I first learned about non-alcoholic fatty liver disease (NAFLD) after medical school, and in that education it became obvious that this condition is mostly driven by poor metabolic health/disease. Now I see its name is being changed to reflect that reality – “Metabolic dysfunction-Associated Fatty Liver Disease (MAFLD).”
The authors of one of the papers cited below emphasize the point that the medical profession can and should exercise great care in naming diseases, and this name change is a welcome one.
Recently, a consensus of international experts proposed that the dis- ease acronym be changed from NAFLD to metabolic (dysfunction) associated fatty liver disease or ‘MAFLD’. This change goes far beyond a mere semantic revision and may be the first step that catalyses the process to better conceptualize the disease for health promotion, patient orientation, case identification, ongoing clinical trials and for health services delivery.Fouad Y, Waked I, Bollipo S, Gomaa A, Ajlouni Y, Attia D. What’s in a name? Renaming ‘NAFLD’ to ‘MAFLD.’ Liver Int [Internet]. 2020 Jun 28 [cited 2021 Feb 26];40(6):1254–61. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.14478
A more expansive definition
MAFLD has a more expansive and rational definition, in that it doesn’t exclude alcohol use as the NALFD definition did.
An astonishingly high prevalence
Among overweight/obese people:
- United States: 34%
- France: 37%
- India: 51%
- China: 52%
These are typically observational studies – most people who have MAFLD don’t know they have it; however, if they have metabolic disease, there’s a good chance they have it.
Still no pharmacologic treatment … only diet
The redefinition and alarming prevalence statistics are as important as ever, given that there is no pharmacologic treatment for this condition, it can devolve into a host of life threatening conditions, and it is now the #2 indication for liver transplantation in the United States.
The only treatment available is diet. What kind of diet? Hint, not the Stadnard American Diet (SAD).
I’ve written a few blog posts about this:
- Just Read: How a low-carbohydrate diet rapidly reverses risk factors in people with high liver fat, in the disease we’ll all be hearing about – NAFLD, NASH, Diabetes Reversal
- Just Read: The role of diet and nutritional intervention for the management of patients with non-alcoholic fatty liver disease (NAFLD)
- Just Read: High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance (except that maybe it’s not))
The renaming makes complete sense and puts metabolic health front and center in our lives, where it has been all along, we just haven’t been paying enough attention.
- Fouad Y, Waked I, Bollipo S, Gomaa A, Ajlouni Y, Attia D. What’s in a name? Renaming ‘NAFLD’ to ‘MAFLD.’ Liver Int [Internet]. 2020 Jun 28 [cited 2021 Feb 26];40(6):1254–61. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.14478
- Liu J, Ayada I, Zhang X, Wang L, Li Y, Wen T, et al. Estimating global prevalence of metabolic dysfunction-associated fatty liver disease in overweight or obese adults. Clin Gastroenterol Hepatol [Internet]. 2021 Feb; Available from: https://linkinghub.elsevier.com/retrieve/pii/S1542356521002081