Posted on 05/16/2026 8:48:24 PM PDT by Red Badger

A new global analysis published in The Lancet Gastroenterology & Hepatology reports that cases of metabolic dysfunction-associated steatotic liver disease (MASLD) have surged 143% since 1990, reaching an estimated 1.3 billion people in 2023, according to the study, as reported by registered dietitian Molly Knudsen. The condition, driven by metabolic risk factors including high fasting plasma glucose, high body mass index (BMI), and smoking, is projected to affect 1.8 billion people by 2050 unless interventions are implemented, researchers stated.
Liver cancer cases are expected to nearly double from 870,000 in 2022 to 1.52 million by 2050, with MASLD identified as the fastest-growing cause due to rising obesity rates, according to a separate analysis published in The Lancet [1]. The findings underscore a largely preventable public health crisis that is accelerating worldwide.
What Is MASLD? MASLD, formerly called nonalcoholic fatty liver disease (NAFLD), involves excess fat accumulation in the liver not due to alcohol consumption, per the 2023 nomenclature update. The condition is linked to insulin resistance, elevated blood sugar, and obesity, officials explained. It differs from alcohol-associated liver disease, which is driven by excessive alcohol intake.
Non-alcoholic fatty liver disease is one of the primary hallmarks of visceral fat accumulation in the liver, according to a book on longevity [2]. The condition often develops silently, with most individuals experiencing no early symptoms, allowing undetected progression to steatohepatitis, fibrosis, cirrhosis, or liver cancer, experts noted.
Reasons Behind the Rise High fasting plasma glucose accounted for the largest share of MASLD-related deaths and disability globally, the study found. High BMI followed closely, while smoking also contributed, researchers said. Dietary shifts, sedentary lifestyles, and the global rise in metabolic conditions have created what the report called a ‘perfect storm’ for liver disease.
Research indicates that fructose, a common component of sweeteners like table sugar and high-fructose corn syrup, uniquely promotes triglyceride synthesis and fat storage in the liver, acting as a ‘metabolic signal that promotes fat production and storage in ways that differ fundamentally from glucose,’ according to a review published in Nature Metabolism [3][4]. Additionally, occasional binge drinking can triple the odds of developing advanced liver fibrosis in individuals with an underlying liver condition, a study from the University of Southern California published in Clinical Gastroenterology and Hepatology found [5].
Silent Progression and Global Projections
MASLD-related deaths increased by 83% between 1990 and 2021, with liver cancer and cirrhosis accounting for the majority of fatalities, the study stated. Prevalence peaks between ages 50 and 59, but cases are rising across all age groups, including younger populations. By 2050, researchers project 1.8 billion people will be living with MASLD, a 42% increase from current levels, with the largest growth expected in regions already grappling with rising obesity and diabetes rates.
Forever chemicals, specifically perfluorooctanoic acid (PFOA) and perfluoroheptanoic acid (PFHpA), can nearly triple an adolescent’s risk of developing MASLD, a landmark study found [6]. Daily diet soda intake is linked to a 60% higher risk of serious fatty liver disease, while sugary drinks raise the risk by 50%, according to a separate study [7]. These environmental and dietary factors compound the metabolic drivers already fueling the epidemic.
Screening and Management Strategies Screening via blood tests (ALT, AST) and imaging techniques such as ultrasound or FibroScan is recommended for those with metabolic risk factors, according to clinicians. No specific medication is approved for MASLD; lifestyle interventions — blood sugar balance, diet, exercise, weight management, and smoking cessation — are the primary defense, the report indicated.
The gut microbiota plays a critical role in controlling adipose tissue expansion, gut barrier function, and glucose metabolism, with prebiotics and probiotics showing potential for metabolic health, according to a book on probiotics and prebiotics [8]. Molly Knudsen, a registered dietitian who reported on the study, stated that ‘prioritizing blood sugar balance through diet and movement’ and ‘limiting alcohol’ are foundational strategies to reduce liver fat. She added that a diet rich in whole foods low in ultra-processed options, regular physical activity, and avoiding smoking can help reduce liver fat and slow disease progression.
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I use only sugar for my Tea or coffee. My liver function is normal at age 86. I have eaten more deserts than most humans during my 55+ cruises. So sugar can’t be that harmful.
Summarized keto: Eat fat to lose fat(visceral).
Sugar is fine.
Fructose and especially High Fructose Corn Syrup, HFCS, is bad for us.
We are not bears, that need to fatten up to hibernate.
Sadly so many items contain HFC. I do watch labels.
bump
I guess it okay if you regularly run marathons, but that would be about it.
Fatty liver must be one of the most popular topics on YouTube. Lots of great info.
https://m.youtube.com/results?sp=mAEA&search_query=Fatty+liver&ra=m
https://m.youtube.com/results?sp=mAEA&search_query=masld&ra=m
https://m.youtube.com/results?sp=mAEA&search_query=Nafld&ra=m
Considering your age, a lot of the food you ate for decades was very different from a good part of the ‘food’ served today. Your beef was likely grass fed for quite some time, your milk was mostly milk with limited/no hormones, the sugar was cane sugar not high-fructose corn syrup, your chicken was all chicken and limited meds/chems, goodness, even your chocolate bars had real cacao and cocoa butter (as opposed to ‘chocolatey’ and ‘vegetable oil chocolate candy’ today).
So, you ate well and hearty, and you’re still around and doing well. However, your personal experience largely stems from a time when food was ‘real’. You did not build a dietary foundation of cr@p, and Id even bet the coca cola you drank in your youth was likely more healthy than vitamin water today (slight exaggeration, but not by much).
“Fructose and especially High Fructose Corn Syrup, HFCS, is bad for us.”
Yep, you got it. The timing is impeccable. HFCS basically took over the sweetener market from sugar around 1980, prior to that, kids (and others) mostly ate sugar. Then, over the years, our livers got trashed by HFCS and became vulnerable to carbs, particularly our re-engineered form of wheat...and now we have the explosion of diabetes and obesity, with even young kids getting Type 2...which NEVER happened in the past (Type 1 yes, but never Type 2).
But Big Food/Pharma wants us to think otherwise, that we all just got ‘lazy’ starting in 1980 and decided to get fat and sick, similar to what ‘teachers’ say about education which is that parents decided, all at once, to not give a crap about whether their kids could read or do arithmetic...rather than look inward to garbage they now push inside our schools.
This is a thoughtful well reasoned response.
I have a healthy diet and have for years. Very occasionally I will try a food from my childhood. Not good.
Heck until I was 21 ice cream had to consist of cream.
More important that we ensure enough local school budget to include those soda machines so we can flood the zone with HFC. (Do I really need the /s tag for this?)
I think it’s the high fructose corn syrup that is bad not sugar.
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