Non-alcoholic fatty liver disease (NAFLD) is a common condition that affects millions of people worldwide. It is characterized by the accumulation of fat in the liver, which can lead to inflammation and scarring of the liver tissue (1). While diet and exercise are known to be important factors in the development and progression of NAFLD, recent research has also shown that stress may play a role in this disease (2, 3). Stress is a natural response to challenging situations, but chronic or long-term stress can have negative effects on the body, including the liver. When we experience stress, our body releases a hormone called cortisol, which has been linked to the development of metabolic disorders (3). For the liver specifically, stress-related cortisol release may be linked to liver insulin resistance and inflammation, which could increase the amount of fat stored in the liver cells (2, 3). Further, chronic stress has been linked to behavioural changes such as increased food consumption, alcohol intake, and decreased exercise, which all have implications on obesity and fatty liver disease (4-6). Although few studies have investigation this relationship directly, one study published in Scientific Reports, found that higher levels of perceived stress were associated with higher NAFLD prevalence in both men and women previously thought to be healthy (2). While the exact mechanisms underlying the relationship between stress and NAFLD are still not fully understood, there is evidence that stress could be a contributing factor to the progression of NAFLD. Therefore, it could be important to manage stress as part of a comprehensive approach to preventing and treating this disease. There are several strategies that can help individuals manage stress. These include regular exercise, mindfulness-based stress reduction techniques such as yoga and meditation, and seeking support from family and friends (7). In summary, while diet and exercise are the most important currently available preventative measures and treatments for NAFLD, managing stress could also be a helpful tool for the prevention and treatment of this disease. References: Loomba R, Sanyal AJ. The global NAFLD epidemic. Nature reviews Gastroenterology & hepatology. 2013 Nov;10(11):686-90. Kang D, Zhao D, Ryu S, Guallar E, Cho J, Lazo M, Shin H, Chang Y, Sung E. Perceived stress and non-alcoholic fatty liver disease in apparently healthy men and women. Scientific reports. 2020 Jan 8;10(1):1-8. Shea S, Lionis C, Kite C, Atkinson L, Chaggar SS, Randeva HS, Kyrou I. Non-alcoholic fatty liver disease (NAFLD) and potential links to depression, anxiety, and chronic stress. Biomedicines. 2021 Nov;9(11):1697. Dallman MF, Pecoraro N, Akana SF, La Fleur SE, Gomez F, Houshyar H, Bell ME, Bhatnagar S, Laugero KD, Manalo S. Chronic stress and obesity: a new view of “comfort food”. Proceedings of the National Academy of Sciences. 2003 Sep 30;100(20):11696-701. Moore-Greene GM, Gross SM, Silver KD, Perrino CS. Chronic stress and decreased physical exercise: impact on weight for African American women. Ethnicity & disease. 2012;22(2):185. Bahi A. Increased anxiety, voluntary alcohol consumption and ethanol-induced place preference in mice following chronic psychosocial stress. Stress. 2013 Jul 1;16(4):441-51. Varvogli L, Darviri C. Stress management techniques: Evidence-based procedures that reduce stress and promote health. Health science journal. 2011 Apr 1;5(2):74