Non-Alcoholic Fatty Liver Disease (NAFLD) – Causes, Symptoms, Treatment & Herbal Remedies

Abstract

Non-Alcoholic Fatty Liver Disease (NAFLD), also called Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD), is increasingly affecting children due to rising obesity, poor diet, and sedentary lifestyles. Early stages are often symptom-free but can progress to inflammation, fibrosis, and cirrhosis. In India, about 35.4% of children show NAFLD, with rates higher in obese children (63.4%) than non-obese (12.4%), raising risks for diabetes and heart disease. Early detection, healthy diet, regular exercise, and weight control are crucial. Ayurveda emphasizes addressing root causes by strengthening Agni (digestive fire), balancing doshas, and restoring body harmony.

Introduction

Non-Alcoholic Fatty Liver Disease (NAFLD) is a serious concern and nowadays even kids are gripped by this disease. It is caused without the involvement of alcohol intake or abuse, so the term ‘Non Alcoholic Fatty Liver Disease’ is used here. It is also known as Non Alcoholic Steatohepatitis (NASH) or more recently, Metabolic dysfunction Associated Steatotic Liver Disease (MASLD) is the term used for it. With the global increase in childhood obesity, pediatric MASH has emerged as one of the leading causes of chronic liver disease among children and adolescents. Timely identification through screening, especially in high-risk groups such as obese, prediabetic, or dyslipidemic children, is essential. Lifestyle interventions, including a balanced diet, regular physical activity, and effective weight management, continue to be the cornerstone for both prevention and treatment.

Stages of Non Alcoholic Fatty Liver Disease in Children

Fatty liver disease progresses through five stages, which are determined by the extent of fibrosis (scarring) in the liver. Most children remain at stage 0, while only a few may advance further if left untreated. The stages are-

1. Stage 0 – Simple Steatosis (Fatty Liver)

Fat starts accumulating in the liver cells, but the liver continues to function normally. There is no scarring or permanent injury at this stage.

2. Stage 1 – MASH With Mild Fibrosis

Excess fat leads to liver inflammation (swelling and irritation). Minimal or no scarring is present. Lifestyle changes at this stage can often reverse the condition.

3. Stage 2 – MASH With Moderate Fibrosis

Ongoing inflammation begins to cause noticeable scarring. The liver still works effectively, and most of the damage can still be repaired.

4. Stage 3 – MASH With Advanced Fibrosis

Scarring becomes more widespread. The liver may still function well, but without intervention, the risk of cirrhosis increases. Preventing further damage is critical at this point.

5. Stage 4 – Cirrhosis

This represents long-term, severe liver injury where large portions of the liver are scarred. The liver may continue to function for some time, but if too much tissue is damaged, it struggles to perform essential tasks.

Causes

• Excess weight and obesity- Primary cause of fat deposition in the liver.
• Insulin resistance and metabolic issues.
• Abnormal lipid profile.
• Poor dietary habits- High sugar, junk food, packed, canned and processed meals contribute to risk.
• Lack of physical activity.
• Genetic mutations such as PNPLA3 and TM6SF2 heighten susceptibility.
• Gut microbial imbalance.
• Low birth weight or exposure to maternal diabetes.
• Certain medications like corticosteroids may aggravate liver fat.

Role of Junk/Processed Food in NAFLD/MASLD in Kids

Junk food high in sugar, refined carbs, and unhealthy fats overwhelms the liver, converting excess sugars into fat through ‘de novo lipogenesis’. When fat production exceeds the liver’s ability to process and remove it, fat builds up in liver cells, leading to hepatic steatosis. This excess fat promotes insulin resistance, oxidative stress, and inflammation, which damage liver tissue. Gut microbiota imbalance and harmful compounds like AGEs from processed foods further worsen the condition, eventually pushing fatty liver disease toward more severe stages such as MASH and fibrosis.

Symptoms

Usually, no signs and symptoms are seen until a lot of damage is done already. By the time, some symptoms show and the child starts feeling discomfort, the child may already have extensive liver damage.

