Nonalcoholic fatty liver disease (NAFLD) can be reversed with several lifestyle changes, including diet and physical activity.

Nonalcoholic fatty liver disease (NAFLD) is now known as metabolic dysfunction-associated steatotic liver disease (MASLD). This new name is more accurate and helps reduce the stigma associated with its older name.

A group of multinational liver societies and organizations, including the American Association for the Study of Liver Diseases (AASLD), developed and finalized the name change and announced it in June 2023.

MASLD is the most common liver condition in the world. About 30% of adults have MASLD, and the rate is on the rise.

If you’re like many people, you may have been diagnosed with MASLD after being checked for another health condition. It’s often found incidentally, as there are usually no symptoms.

For example, it can be found during an ultrasound that’s being used to evaluate abdominal pain.

MASLD is not caused by drinking excess alcohol.

For reasons that we don’t completely understand, MASLD sometimes progresses and leads to liver damage. In many cases, MAFLD can be managed or reversed with diet and activity changes.

The liver is an organ in the body that plays a part in storing energy in the form of glycogen (the stored form of glucose or sugar) and fat. It’s typical for some fat to get stored in the liver. MASLD develops when too much fat builds up in the liver.

MASLD is diagnosed when the amount of fat in your liver makes up more than 5% of your liver weight, but there’s no inflammation or liver damage.

MASLD is highly associated with metabolic syndrome. People with metabolic syndrome are at greater risk of developing MASLD.

Metabolic syndrome involves insulin resistance. This is when the body doesn’t use insulin properly. When insulin doesn’t work as it should, extra sugar stays in the blood. This can also raise levels of fat called triglycerides in the blood. This extra fat is more likely to get stored as fat in the liver, leading to MASLD.

Your doctor may suspect MASLD if your blood work shows a mild increase in liver enzymes. To confirm MASLD, your doctor may send you in for a liver ultrasound to find out how much fat is present in your liver and whether there’s any damage.

Yes. If you’ve been diagnosed with MASLD but there’s no sign of liver damage, it can be slowed or reversed.

Sometimes MASLD progresses to another condition called metabolic dysfunction-associated steatohepatitis (MASH), formerly known as nonalcoholic steatohepatitis (NASH). MASH develops when the liver contains extra fat and there are signs of liver inflammation.

How long does it take?

It’s not possible to predict exactly how long it might take to reduce the fat in your liver. As with many health conditions, different people will have different responses.

The liver is constantly storing fat and breaking down fat. The goal of treatment is to slow down the amount of extra fat that gets stored in the liver. Changes to your diet and activity level often help with this.

Many trials show that with increased exercise, a reduction in liver fat can happen within weeks to months.

Lifestyle changes

Several healthy habits can improve MASLD. Diet can play a part in preventing excess fat from being stored in the liver.

Here are some things you can do to promote liver health:

  • Eat plenty of fiber sources, including fruits, vegetables, beans, nuts, seeds, and whole grains.
  • Limit foods high in sugar, such as baked goods, candy, juice, and soda.
  • Include sources of healthy fats in your diet, such as fish, nuts, seeds, avocado, and olive oil.
  • Limit fried foods and sources of saturated fat such as red meats and high fat dairy products.
  • Eat balanced meals on a regular schedule.
  • Limit or avoid alcohol, even if alcohol intake did not contribute to developing MASLD.

If you have diabetes or prediabetes, managing your blood sugar levels with activity, medication, and food choices may also help to lower the amount of fat in your liver.

Medications

There are no specific medications approved to treat MASLD. If you have type 2 diabetes, any medications you take for this may also help to protect your liver from the effects of high blood sugar.

According to a 2019 research review, among people with type 2 diabetes, 55.5% also have MASLD.

There are many things you can do to keep your liver healthy. Many of these recommendations are similar to how you would manage heart disease or diabetes. There’s a link between all of those conditions.

Tips for a healthy liver include:

  • staying active
  • eating a healthy diet high in fruits, vegetables, whole grains, nuts, seeds, and beans
  • choosing healthier fats such as those from canola oil, olive oil, nuts, nut butters, seeds, avocado, and fish
  • not smoking or taking steps to reduce smoking
  • avoiding or limiting alcohol
  • getting more quality sleep

There is no specific medication for MASLD. There are steps you can take to manage MASLD by changing your lifestyle. Eating a healthy diet, avoiding alcohol, and being more active may help

If you also live with metabolic syndrome, managing cholesterol, blood sugar levels, and blood pressure levels may help to protect your liver.

MASLD is a common liver condition throughout the world. In many people, MASLD does not progress and the extra fat on the liver does not cause long-term problems.

It’s estimated that about 20% to 30% of people with MASLD will progress to MASH.

One theory of why some people progress to MASH is called the “two-hit hypothesis.” The first “hit” to the liver is MASLD.

The second hit is something else that triggers damage, such as genetics, diet, or the gut microbiome. About 5% to 20% of people with MASH may develop cirrhosis. These estimates are based on a combination of older resources. More current research on the topic is necessary.

Cirrhosis is a severe and irreversible form of fibrosis, which is when damage to the liver causes scar tissue. This interferes with liver functioning.

MASLD is a common liver condition. It’s often found by accident. It’s associated with metabolic syndrome and as rates of metabolic syndrome rise, more people are also diagnosed with MASLD.

It’s possible to reverse MASLD through lifestyle changes that reduce the amount of fat that gets deposited in the liver. A high fiber diet, plenty of activity, avoiding or limiting alcohol, and managing other health conditions may help to prevent MASLD from progressing.