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Glossary

MASLD

Defined in topic 14

Metabolic dysfunction-associated steatotic liver disease, the 2023 renaming of nonalcoholic fatty liver disease. It affects about 30% of adults worldwide, and far more of them die of heart disease.

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Where this comes from

In the reference topic that owns this term

Reference topic 14, The Liver and the Chemical Century, states the mismatch as a card: what the system evolved to expect, what it gets instead, and what happens in the gap.

Mismatch card

What it expects

Daily plant defense chemicals, occasional natural toxins such as aflatoxin, and food energy that took work to get.

What it gets

Surplus calories from sugary drinks and alcohol, and more than 350,000 registered chemicals and mixtures, a few of them, such as the long-lived PFAS, beyond its power to break down.

What happens in the gap

About 30% of adults worldwide have fatty livers, and more of them die of heart disease than of liver disease; the main PFAS linger for years in nearly every American's blood.

The full card, and the topic behind it

What that chapter recommends

3 of the 9 graded recommendations in Reference topic 14, strongest evidence first. How the grades work.

  1. Keep alcohol low

    StrongEvidence grade: Strong. Multiple randomized controlled trials, or consistent large cohort studies with a well-understood mechanism.

    Cirrhosis risk climbs steeply with heavy daily drinking, and in women it rises even at one drink a day. With significant liver scarring, graded F2 (fibrosis stage 2) or worse, US liver guidelines advise none at all.

    Read it in full

  2. Move about 150 minutes a week at brisk-walking effort

    StrongEvidence grade: Strong. Multiple randomized controlled trials, or consistent large cohort studies with a well-understood mechanism.

    the dose that lowered liver fat in trials.

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  3. Lose weight if you carry extra

    StrongEvidence grade: Strong. Multiple randomized controlled trials, or consistent large cohort studies with a well-understood mechanism.

    A 3-5% loss improves liver fat, but inflammation and scarring generally need more; aim for 10%.

    Read it in full

Related terms

The argument behind this term, its studies and its notes are in Reference topic 14 of the reference library. The book gives the practical version. Get the book.