Non-alcoholic fatty liver disease, recently renamed ‘metabolic dysfunction-associated steatotic liver disease’ to remove the association with alcohol, has become endemic in Western societies. Yet it’s wholly preventable with the right nutrition and lifestyle education. In this article we look at the role that ultra-processed foods play in this potentially life-threatening disease. Action Alert!
This article was adapted from ANH International’s recent analysis of the issue. Read the original here.
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THE TOPLINE
- MASLD (formerly non-alcoholic fatty liver disease, or NAFLD) is a widespread, preventable liver disease now affecting up to one in three adults and one in ten children, driven largely by poor diet and metabolic dysfunction rather than alcohol use.
- Ultra-processed foods (UPFs) are a major contributor, making up nearly 60% of the US diet and linked to obesity, diabetes, heart disease, and liver damage through mechanisms like gut-liver axis disruption and food addiction.
- Systemic change is urgently needed, including ending subsidies for UPFs, regulating harmful marketing (especially to children), investing in nutrition education, and ensuring access to real, whole foods for all communities.
Non-Alcoholic Fatty Liver Disease Has a New Name!
In an attempt to de-stigmatize the liver disease historically known as non-alcoholic fatty liver disease (NAFLD) as it’s become so endemic in Western societies, its new name is Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Neither roll off the tongue very easily. However, while avoiding what’s been deemed the offending word – alcoholic – at least the new name more accurately reflects the cause as metabolic dysfunction—but then replaces the word, fatty, with steatotic. Medically the same thing, but less well-recognized to the lay public, the term “steatotic” could mask how closely linked it is to rising rates of obesity, type 2 diabetes, consumption of ultra-processed foods, and sedentary lifestyles. If medics and public health advocates had got their heads together in an effort to come up with a better name, perhaps we might have ended up with more meaningful terms like Metabolic Fatty Liver Disease, or Nutrition-Related Fatty Liver?
Names aside, NAFLD, now MASLD, is rife in the developed world, affecting around 24% to 35% of US adults—about 80 to 100 million individuals. MASLD is very often without symptoms, but can precede more serious diseases like non-alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer. The American Liver Foundation say that MASLD is present in up to 75% of overweight individuals and 90% of those with severe obesity.
The Ultra-Processed Food Crisis
The rise in the consumption of ultra-processed foods (UPFs) is one of the most far-reaching and under-addressed dietary shifts of the 21st century. In the US, UPFs now account for 58% of total daily energy intake. These products, ranging from ready-to-eat meals, soft drinks, and packaged snacks, are engineered for taste, their ability to hit the ‘bliss point’ (linked to food addiction), shelf life, and affordability. But behind their convenience lies a troubling reality: UPFs are created to be high in unhealthy fats, added sugars, salt and calories, while offering little in terms of fiber, vitamins, or other essential nutrients. They drive food addiction, unhealthy food behaviors and metabolic dysfunction.
Despite mounting evidence linking UPFs to chronic diseases like heart conditions, obesity and diabetes, recent studies (here and here) have drawn attention to another serious consequence: the development of MASLD. Currently the world’s most common liver disease, MASLD affects an estimated 38% of adults globally—a figure projected to rise to 55% by 2040. While health systems struggle with the growing burden, UPF sales continue to soar, with food manufacturers paying out a staggering $58 billion to shareholders in 2021 alone.
Unlike previous public health crises, such as tobacco use or HIV, where scientific consensus triggered strong policy responses, action on UPFs has been slow and largely ineffective. Government interventions remain weak, often outpaced by the aggressive marketing and lobbying efforts of the food industry. This raises urgent questions about the health risks of UPFs, their significantly addictive power, the corporate structures that perpetuate them, and steps to take in reclaiming our diets and our food behaviors.
How Ultra-Processed Foods are Fueling the Rise of MASLD
In recent years, mounting evidence (here, here and here) has drawn a strong connection between UPF consumption and MASLD/NAFLD. Unlike liver damage caused by alcohol, MASLD stems from metabolic dysfunction largely driven by poor diet. A major mechanism is the gut-liver axis: UPFs, especially those high in fructose and low in fiber, disrupt gut microbiota, weaken the intestinal barrier, and allow inflammatory toxins to travel to the liver. This process not only damages the liver but also increases the risk cardiovascular disease, the leading cause of death in MASLD patients.
