Bhubaneswar: One in four people in Odisha has non-alcoholic fatty liver disease (NAFLD) — termed metabolic dysfunction-associated steatotic liver disease (MASLD) — according to the data of the health and family welfare department. “The prevalence of MASLD is 25-30% in the state,” said an official source.With World Liver Day being marked on Sunday, doctors have raised concerns about the rise in fatty liver disease among the non-alcoholic population, terming obesity and diabetes as major causes.Take the case of 36-year-old Mukesh Sahu, who said he had been feeling tired and losing appetite for quite some time. After a health check-up and ultrasound, his doctor said he had fibrosis in liver.“I do not drink alcohol. I did not have any clue how it happened silently,” said the resident of Patia here.Like him, many people are getting MASLD, without even consuming alcohol. Apart from obesity and diabetes, high blood pressure and dyslipidaemia (abnormal levels of lipids in bloodstream) are also major reasons.Head of gastroenterology department at AIIMS-Bhubaneswar, Dr Manas Kumar Panigrahi said fatty liver occurs when fat builds up in the vital organ. “Our body converts the fat into glucose when we do exercise and physical activity. The liver accumulates fat because of sedentary lifestyle and intake of unhealthy food. After a long period, inflammation in the liver occurs. Next stage of the fatty liver is fibrosis, where the organ gets stiff. Then it enters into cirrhosis stage, and finally ends in liver cancer,” he said.Another expert said alcohol directly damages liver cells, primarily through the toxic byproducts created when the organ attempts to break it down. It also aids in building toxic fat in the liver, said the expert.But the good news is that fatty liver condition can be reversed by changing sedentary lifestyle, taking a healthy and balanced diet, and adopting regular physical activity, said senior gastroenterologist Dr Manoj Sahu.“I have seen a dramatic rise in this disease decade after decade. One-third of Bhubaneswar’s population, even school-going children, has fatty liver disease. In future, these kids will develop high blood pressure and cholesterol if the MASLD condition is not addressed early,” he said, adding it will become a rapidly growing pandemic. Regular check-up is needed because liver disease hits a person silently, he said.Surgical gastroenterologist Dr Salil Kumar Parida said he has also found 30-35% MASLD prevalence among people in the city. “Active lifestyle with exercise and morning walk can help us fight liver disease. Some research papers advocate that fibrosis (up to grade II) can be reversed if the patient adopts good habits,” he said, adding liver is a big organ, which can regenerate. “We can heal the organ by using preventive steps. If people do not take MASLD seriously, it will become the number one disease in the state and country,” he said.Centre-funded Phenome India-CSIR Cohort study, published in The Lancet in Feb, said MASLD prevalence in Bhubaneswar is close to the national level.“Many people have fatty liver without knowing it. Most did not have symptoms. Fatty liver disease often stays hidden until it becomes serious, which makes early detection difficult,” said the study.