February 17, 2025

MAFLD: Strategies for Supporting Patients’ Liver and Metabolic Health

Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is a serious health concern – one that may already affect many of your patients. With obesity and metabolic dysfunction now impacting over 40% of U.S. adults, [1] MAFLD cases are more prevalent than ever.

MAFLD occurs when the body can't store any more fat, and the liver starts stockpiling excess fatty acids to compensate – setting the stage for this progressive condition. But MAFLD is not just about liver health; it's deeply connected to chronic illnesses like Type 2 diabetes, hypertension, and cardiovascular disease.

How MAFLD Progresses

MAFLD is the most common cause of chronic liver disease today, affecting 1 in 4 adults in the U.S. and 34% worldwide. [2] By 2030, experts believe the global number could increase to 56%!

About 30% of MAFLD cases progress to non-alcoholic steatohepatitis (NASH), [2] a more severe condition that involves liver inflammation and scarring (fibrosis). Left unchecked, NASH can lead to cirrhosis, liver failure, or even cancer.

What’s Happening Inside the Liver

MAFLD is fundamentally an inflammatory condition driven by insulin resistance, obesity, and metabolic syndrome. [3] It manifests when fat builds up in liver cells, either from the body’s fat stores or from excess carbs. Diagnosis is often made with a simple ultrasound, but newer technologies like FibroScan® can now provide a more detailed picture, measuring both fat accumulation and scarring in the liver. [4]

Beyond metabolic dysfunction, the gut also plays a crucial role in MAFLD’s progression. The gut-liver axis serves a two-way communication pathway, where toxins like LPS (lipopolysaccharides) can slip through a weakened intestinal barrier and travel to the liver. [5] This triggers an inflammatory response that can worsen liver damage. An unbalanced gut microbiome, often seen in MAFLD, can also overproduce harmful bacteria and even ethanol, fueling oxidative stress and inflammation. [2]

Who’s at Risk?

Middle-aged adults (ages 45–64) are most at risk, with men generally more affected than women. [3] Obesity and metabolic syndrome are big contributors to MAFLD, along with poor diet (think sugary, high-fat foods), a sedentary lifestyle, and genetics. However, not all MAFLD patients are overweight. Lean individuals can also develop the disease, often due to visceral fat (around organs), gut inflammation, or a disrupted gut microbiome. [4]

How Can We Help Our Patients?

Thankfully, there’s good news: MAFLD can be managed – and even reversed – through targeted lifestyle changes:

Improve Diet: A plant-based, fiber-rich diet fuels good gut bacteria, producing short-chain fatty acids (SCFAs) that reduce liver inflammation and support overall health.
Boost Bile: Natural aids like artichoke, milk thistle, and turmeric (plus TUDCA) promote bile production for better fat digestion and detoxification.
Address Oral Hygiene: Yes, your patients’ dental health matters! Keeping the oral microbiome in balance reduces systemic inflammation that can affect the liver.

Living with MAFLD

MAFLD is a complex condition but managing it can be fairly straightforward. Helping your patients make healthy, sustainable diet and lifestyle changes, support healthy bile production, and balance their oral and gut microbiomes are small but powerful steps that can slow and even reverse MAFLD’s progression. Patient education and early intervention are key.

Read our MAFLD protocol sheet for evidence-based clinical strategies and guidelines for giving patients the tools they need to take control of their liver and metabolic health.

Resources:

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