In case some early symptoms present, they generally are-

• Abdominal pain or discomfort.
• Constant tiredness and low energy.
• Irritability or mood changes.
• Frequent headaches.
• Trouble focusing or poor concentration.
• Low mood or signs of anxiety.
• Darkened skin patches (acanthosis nigricans), especially in folds or near joints.

Later symptoms may include-

• Yellowing of the skin and eyes (jaundice).
• Dark-colored urine.
• Itchy skin.
• Black, tarry stools.
• Enlarged liver or spleen.
• Swelling in the abdomen (ascites)- if the disease has progressed to Liver Cirrhosis.

Diagnosis

1. Family History And Medical History

May reveal genetic disposition, or metabolic disorders.

2. Physical Examination

Pain in Rt. abdomen, overweight.

3. Liver Function Test

Elevated ALT, AST, Gamma Glutamyl Transferase (GGT).

4. Imaging Tests

Ultrasound, MRI, Elastography to get a clear idea.

5. Liver Biopsy

Confirmatory but usually not recommended in children.

Treatment

As per Allopathic management, there are no medications for MASLD in children. But Ayurveda has herbal formulations to reverse this fatty liver disease and maintain the overall health of the kid. Managing weight, cutting off junk food, staying physically active and eating a balanced diet can help.

Ayurvedic Overview

In Ayurveda, NAFLD in children can be called a Santarpanjanya Vyadhi (Diseases caused by over-nutrition). When children indulge in Ahita ahara-vihara (unwholesome diet and lifestyle) like Atimadhur (Excessively sweet), Atisnigdha (Excessively oily), Abhishyandi (Blocking channels) food, Adyashana (Eating again when previous food is still undigested), without indulging in physical activities, then Vata and Kapha dosha gets vitiated and causes obstruction in various channels, especially in Medovaha Srotas (Fat carrying channels). This further affects the Jatharagni (Digestive fire) and forms Aam (metabolic endotoxins) in the body. All the causative factors lead to accumulation of Medo dhatu (Fat tissue) in the body as well as in the liver. Therefore, Fatty liver disease manifests in kids when the lifestyle becomes sedentary and there is abundance of processed, junk food in their diet.

Kids generally show symptoms like Udarashoola (Pain in abdomen), Anaha (Abdominal distension), variable appetite, nausea, shrama (lethargy), breathlessness due to sthaulya (obesity), body ache and also, Mukhvirasyata (Foul taste in the mouth). Ayurvedic management focuses on restoring Agni (digestive fire), correcting imbalanced doshas, and detoxifying the liver using herbal formulations and lifestyle interventions. Key therapies include Nitya Virechana (regular purgation) and Asthapan Basti (decoction enemas) using sour-tasting (Amla Ras) herbs to enhance digestion. Effective classical formulations include Pippalyadi Churna, Vidangadi Kshar, Rohitak Ghrit, Takra, Yakritplihantak Churna, Phaltrikadi Kwath, Bhumi Amla, and Punarnava Mandur, which help reduce abdominal distention and support liver function by detoxifying liver. Regular Yoga and Pranayama is also beneficial to maintain overall health and boost immunity in children.

Dietary Habits and Lifestyle Modifications

Dietary Habits

Diet should include whole grains, lean protein, fresh fruits and vegetables. Beetroot, pumpkin, garlic, cucumber, zucchini, bitter gourds, carrots, tomatoes, spinach, broccoli, cabbage, radishes and papaya are useful in this condition. For protein, home-made raw cottage cheese, sprouted seeds and grains, raw nuts, especially almonds are advised. Avoid all refined, processed and canned foods, sugar in any form, caffeine, excessive use of salt, white flour and products made with it, fried foods, pickles and alcoholic beverages.

