Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as fatty liver disease, affects an estimated 25% of adults in the U.S., making it the most common chronic liver disease. According to a national health survey, less than 5% of individuals with MASLD are aware they have the condition.
MASLD develops gradually and often presents no symptoms. However, it can lead to irreversible liver damage, such as cirrhosis, if left untreated, according to Dr. Susan Kais, a gastroenterologist at UC Health. Fortunately, MASLD is largely preventable and reversible through a healthy diet and lifestyle.
Experts identify sugar as a primary driver of MASLD. When the body consumes more sugar than it needs for energy, the liver converts the excess into fat, which accumulates in liver cells over time. This process is exacerbated by sugar-sweetened beverages like soda, fruit juice, and energy drinks, which lack nutrients that could slow sugar absorption. This can lead to blood sugar spikes, increased insulin production, and insulin resistance, promoting fat storage in the liver.
"There is no single food item responsible for MASLD, but sugar-sweetened beverages, like sodas, energy drinks and sweet teas, loaded with added sugars or high-fructose corn syrup, are major culprits, since the body simply can’t utilize all of that sugar, leaving the liver to convert the surplus directly into fat," Kais said.
Fat, particularly saturated and trans fats, also contributes to MASLD. Fried foods, which are high in these fats, can stress liver cells. A study involving over 200,000 participants found a correlation between frequent consumption of fried foods, especially french fries, and an increased risk of MASLD.
Refined carbohydrates, such as white rice, white bread, and pastries, are also implicated. These foods behave similarly to sugar in the body. Research published in the American Journal of Gastroenterology indicates that diets high in refined carbohydrates are associated with a greater risk of MASLD.
While not in the top three, alcohol is also a concern. It can contribute to insulin resistance and liver inflammation, both of which are detrimental to liver health.
To support liver health, experts recommend adopting a Mediterranean diet, which emphasizes vegetables, fruits, plant-based proteins, seafood, lean proteins, and olive oil, while minimizing ultra-processed foods and red meat. A study analyzing data from over 47,000 individuals over 13 years found a link between adherence to a Mediterranean diet and improved liver health.
For sweet cravings, whole fruits, particularly berries, are recommended due to their fiber, antioxidant, and vitamin content. Dark chocolate with a high cocoa percentage can also satisfy sweet cravings while providing beneficial antioxidants. Coffee, consumed without excessive sugar, is another beverage associated with better liver health.
Dietary changes can significantly impact liver health, and minimizing the intake of sugary drinks, fried foods, and refined carbohydrates is a crucial starting point for prevention and reversal of MASLD.