As we’ve seen, the scale of this crisis is staggering. MASLD might be affecting around one in three adults, but it’s a shocking indictment of our time that we are now seeing one in ten children affected globally. A 2023 US study found that adolescents with the highest UPF intake had up to 183% higher odds of developing fatty liver disease. Another study showed that each 10% increase in UPF consumption raised the risk of heart attack or stroke by 13%. Tackling this epidemic calls not just for better health care interventions that can also tackle food addiction, but also legislation to rein in the food conglomerates from knowingly abusing the public for profit, and of course, a fundamental shift back to eating food as it used to be: the kinds of foods produced by regenerative agriculture that is fully sustainable and organic.
More On the Business of Addiction: Big Food’s Role in the UPF Epidemic
Before the 1980’s, most people ate more whole foods that were home-cooked and minimally processed meals with limited additives and preservatives. Food and mealtimes were social events woven into daily life, prepared with intention, not just for taste but to truly nourish, both nutritionally and emotionally. For many, that relationship has been severed. In recent decades, UPFs often combined with eating on the move, or in front of digital devices, have taken center stage through calculated strategies by powerful food corporations determined to replace real food with addictive, hyper-palatable products. Their aim isn’t nourishment, it’s the domination of the food system.
Each year, Big Food spends over $14 billion on marketing—80% of which goes to promoting UPFs loaded with sugar, salt, and unhealthy fats, targeting families and children with relentless precision. To keep these products cheap and ever-present, corporations exploit government subsidies for commodity crops and rely on technologies that lower production costs, regardless of health consequences. In the US, this has resulted in over 73% of the food supply being ultra-processed, with UPFs being 52% cheaper than minimally processed alternatives.
Regulatory efforts remain weak, often delayed or blocked by corporate lobbying. The result is a system where unhealthy food is the easiest choice, and where the rise in diet-related diseases like MASLD is not an accident, but the predictable outcome of an out-of-control business model.
The Way Forward: Reclaiming Food for Health, Not Profit
It is time we rise to reclaim our food—not as a product of profit-driven industry, but as a source of nourishment, culture, and wellbeing. This requires more than urging individuals to make better choices; it requires systemic, seismic, change. Currently, governments around the world subsidize UPF ingredients by up to $42.5 billion annually. These funds must be redirected. Policies should abolish subsidies for commodity crops used in UPFs and instead incentivize the production of whole foods, fresh fruits, and vegetables, which often face trade barriers like tariffs. Harmful UPF advertising—especially to children—should be taxed or banned, and labelling regulations restructured to mandate full disclosure of what these product really contain.
At the same time, consumers must be empowered, not blamed. Nutrition education should begin early and extend into communities, schools, and healthcare systems. Access to fresh, healthy foods must be treated as a right, not a privilege, supported by policies that bring healthy options into underserved areas. Unsustainable and exploitative business practices should be recognized as abuses of market dominance and subject to antitrust enforcement. Reclaiming food for health is not abstract; it is entirely achievable—if we act together and with resolve.
Where Does This Leave Us?
While we wait for governments to implement the bold reforms needed to fix our broken food system, individuals can still protect their health. There is currently no magic bullet in the form of a drug that can fully reverse MASLD. Prevention, treatment and management is all down to lifestyle changes: a sea change in nutrition and food choices, eating habits, regular physical activity, adequate sleep, the avoidance of smoking and dependence on alcohol and recreational drugs, managing stress, engaging in positive social connection and spending time outdoors in nature.
As with any change, just taking the first, often tiny, step is all that’s needed, and the rest will naturally follow. A good start is to become more aware of what you eat. Read labels, watch out for ‘bliss point’ foods that have an excess of salt, unhealthy fats and added sugars (not sure what these might be? Think about the smell of fresh donuts and that combination of warm fats and sugars…), and opt for natural, whole foods when possible. Instead of sweetened yogurts or frozen ready meals, choose natural yogurt and add a hand full of fresh berries, prepare healthy dishes at home in larger batches and freeze portions for later. These changes don’t require stress, overwhelm or perfection, only consistency.
Over time, these habits—combined with others, including use of natural products such as milk thistle, berberine, curcuminoids (from turmeric root), resveratrol, Omega-3 fatty acids, N-acetyl-cysteine, and polyphenol-rich supplements, as well as intermittent fasting—can help to heal the liver, reshape our relationship with food, and even reconnect us with the joy of eating healthy meals again.
