One in four adults has fat in their liver and doesn't know it
Um em cada quatro adultos no mundo carrega gordura no fígado sem o saber — uma condição silenciosa que só revela a sua gravidade quando já avançou para territórios difíceis de reverter. A doença hepática associada à disfunção metabólica, ou MASLD, tornou-se a doença hepática crónica mais comum do planeta, espelhando nos órgãos internos os padrões de vida modernos: sedentarismo, obesidade, diabetes, alimentação ultraprocessada. Portugal acompanha esta tendência global, e o Dia Mundial do Fígado Gordo, a 11 de junho, surge como um apelo à consciência coletiva: o fígado fala, mas em voz baixa — e é preciso aprender a ouvi-lo antes que o silêncio se torne irreversível.
- Centenas de milhões de pessoas têm gordura a acumular-se no fígado neste momento, sem qualquer sintoma que as alerte para o perigo.
- A ausência de dor ou sinais visíveis nas fases iniciais faz com que a doença avance em silêncio até atingir inflamação, cirrose ou cancro hepático.
- Portugal regista um aumento de casos associado ao crescimento da obesidade, da diabetes e de hábitos alimentares cada vez mais afastados do padrão mediterrânico.
- A deteção precoce através de ecografia e análises específicas pode travar a progressão — e em fases iniciais, a perda de peso e o exercício físico chegam a reverter os danos.
- Especialistas como Sofia Carvalhana, do ULS Santa Maria e do Hospital Lusíadas Lisboa, defendem que esta é uma crise de saúde pública que exige rastreio ativo nos grupos de risco.
Um em cada quatro adultos no mundo tem gordura a acumular-se no fígado — e a maioria não sabe. Não há dor, não há náuseas, não há sinais visíveis. O organismo funciona aparentemente bem enquanto, em silêncio, algo se vai alterando.
Esta condição chama-se hoje doença hepática associada à disfunção metabólica, ou MASLD, e é a doença hepática crónica mais prevalente no planeta. O nome antigo — doença hepática não alcoólica — não captava a essência do problema. A nova designação reconhece que a gordura no fígado é um sinal de perturbação metabólica mais ampla: obesidade, diabetes tipo 2, síndrome metabólica, hipertensão. O fígado conta a história do corpo inteiro.
Portugal não escapa a esta tendência. O aumento do sedentarismo, da obesidade e do consumo de alimentos processados e açúcares adicionados tem feito crescer os casos no país, tal como noutras nações europeias. A predisposição genética também conta, mas os fatores de risco são em grande parte moldados pelo estilo de vida contemporâneo.
O perigo está precisamente no silêncio das fases iniciais. Quando os sintomas aparecem, a doença pode já ter evoluído para inflamação, fibrose, cirrose ou cancro hepático — danos que podem tornar-se irreversíveis. Mas existe uma janela de oportunidade: detetada a tempo, através de ecografia ou análises específicas, a MASLD pode ser travada — e até revertida — com perda de peso, exercício regular e melhoria alimentar. Não são soluções farmacológicas; são mudanças de vida que os estudos confirmam serem eficazes.
É neste contexto que o Dia Mundial do Fígado Gordo, a 11 de junho, ganha significado. Sofia Carvalhana, gastrenterologista no ULS Santa Maria e no Hospital Lusíadas Lisboa e vice-presidente da Associação Portuguesa para o Estudo do Fígado, descreve a situação como uma crise de saúde pública que permanece demasiado invisível. O fígado tem uma capacidade notável de se regenerar — mas apenas se o problema for identificado a tempo.
One in four adults walking around the world right now has fat accumulating in their liver. Most of them don't know it. They feel fine. They have no symptoms. Their liver is quietly filling with lipids, and they're going about their day unaware that something is shifting inside them.
