Grade 1 Fatty Liver Disease: Causes, Symptoms and Treatment

Busy Life, Silent Liver: Is Yours Under Hidden Stress?

You wake up, rush through work, manage a quick meal, tick off your endless to-do list, reward yourself with a good dinner, and binge-watch your favorite show. By the time you collapse into bed, everything feels perfect. But your body doesn't follow your schedule.

While you sleep or scroll late at night, your organs silently work, repair, and regenerate. Your liver, the ultimate silent warrior and the regenerative organ, is at the center of it all. Yet, many of us unknowingly overload it. Fat quietly starts piling up, sending subtle warning signs like fatigue or mild discomfort.

According to AIIMS, nearly 4 in 10 Indian adults 38% are silently developing fatty liver. Grade 1 fatty liver, the earliest stage, often shows no symptoms, yet it stresses your liver just like a heavy load strains a hardworking engine. The good news? With simple lifestyle tweaks, timely checkups, and a liver-friendly diet, you can reverse the damage.

In this blog, we'll dive into everything you need to protect your liver, keep it strong, and give your silent warrior the care it deserves.

What exactly is Grade 1 fatty liver? 

Fatty liver refers to the deposition of fat in the liver. The main organ responsible in your body for processing food and waste is your liver. Grade 1 fatty liver is the mildest stage of non-alcoholic fatty liver disease. At this stage:

• Small amounts of fat begin to accumulate in liver cells.
• Inflammation and scarring are minimal, so liver function is mostly normal.
• Most people don't notice any symptoms, which makes early detection crucial.

It is almost like your liver is nudging you, "Hey, take better care of me before things get worse." Even a simple lifestyle shift at this stage can make a huge difference and keep your liver safe for the coming years. 

What are the leading causes of Grade 1 fatty liver? 

Several factors contribute to the development of grade 1 fatty liver:

• Insulin resistance: This happens when the cells of your body become less sensitive to the insulin hormone that controls the blood sugar levels of your body. Excess sugar in the bloodstream can then be stored as fat in the liver, which results in insulin resistance. 
• Obesity- Carrying extra weight, especially around your abdomen, is a significant risk factor. Abdominal fat directly affects your liver and makes it more likely for fat to accumulate inside it.
• Metabolic syndrome- High blood pressure, high cholesterol, high blood sugar, and excess belly fat often occur together. This combination, known as metabolic syndrome, significantly increases your chances of developing fatty liver.
• Diet- Eating too many saturated fats, sugary drinks, and refined carbs can contribute to fat buildup in the liver. Think of junk food and soft drinks as silent triggers that slowly overload your liver.
• Genetics- Sometimes, it's in your genes. If liver issues run in your family, you may be more susceptible to fatty liver, even if your lifestyle is relatively healthy.

Tip: Even small changes, like replacing sugary drinks with water or walking 30 minutes daily, can help prevent fat buildup.

Fatty Liver Vs. Normal Liver

Parameter	Normal Liver	Fatty Liver
Lab Values	- ALT, AST: Within normal range (<40 U/L) - Bilirubin: Normal (<1.2 mg/dL) - No elevated triglycerides or abnormal lipid profile	- ALT, AST: Mildly elevated - Bilirubin: May be normal or slightly elevated - Elevated triglycerides and abnormal lipid profile
Physical Findings	- Liver size: Normal - No tenderness - No palpable enlargement - Size of liver in women and 10.5 cm in men (normal values)	- Liver enlargement (hepatomegaly) - Mild abdominal tenderness - Fat accumulation detectable on imaging - fatty liver is 2 to 3 cm larger than normal size
Liver Shape (Imaging)	- Smooth, homogeneous texture on ultrasound or MRI	- Enlarged liver with bright echotexture indicating fat deposition (on ultrasound)
Symptoms	- Asymptomatic - No significant fatigue or discomfort	- May include fatigue, mild abdominal discomfort, and bloating - In severe cases, jaundice or dark urine may develop

What are the Symptoms of Grade 1 Fatty Liver?

Many people with Grade 1 fatty liver disease do not show any symptoms, while some might show subtle symptoms. Here are some common symptoms-

• Fatigue and Weakness
• Upper abdominal discomfort
• Elevated liver enzymes
• High triglycerides levels
• Sudden weight gain 
• Uncontrolled blood sugar levels
• High Triglycerides levels
• Nausea
• Loss of appetite
• Swelling in legs, feet, and hands
• Yellowish skin and white eyes

How to diagnose Grade 1 Fatty Liver?

To diagnose grade 1 fatty liver, your doctor may recommend blood tests or imaging tests. Here are some diagnostic tools used to detect NAFLD:

Blood Tests

• Liver Function Tests (LFTs)- Measures enzymes like ALT and AST to detect liver inflammation or damage.
• Lipid Profile Test- Assesses cholesterol and triglyceride levels.
• Fasting Blood Sugar (FBS) & HbA1c- Evaluates risk of diabetes, which is often linked to fatty liver.
• Complete Blood Count (CBC) - Check overall health and inflammation markers.

