Researchers have known for decades about the effects of cholesterol on the heart. But only in the past 10 years have they started realizing that diet also affects liver health.

In the past 20 years, the prevalence of nonalcoholic fatty liver has doubled in adults. Now the disease affects between 20 and 30 percent of adults in the U.S.

"It's a hard number to believe," said my doctor, Michael Charlton, the director of hepatology and the liver transplant program at Intermountain Medical Center.

The disease causes fat to build up in the normally soft liver. Eventually, the liver becomes scarred and inflamed. That's known as nonalcoholic steatohepatitis, or NASH.

For years, hepatitis C has been the leading cause of liver transplants. NASH is projected to overtake it by 2020.

Nonalcoholic fatty liver is also becoming rampant among children. An estimated 1 in 10 children have nonalcoholic fatty liver, a number that has more than doubled over the past 20 years.

I was a farm kid who grew up on meat and potatoes.

We liked red meat and we liked half-and-half in our coffee, and we liked ice cream. We liked all of the packaged foods and sausage and cheese.

I didn't know that my diet, typical of so many Americans, was dangerously high in sugar, cholesterol and saturated fats.

Charlton recalled one study where researchers fed mice a typical fast-food diet to see what would happen to their livers. Within six months, they all developed NASH with progressive fibrosis.

"They loved it. They got really big," Charlton said. "But their livers got really sick."

Physicians have to overcome another problem in the battle against fatty liver: The disease can be tricky to diagnose.

Liver disease typically doesn't cause pain or other symptoms until it's too late. That's why doctors call it the silent liver disease.

And liver biopsies — long considered the gold standard for a diagnosis — are prone to error. Because biopsies provide a snapshot of about 1/50,000th of the liver, they can lead to conflicting results if the patient's liver has a lot of variation.

That's what happened to me, and it's why I remained undiagnosed for five years.

So I drove from Boise to Utah to go through one of these machines.

It didn't take long for Charlton to come back to me with a diagnosis.

The machine "confirmed what the surgeon had seen at the beginning," Charlton said. I had nonalcoholic fatty liver disease that had progressed to cirrhosis, for which there is no cure.

* * *

To prevent further scarring and loss of liver function, Charlton prescribed vitamin E and 60 milliliters of extra virgin olive oil every day. Both are antioxidants that have been found to improve NASH symptoms.

He also put me on the Mediterranean diet, which is high in fish, fruits, vegetables, whole grains, nuts and healthy fats like olive oil. A large study published in The New England Journal of Medicine showed the diet was powerful in reducing the risk of heart attack, stroke and death from heart disease.

It takes some getting used to, but I was sick of hauling around that picture of my liver. And I was tired of seeing my wife sitting by my hospital bed and crying.

So we buy low-sugar tomato sauce, eats lots of vegetables and swallow my olive oil, every day, like the medicine that it is.

I was pleased by a quote my doctor made to the local paper, "If every patient took on board medical advice to the degree Mr. Eskridge does, there'd be a lot less work in medicine," Charlton said.

Nobody knows yet if the damage done to my liver can be reversed, but there are some promising signs: Blood tests indicate that fewer of my liver cells are dying.

In the back of your mind, you can look at that beautiful prime rib and say, 'That sucker will hurt me,'. You've got to develop a little scale in your mind that lets you feel OK about not having that pleasure.