Liver Disease

Alcohol accounts for only about 4% of fatty liver disease cases; the dominant form is non-alcoholic and metabolic in origin. Liver disease is explicitly identified as another major area of new evidence in the update. Non-alcoholic fatty liver disease (NAFLD) is now rising sharply, including in children. The liver is the primary site of alcohol metabolism, and repeated exposure initiates a progressive pattern of damage. Untreated fatty liver progresses through inflammation and fibrosis to cirrhosis — irreversible scar tissue. Three overlapping mechanisms drive liver disease: inflammation, fatty liver accumulation, and scar tissue accumulation (fibrosis) that eventually progresses to cirrhosis. Liver disease follows a predictable progression: fat accumulation, then inflammation, then fibrosis, then cirrhosis. Chronically elevated insulin drives more visceral fat around the liver, more ectopic fat inside liver cells, and progressive liver dysfunction. The liver can sustain significant damage and still recover, but there is always a threshold beyond which recovery becomes impossible. Bile salts backing up into the bloodstream deposit in peripheral tissues, producing itching most prono…