Opinion | The Silent Fat: Why Fatty Liver Is Quietly Spreading Across Kashmir

Ask a radiologist in Srinagar, Anantnag or Baramulla what they see most often on an abdominal ultrasound, and many will give the same answer. A bright, fatty liver. The line in the report has become so routine that patients barely flinch when they read it. They fold the paper, put it in a bag and go home to a dinner of rice and gravy. That calm is exactly what worries doctors.

Fatty liver just means there is an accumulation of fat in the liver. This condition is not necessarily caused by excessive consumption of alcohol. It has been described by doctors to be metabolic dysfunction associated steatotic liver disease, where the liver is having difficulty due to imbalance in the body’s metabolism. Fatty liver disease is often graded using ultrasound in one to three, which represents mild, moderate, and severe conditions. The problem with fatty liver is that there is no pain involved. One could experience feeling fatigue, discomfort in the right upper part of the abdomen, or nothing at all.

Why the Valley is feeling it

There is nothing mysterious about it all. Kashmiri culture is changing much faster than the Kashmiri body can cope. Our cuisine has always been nourishing and comforting, and nobody wants to give up the pleasure of sitting around a wazwan table or even a simple dish of rice with ghee. However, while the same food was consumed by the earlier generation who had a physically active lifestyle spending most of its time working in the orchards, farmlands and going for long walks, the modern generation eats the same food, but sits behind a desk, drives around on a scooter, shops in markets and scrolls their smartphones in the evenings.

Winter just makes it worse. For several months of the year when the climate forces you inside by the fire of a kangri, physical activities become a burden instead of a habit. Insomnia, stress and increased waistline follow soon. Fatty liver along with diabetes, high blood pressure and cholesterol also become frequent companions to doctors in the Valley. Children also face similar problems because chips and soft drinks have come to the schools in the form of packed products replacing the homemade bread and fresh fruits.

Preventing it before it begins

The good news is that the liver is among the most forgiving organs in the body. Prevention does not need expensive diets or gym memberships. It needs steady, ordinary habits. Eat smaller portions of rice and give more room on the plate to vegetables, and Kashmir has plenty of good ones, from haakh and lotus stem to turnips and seasonal greens. Let ghee, oil and red meat be a part of the meal instead of the whole meal. Replace sugary drinks with water, unsweetened lassi or plain tea. Let go of the habit of frequent bakery snacks.

Move every day. Thirty minutes of brisk walking is enough to begin with, and in winter it can happen indoors, by climbing stairs, doing simple exercises or walking inside a hall. Watch your waistline more than the weighing scale, because fat around the belly is the kind that harms the liver most. Sleep seven hours if you can. Avoid alcohol. Be careful with herbal powders and self prescribed painkillers, because the liver has to process everything we swallow. And get a basic check up once a year, with blood sugar, cholesterol and liver function tests, especially if you are over thirty, overweight or have diabetes in the family.

If you have been told grade two or grade three

The first step is don’t get panicked because fatty liver condition can be quite alarming; however, it does not mean the end of your life. In many cases, people managed to turn it around. The first thing is to visit a gastroenterologist or hepatologist instead of believing in the ultrasound only. Usually, in the beginning, the doctor orders some blood test, and there may be necessary to undergo an additional test such as FibroScan to determine whether the fibrosis has started.

The most powerful treatment is gradual weight loss. Losing around seven to ten percent of your body weight over several months can reduce liver fat significantly, and in many people it eases the inflammation too. Crash diets and starvation backfire, so aim for no more than half a kilo to one kilo a week. Cut down on sugar, refined flour, fried food and sweetened drinks. Choose whole grains, pulses, vegetables, fish, eggs, curd and a modest handful of nuts. Cook with less oil. Exercise for about 150 minutes a week, which is roughly half an hour on five days, mixing brisk walking with some strength work if your doctor agrees. Give up alcohol completely.

Take just as seriously the factors that surround fatty liver as you do the liver itself. If you are diabetic, make sure that your sugar is well controlled. If you have high blood pressure or high cholesterol levels, take your drugs religiously. At the moment, there are certain drugs that have been proven helpful for selected individuals, although only a doctor is in a position to prescribe them.

Be aware of certain symptoms that require prompt action on your part; some of these symptoms include yellowing of the eyes or skin, swelling of the legs or abdomen, black stools, vomiting blood, and confusion or drowsiness.

A change that starts at home

Fatty liver is not just a medical condition. It is a family affair. If one person decides to make different eating choices, the whole family sits down for healthier meals. Mothers, who often prepare what goes on the plate, can ensure the well-being of their three generations without saying a thing. Health professionals, teachers, religious leaders, anyone else who could speak up and do so without reservation can make sure that a simple liver check-up turns into a conversation starter rather than a piece of paper forgotten in some drawer.

Hospitality, food and resilience – all of that makes Kashmir a unique place. Nothing of that has to change. What has to change is the balance: a little bit more exercise, a little bit less sugar, and the willingness to hear what our body tries to tell us before it screams from pain. The liver, with its patience, gives us that chance. It is up to us to take it.

Author can be reach at : mdmuslimbhat@gmail.com