This condition—now called metabolic-associated fatty liver disease, or MASLD—has become the most common chronic liver disease on the planet. It used to be called nonalcoholic fatty liver disease, a name that missed the point. The new terminology reflects what doctors have come to understand: this isn't just about fat in the liver. It's about what that fat signals. It's a marker of deeper metabolic trouble—obesity, type 2 diabetes, metabolic syndrome, high blood pressure. The liver is telling a story about the whole body.
Portugal is not exempt from this trend. Like other European countries, the nation has seen cases climb as sedentary habits have deepened, as obesity rates have risen, as diabetes has spread, and as eating patterns have shifted toward processed foods, added sugars, and saturated fats. The risk factors are familiar to anyone paying attention to modern life: excess weight, abdominal obesity, type 2 diabetes, insulin resistance, elevated cholesterol and triglycerides, high blood pressure, physical inactivity. Genetic predisposition plays a role too. So does what you eat.
The insidious part is the silence. In the early stages, MASLD produces no warning signs. You don't feel it. There's no pain, no nausea, no yellowing of the skin. A person can have significant fat accumulation in their liver and pass a routine physical without anyone noticing. This is why it's dangerous. By the time symptoms appear, the disease may have already progressed to inflammation, to scarring of the tissue, to cirrhosis, or even to liver cancer. The damage can become irreversible.
But there's a window. Early detection changes everything. Imaging studies and specific blood tests can catch the disease before it hardens into something untreatable. And once caught, the intervention is straightforward in principle, though demanding in practice: lose weight, move your body regularly, eat better. These aren't pharmaceutical solutions. They're lifestyle changes. Yet they work. Studies show significant benefits. In many cases, early damage can actually be reversed.
This is why June 11th—Global Fatty Liver Day—matters. It's a date designed to push back against the silence, to raise awareness of a condition that affects hundreds of millions of people but remains largely invisible in public conversation. Sofia Carvalhana, a gastroenterologist at ULS Santa Maria and Hospital Lusíadas Lisboa and vice president of the Portuguese Association for the Study of the Liver, frames it as a public health crisis that demands attention. The disease is frequent, it's serious, and it's preventable if caught early.
The stakes are high. Without intervention, MASLD can progress to liver failure. It can lead to cancer. It can shorten lives. Yet because it whispers rather than shouts, because it hides in the asymptomatic early years, it often goes undiagnosed until the damage is done. The challenge now is to break that pattern—to make people aware that they might have it, to encourage screening in those with risk factors, and to demonstrate that change is possible. The liver, unlike some organs, has remarkable capacity to heal. But only if we catch the problem in time.
Notable Quotes
Early detection through imaging and blood tests, combined with lifestyle changes, can prevent irreversible liver damage and reverse initial harm— Sofia Carvalhana, gastroenterologist and vice president of the Portuguese Association for the Study of the Liver
The Hearth Conversation Another angle on the story
Why does it matter that we changed the name from nonalcoholic fatty liver disease to MASLD?
Because the old name was a negative definition—it told you what it wasn't, not what it was. MASLD names what's actually happening: your metabolism is broken, and the liver is the organ showing the damage. It reframes the whole conversation.
But if most people have no symptoms, how do you convince someone to get tested?
That's the hard part. You have to reach people before they feel sick. You target those with known risk factors—overweight, diabetic, sedentary. You make screening routine, like cholesterol checks. And you tell them the truth: early detection lets you reverse it.
Is this really a new disease, or are we just noticing it now?
We're noticing it now because the conditions that cause it have become epidemic. Sedentary life, processed food, obesity—these are modern. The disease follows the lifestyle.
What happens if someone ignores it?
It progresses. Inflammation, scarring, cirrhosis, liver cancer. The liver can heal itself, but only if you catch it before the scarring becomes permanent.
Can you actually reverse it?
Yes, if you catch it early enough. Weight loss, exercise, better eating—they work. The liver responds. But you have to act before the damage hardens into something irreversible.
Why is Portugal seeing more cases?
Same reason everywhere else: more sedentary time, more obesity, more diabetes, more ultra-processed food. The modern environment is built for this disease to spread.