing the urban liver crisis requires collaboration between governments, city authorities, healthcare providers, and communities. City-level interventions such as awareness campaigns, early screening programs, better urban planning that promotes active lifestyles, and stricter alcohol regulations can significantly reduce the burden of chronic liver diseases. Collective action at both policy and community levels will be crucial to prevent the silent epidemic from escalating further.

  • Producing Vitamin K-dependent Clotting factors
  • Producing hormones
  • Cholesterol metabolism and production
  • Glucose storage and metabolism
  • Toxin removal and purification of blood
  • Storage of blood
  • Producing proteins, etc.

References

Dr Nandini Dayalan

MDS in Oral & Maxillofacial Surgery, Author
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