The Surprising Reason South Asians Struggle with Fatty Liver

4 min readNew DelhiJun 12, 2026 05:57 PM
First published on: Jun 12, 2026 at 05:57 PM

Nonalcoholic fatty liver disease (NAFLD) is increasingly being diagnosed among South Asians. The condition, marked excess fat accumulation in the liver, is closely linked to insulin resance, blood sugar dysregulation, and lifestyle habits that quietly strain metabolic health over time. Dr Tanisha Shekdar, who works with such patients, says the patterns she sees are strikingly repetitive. In an Instagram post, she pointed out that the lifestyle behaviours of people who are “metabolically stuck” tend to look the same, regardless of age or gender. She captioned the video, “South Asians with fatty liver are making these 3 makes daily.”
One of the most common issues, according to Dr Tanisha, is “late-night eating.” She explained that late-night snacking, snacking after bedtime, eating close to dinner time, and never giving insulin a true break are major contributors to fatty liver disease in South Asian people. Another frequent make is starting the day with a “breakfast that isn’t protein anchored — coffee, something light, mostly carbs.”
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
The third pattern she consently observes is a complete lack of resance training. “Little to no resance training means insulin sensitivity never improves,” Dr Tanisha explained. She added that the average South Asian with fatty liver does zero resance training and instead spends time doing endless cardio or sitting at a desk for 12 to 14 hours a day. “There is no stimulus to improve insulin sensitivity or muscle glucose uptake, and no one is teaching these people how these habits are quietly keeping insulin elevated and fat trapped in their liver,” she cautioned.
But why does late-night eating and not giving insulin a break have such a strong impact on fatty liver risk?
Dr Palleti Siva Karthik Reddy, MBBS, MD, general medicine, FAIG, consultant physician at Elite Care Clinic, tells , “Late night eating keeps insulin levels elevated at a time when the body is biologically programmed to rest and repair. When insulin does not get adequate downtime, the liver is forced to continuously convert excess glucose into fat, which accelerates fatty liver development.” 

He adds that this effect is particularly pronounced in South Asians due to a higher genetic tendency toward insulin resance and central fat storage even at lower body weights. Eating late disrupts circadian alignment, reduces overnight fat oxidation, and promotes liver fat accumulation.
How a protein-anchored breakfast changes blood sugar control, cravings, and energy levels
A protein-anchored breakfast stabilises blood sugar slowing glucose absorption and reducing post-meal insulin spikes. Dr Reddy states that this leads to “better glycaemic control through the day, fewer mid-morning crashes, and significantly reduced cravings for refined carbohydrates.” 
For individuals with fatty liver or pre-diabetes, he suggests starting the day with adequate protein, which also improves satiety hormones, supports muscle metabolism, and enhances overall insulin sensitivity. 
Why is resance training so critical?
Resance training improves insulin sensitivity increasing muscle mass, the primary site of glucose uptake. More muscle means better blood sugar disposal and less glucose being diverted to the liver and stored as fat. This directly benefits fatty liver reversal. 
“Unlike cardio alone, strength training creates long-term metabolic improvements even at rest. Beginners should start with bodyweight exercises or light resance two to three times a week, focusing on proper form and gradual progression. Even short, structured sessions can deliver significant metabolic benefits when done consently,” concludes Dr Reddy.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.