Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), is rapidly becoming one of the most common liver conditions in the United States. It’s a disorder characterized by excess fat accumulating in the liver, not caused by alcohol consumption, and it often develops quietly over time. When this fat buildup leads to liver inflammation and scarring, the condition can progress into a more severe form called metabolic dysfunction-associated steatohepatitis (MASH).
Both MASLD and MASH are intricately linked to chronic conditions like obesity, diabetes, high blood pressure, and heart disease. These associations make understanding and addressing them crucial for anyone looking to maintain long-term health.
The Connection Between Liver Health and Chronic Disease
Obesity and Metabolic Syndrome
At the heart of MASLD and MASH lies metabolic dysfunction. Obesity, especially central or belly fat, is a leading risk factor. When combined with other traits of metabolic syndrome—such as insulin resistance, abnormal cholesterol levels, and high blood pressure—the risk of developing MASLD rises significantly.
In fact, dyslipidemia (unhealthy blood lipid levels) affects up to 70% of individuals with MASLD. These individuals often have elevated LDL (“bad” cholesterol), increased triglycerides, and reduced HDL (“good” cholesterol), creating a dangerous environment not only for the liver but also for the heart.
Type 2 Diabetes
The relationship between MASLD and type 2 diabetes is particularly strong. Nearly 80% of people with MASLD may also have type 2 diabetes, and almost half of those with MASH are diabetic. The underlying issue is insulin resistance, a hallmark of type 2 diabetes that also contributes to the liver’s fat accumulation and inflammation.
Heart and Kidney Complications
MASLD isn’t just a liver problem—it’s a systemic one. Up to 70% of individuals with cardiovascular disease are also living with MASLD. The liver inflammation and fat accumulation associated with this condition can increase the risk of heart attacks, arrhythmias, and heart failure. Similarly, between 20% and 50% of people with MASLD also have chronic kidney disease, suggesting a broader impact on overall organ health.
A Closer Look at Impact on the Hispanic Community
Latino communities in the U.S. are especially vulnerable to MASLD and MASH. According to studies, almost half of Hispanic adults are affected, compared to 40% or fewer in other ethnic groups. Among youth aged 12 to 29, the prevalence is also high—particularly among Mexican Americans.
This disparity is partly due to genetic factors. The PNPLA3 gene variant, more common in Hispanic populations, predisposes individuals to liver fat accumulation. But genes aren’t the only factor. Dr. Blanca Lizaola-Mayo, a hepatologist at the Mayo Clinic, highlights the combined influence of diet, socioeconomic barriers, and cultural factors. A Western-style diet high in preservatives, sugar, and unhealthy fats further increases the risk.
Other contributors include:
- Limited access to healthy foods
- Language barriers in healthcare settings
- Misinformation or stigma associating liver disease solely with alcohol
- Delayed diagnosis due to lack of healthcare coverage
- High rates of obesity and diabetes within the community
As Dr. Lizaola-Mayo explains, cultural awareness in medical guidance is essential: “If I have a Peruvian, Mexican, or any other Hispanic patient and I recommend foods they have never eaten before, we won’t get anywhere.”
Why Early Diagnosis Matters
One of the challenges with MASLD and MASH is that they often go undetected. People may assume liver problems are tied only to alcohol consumption, but these conditions frequently affect non-drinkers. Because symptoms like fatigue or mild belly discomfort are easy to overlook, diagnosis is often delayed until the liver is already inflamed or scarred.
Common screening methods include:
- Blood work
- Liver ultrasound or sonogram
- Advanced imaging to detect fibrosis (scarring)
Identifying MASLD early can help prevent progression to cirrhosis or liver cancer and also reduce the risk of heart disease—another top cause of death in these patients.
Managing MASLD and MASH Through Lifestyle
While there’s no single “cure” for MASLD, lifestyle changes are a powerful tool for slowing, halting, or even reversing disease progression. Losing 7% to 10% of your body weight can significantly reduce liver fat and inflammation.
Recommended changes include:
- Quitting smoking and limiting alcohol
- Eating more fruits, vegetables, and whole grains
- Choosing lean protein over red or processed meats
- Avoiding sugary drinks and refined carbs
- Getting regular physical activity
- Managing blood sugar and cholesterol levels
- Reviewing medications with a doctor to avoid liver harm
Dr. Lizaola-Mayo encourages a realistic and culturally appropriate approach to diet: “A diet that is healthy, that you enjoy, and that you can maintain.”
What About Supplements or Natural Remedies?
Despite growing interest in holistic health, there’s no evidence that supplements or extreme diets effectively treat MASLD or MASH. In fact, many herbal remedies can be harmful to the liver. The Mediterranean diet—rich in olive oil, nuts, vegetables, and healthy fats—remains the most evidence-backed option. Unsweetened black coffee, in moderation, may also offer some liver protection.
Advances in Medical Treatment
For some, lifestyle changes alone aren’t enough. That’s where medications come in. GLP-1 receptor agonists, including semaglutide, liraglutide, and tirzepatide, have shown promise in reducing weight and liver inflammation.
In 2024, the FDA approved resmetirom (Rezdiffra) to treat MASH with moderate to advanced fibrosis. When combined with diet and exercise, it may help reduce scarring and improve liver function.
The Outlook: Hope Through Awareness and Action
MASLD and MASH are more common than many people realize, with an estimated 75 to 100 million people in the U.S. affected. While these conditions pose serious risks, they are also highly manageable—especially with early detection, lifestyle modification, and appropriate medical care.
Dr. Lizaola-Mayo emphasizes: “Understanding this highly prevalent disease, gaining access to healthy food, quality medical care, and effective treatments can truly transform lives.”
Takeaway
Metabolic liver diseases like MASLD and MASH are rising silently alongside obesity, diabetes, and other chronic illnesses. But there is hope. Stay informed. Seek regular health screenings. Make sustainable lifestyle changes. And most importantly, work with a healthcare provider who understands your needs—culturally, medically, and personally.