Lifestyle Modifications

Regular physical exercise should be done for weight loss in overweight children, and also in general, to stay fit. Yogasanas like Bhujangasana (cobra pose), Trikonasana (triangle pose), Dhanurasana (Bow pose) are recommended. Practising Pranayama (Breathing techniques) like Anulom-vilom (Alternate nasal breathing), Kapalabhati Pranayama (Skull Shining Breath) and Bhramari Pranayama (Bee Breath) are extremely helpful too.

Herbal Remedies For NAFLD/MASLD In Kids By Planet Ayurveda

Planet Ayurveda is a trusted global brand that brings the healing wisdom of Ayurveda into modern life. From daily wellness to managing chronic conditions, their wide range of herbal capsules, powders, oils, and teas support natural healing. Backed by expert Ayurvedic doctors, Planet Ayurveda ensures authenticity and quality in every formulation. Today, it’s not just a brand but a movement reviving Ayurveda worldwide.

For NAFLD in kids, we have the following medicines-

• Yakrit Plihantak Churna
• Livo Plan Syrup
• Digesto Plan Syrup
• Liver Detox Formula

Product Description

1. Yakrit Plihantak Churna

This herbal powder is made from plenty of potent herbs, with key ingredients being, Bhumi Amla (Phyllanthus niruri), Katuki (Picrorhiza kurroa) and Kalmegh (Andrographis paniculata). All these pacify Pitta and Kapha doshas, and mildly balances Vata dosha. Phytochemicals like lignans, alkaloids, glycosides, flavonoids present in these herbs help in protecting liver cells from damage, reduces hepatic fat accumulation and enhances liver enzyme function.

Dosage– ½ tsp twice daily or as directed by the physician.

2. Livo Plan Syrup

This syrup has key ingredients like Bhringraj (Eclipta alba), Bhumiamla (Phyllanthus niruri) and Shyonak (Oroxylum indicum). They cumulatively balance all three doshas. These herbs have active ingredients like ecliptic, wedelolactone, phyllanthin, anthraquinone, aloe-emodin etc. which work by stimulating bile flow and fat metabolism, preventing fat accumulation in the liver. They also have antioxidant and anti-inflammatory properties that help in managing Fatty Liver Disease.

Dosage– 2 tsp twice daily.

3. Digesto Plan Syrup

Digestoplan Syrup by Planet Ayurveda is prepared using Jeera (Cuminum cyminum), Ajwain (Trachyspermum ammi) and Saunf (Foeniculum vulgare) as its key ingredients. This herbal syrup, balances all three doshas (Vata, Pitta and Kapha) and balances our Jatharagni (Digestive fire) as well. This syrup improves digestion and appetite, reducing undigested fat deposition, and acts as a mild hepatoprotective as well.

Dosage– 10 ml twice daily.

4. Liver Detox Formula

These capsules are made using key ingredients like Katuki (Picrorhiza kurroa), Punarnava (Boerhavia diffusa) and Kalmegh (Andrographis paniculata). Balancing all three doshas, these herbs contain active constituents like beta-sitosterol, palmitic acid, glycosides, kalmeghin and andrographolide etc. which supports liver regeneration, promotes liver detoxification and also reduces hepatic inflammation.

Dosage– 1 capsule twice daily.

Conclusion

Non-Alcoholic Fatty Liver Disease (NAFLD), or Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD), is increasingly affecting children, primarily due to sedentary lifestyles, poor dietary habits, and rising childhood obesity. Early detection through screening, particularly in high-risk children, is essential to prevent progression to severe liver damage. While allopathic treatment options in children are none, Ayurvedic approaches offer effective strategies by addressing the root causes- over-nutrition, vitiated doshas, and impaired digestive fire. Herbal formulations, therapies like Nitya Virechana and Asthapan Basti (depending on the age of the child), along with lifestyle modifications, balanced diet, physical activity, Yoga, and Pranayama, help restore liver function, reduce fat accumulation, and improve overall health. Timely intervention through Ayurveda, under the guidance of an Ayurvedic physician, and consistent care can not only reverse fatty liver changes but also promote long-term wellness in affected children.