Imaging Tests

• Ultrasound- The most common test to detect fat accumulation in the liver. Grade 1 fatty liver is diagnosed when mild fat deposits are seen without liver inflammation.
• CT or MRI Scans- May be recommended for detailed imaging if needed.
• FibroScan (Transient Elastography)- Measures liver stiffness to rule out fibrosis or cirrhosis.

Grade 1 Fatty Liver is often reversible with lifestyle changes like improved diet, regular exercise, and weight management. Regular health checkups and liver screenings can help prevent progression to more severe stages.

Diet Recommendations for Grade 1 Fatty Liver

Here are some specific dietary recommendations for managing grade 1 fatty liver-

• Focus on whole foods: Choose unprocessed foods like brown rice, quinoa, and whole-wheat bread over refined options. Fiber helps with digestion, reduces cholesterol levels, and also improves liver function.
• Limit sugar and refined carbs: Try not to drink excessive amounts of carbonated drinks or eat sweet or processed foods. Choose complex carbohydrates like grains and avoid white bread and pastries, as they may worsen your fatty liver symptoms.
• Eat healthy fats: You can consume fats like olive oil, avocados, nuts, seeds, and fatty fish. These foods help reduce inflammation and also improve liver health.
• Eat more fruits and vegetables: berries, green tea, leafy greens, and vegetables high in vitamins A, C, and E. These fruits and vegetables are rich in antioxidants and help protect the liver from inflammation and fat-related damage.
• Add Lean Proteins: Choose sources such as poultry, fish, beans, and legumes instead of red meat. 
• Drink enough water: Stay hydrated throughout the day and avoid sugary and caffeinated beverages.

Food to Avoid in Grade 1 Fatty Liver

Here are the kinds of food resources that you should altogether avoid consuming in fatty liver disease: 

• Processed and Junk Foods: Packaged snacks, chips, and instant noodles are full of unhealthy fats, preservatives, and additives. Your liver has to work extra hard to process these, increasing fat accumulation.
• Fried Foods: French fries, samosas, pakoras, and other fried snacks are high in unhealthy fats. These are hard for your liver to break down, and can accumulate in your liver over time.
• Excess Sugar & Sweets: Cakes, pastries, candies, and chocolates may satisfy your sweet tooth, but too much sugar in your diet can turn into fat in your liver, worsening fatty liver.
• White Refined Carbs: White bread, white rice, pasta, and other refined carbs spike your blood sugar quickly. The body then converts this extra sugar into fat, which can accumulate in your liver.
• High-Fat Dairy Products: Full-fat cheese, butter, and cream contain saturated fats. Eating them in large amounts can increase liver fat and slow down recovery from fatty liver.

Grade 1 Fatty Liver Treatment Options

Your doctor may suggest lifestyle management tips to treat grade 1 fatty liver disease.

• Reduce alcohol intake- To recover your liver health, try to reduce alcohol consumption. Persistent alcohol use may damage your liver and lead to worsening fatty liver.
• Lose some weight- Regular exercising, a healthy diet, and taking medications can help you lose weight.
• Take medications to manage metabolic conditions- Take prescribed medications to manage diabetes, cholesterol, and triglyceride levels.
• Get vaccinated for hepatitis A and B- These viral infections are dangerous if you already have liver disease. 

Other treatment options

1. Glucagon-like-peptides (GLP1) agonists
2. Statins (to treat dyslipidemia in fatty liver patients)
3. Bariatric surgery (for morbidly obese patients)
4. Liver transplantation (if the liver is damaged fully)

Who is at risk of grade 1 fatty liver disease?

One of the most common risk factors for fatty liver disease is obesity, and the consumption of alcohol. With the increasing obesity in the population, there is a rise in the prevalence of fatty liver. Here is who is at high risk of grade 1 fatty liver disease- 

NAFLD

• People having Diabetes mellitus or Insulin resistance
• Older age
• Poor dietary habits
• People with Hyperlipidemia (high cholesterol levels)
• People with Hypertension (high blood pressure)
• Metabolic Syndrome (Hypertension, hyperglycemia, excess body fat around the waist, and abnormal cholesterol levels)
• People with infections such as Hepatitis C
• People with Hypothyroidism (underactive thyroid) 
• People with Hypopituitarism (deficiency of the pituitary hormones)
• Exposure to toxins
• Genetic factors affecting alcohol metabolism
• Presence of Polycystic Ovarian Syndrome

The final words

Grade 1 fatty liver indicates the earliest stage of NAFLD, characterized by mild fat buildup in the liver. If you are diagnosed with Grade 1 fatty liver disease, start taking precautions and regularly consult your doctor. Don't forget to get regular health checkups from Redcliffe Labs to ensure 100% report correctness. 

Adopt a healthy lifestyle and take your medications promptly to reverse Grade 1 fatty liver and restore normal liver function.