Lancet Study: Nearly 40% Indians Affected by Fatty Liver Disease

Lancet Study: Nearly 40% Indians Affected by Fatty Liver Disease | Quick Digest
A recent Lancet study reveals that nearly 40% of adult Indians are affected by Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as NAFLD. This widespread prevalence, linked to obesity and diabetes, signals a significant public health challenge in India, emphasizing the urgent need for awareness and lifestyle interventions.

Key Highlights

  • Nearly 40% of Indian adults are impacted by MASLD (fatty liver disease).
  • The Phenome India cohort study published in The Lancet confirms this high prevalence.
  • Obesity, diabetes, and unhealthy lifestyles are major contributing factors.
  • MASLD, often silent, can progress to severe liver damage including cirrhosis and cancer.
  • Early detection and significant lifestyle changes are crucial for managing and reversing the condition.
  • India ranks among the top countries globally for the rise in fatty liver disease cases.
India is grappling with an alarming surge in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), a condition previously known as Non-Alcoholic Fatty Liver Disease (NAFLD). A recent large-scale study, the 'Phenome India cohort study,' published in *The Lancet Regional Health – Southeast Asia*, has revealed that approximately 38.9 per cent of Indian adults are affected by MASLD. This figure translates to nearly 4 in 10 individuals in cities like Hyderabad carrying excess fat in their livers, highlighting a significant public health concern. The terminology for fatty liver disease was updated in 2023, renaming NAFLD to MASLD, to more accurately reflect that metabolic dysfunction is the primary driver of the condition. This change emphasizes the strong links between liver fat accumulation and metabolic problems such as obesity, type 2 diabetes, high blood pressure, and abnormal cholesterol levels. Several credible sources corroborate the findings of high MASLD prevalence in India. A 2023 AIIMS study, which analyzed various published reports, also concluded that over one-third (38 per cent) of Indians suffer from fatty liver disease. Worryingly, this condition is not limited to adults, with an estimated 35 per cent of Indian children also affected. *The Hindu*, in an article from August 2025, stated that various studies over the past five years suggest 35–40% of the Indian adult population is affected, conservatively estimating that 40-50 crore (400-500 million) people in India are currently impacted. Such widespread prevalence has led news outlets and experts to describe the situation as an 'epidemic' or 'crisis'. The Phenome India study, which screened over 10,000 adults across 27 Indian cities between December 2023 and June 2024, found regional variations in MASLD prevalence. While the national age-adjusted prevalence was 38.9%, Hyderabad recorded 40.9%, slightly above the national average, with other major southern metros like Bengaluru (40.6%) and Chennai (41.2%) showing similar rates. Men in Hyderabad showed a higher prevalence (46%) compared to women (36.2%), a pattern consistent across most Indian cities. Another study, the 'MAP Study' from May 2025, indicated even higher prevalence rates in specific regions, reaching 68.2% nationally by certain measurement criteria, and as high as 73.3% in North India, particularly Uttarakhand (80.0%). The primary drivers behind this escalating health crisis are increasingly recognized as the 'westernization' of diets, characterized by higher intake of processed foods, a lack of healthy fruits and vegetables, and increasingly sedentary lifestyles. Obesity and type 2 diabetes are strongly linked, with MASLD prevalence in Indian individuals with type 2 diabetes ranging from 60–85%. India has experienced one of the sharpest rises in MASLD cases globally, with a 13.2% increase in age-standardized prevalence between 2010 and 2021, placing it just behind China and Sudan. MASLD is often a silent disease, showing no symptoms in its early stages, making community screening critical for early detection. The silent progression, however, can lead to severe complications. Fat accumulation in the liver can progress to inflammation (steatohepatitis), then to fibrosis (scar tissue formation), and eventually to severe conditions like cirrhosis (irreversible scarring), liver failure, and hepatocellular carcinoma (liver cancer). Studies indicate that 2.4% of the Indian population has liver fibrosis, with this figure rising to 6.3% among those with fatty liver, underscoring the severity of the progression. Experts warn that if left unaddressed, MASLD could escalate into India's biggest metabolic syndrome challenge. Despite the gravity of the situation, MASLD is often reversible, especially when detected early. Healthcare professionals emphasize that adopting a healthy lifestyle is the only effective way to combat this 'new epidemic.' This includes maintaining a balanced diet, restricting junk and sugary food intake, and engaging in regular physical activity to achieve and maintain a healthy weight. The lack of approved drug treatments for fatty liver disease further underscores the importance of preventive measures and lifestyle modifications. In conclusion, the widespread prevalence of MASLD in India, affecting nearly 40% of adults, is a pressing public health issue underscored by recent Lancet and other studies. The condition's strong association with prevalent metabolic disorders and unhealthy lifestyles, coupled with its silent progression to severe liver disease, necessitates urgent public awareness campaigns, targeted screening, and comprehensive lifestyle intervention programs across the nation.

Frequently Asked Questions

What is Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)?

MASLD is the new name for what was formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD). It describes a condition where excess fat accumulates in the liver, driven by metabolic problems such as obesity, type 2 diabetes, high blood pressure, and abnormal cholesterol levels, rather than excessive alcohol consumption.

How prevalent is MASLD in India, according to recent studies?

Recent studies, including the Phenome India cohort study published in The Lancet Regional Health – Southeast Asia, indicate that nearly 38.9% of adult Indians are affected by MASLD. Other reports suggest the prevalence ranges from 35% to 40% among adults, with even children being impacted.

What are the primary risk factors contributing to MASLD in India?

The main risk factors for MASLD in India include obesity, type 2 diabetes, high blood pressure, and high cholesterol. Unhealthy dietary patterns, specifically the increased consumption of processed foods and a lack of nutritious options, coupled with sedentary lifestyles, are significant contributors.

What are the potential complications if MASLD is left untreated?

If left unaddressed, MASLD can progress through various stages, from simple fat accumulation to liver inflammation, fibrosis (scarring), cirrhosis (severe and irreversible scarring), liver failure, and even hepatocellular carcinoma (liver cancer).

Can MASLD be prevented or reversed, and how?

Yes, MASLD is often reversible, especially when detected early. The primary approach to prevention and reversal involves significant lifestyle modifications, including adopting a healthy and balanced diet, reducing the intake of junk and sugary foods, and engaging in regular physical activity to achieve and maintain a healthy body weight.

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