Overview
- About one in four Americans has metabolic-associated fatty liver disease, with risk highest among people with overweight, obesity or type 2 diabetes.
- The condition is often silent at first but can advance to fibrosis, cirrhosis and liver cancer, with elevated liver enzymes prompting evaluation and ultrasound used for assessment.
- Recommended care centers on a Mediterranean-style diet, limiting alcohol, avoiding high-fructose corn syrup and ultraprocessed foods, achieving 7–10% weight loss and at least 150 minutes of weekly activity.
- Clinical evidence from the PIVENS trial shows 800 IU/day vitamin E improved liver histology in some nondiabetic patients but not fibrosis, so any use should be selective and medically supervised.
- Studies associate 2–3 cups of black coffee daily with lower fibrosis risk, nuts can be included with portion control of roughly 28 g and without added salt or sugar, and resmetirom has recently entered use as an adjunct therapy.