Robert Lustig explains how fatty liver disease now appears in five-year-olds with the same microscopic damage once seen only in alcoholics. The disease looks identical under the microscope, but a different cause is driving it in children who don't drink.
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So here we have normal liver, okay? So you can see the sinusoids, the bile canaliculi, the Kupfer cells right here. Okay? Nicely ordered. All good. Right. And here, over here we have fatty liver disease. And you can see the fat vacuoles, and you can see the macrophages, and you can see the lymphocyte infiltration, and you can see the beginning of scarring right here. Everybody see that? The problem is, if you look at this under the microscope, what caused it? Prior to 1980, if you saw that under the microscope, that was alcohol. But now five year olds have it and they don't drink alcohol. In fact, alcoholic fatty liver disease and non alcoholic fatty liver disease look exactly the same under the microscope, because they are exactly the same. The only difference is the substrate that caused it.