NAFLD, NASH and fatty liver disease

Also called MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (metabolic associated steatohepatitis)

Non-alcohol related fatty liver disease (NAFLD) is a long-lasting liver condition caused by having too much fat in the liver. It is closely linked with being overweight as well as conditions such as type 2 diabetes and heart and circulatory disease.

Non-alcohol related steatohepatitis (NASH) is a more serious stage of NAFLD. In a small number of people it can lead to liver cancer or liver failure.

The main treatment for NAFLD is eating a well-balanced diet, being physically active and (if needed) losing weight. Research shows these can reduce liver fat and in some cases reverse NAFLD.

Acute fatty liver disease is not the same as NAFLD. Acute fatty liver can occur suddenly during pregnancy (acute fatty liver of pregnancy or AFLP) or due to certain drugs or toxins.

Read more about AFLP here.

Major international organisations of researchers and clinicians have proposed changing the name NAFLD to MASLD . It stands for metabolic dysfunction-associated steatotic liver disease. You say it ma-zuld. Instead of NASH they suggest the name MASH (metabolic-associated steatohepatitis).

One reason for the change is to reduce stigma by taking out the word 'fatty'. It's also helpful to have a name that tells us about the causes of the condition. In liver disease it is important to understand the cause as treating this can help the liver recover.

MASLD is also more clearly defined than NAFLD. It is only used for fatty liver disease (steatosis) in someone who has at least 1 of 5 metabolic signs. Metabolic means something that is related to how the body makes and stores energy from food.

Fatty liver disease that isn’t linked to metabolism or alcohol would be called cryptogenic steatotic liver disease. This means fatty liver disease with an unknown cause.

You will probably see both terms being used for the next few years. This can be confusing for everyone. Remember it is always okay to ask your doctor to explain what they mean and to ask questions.

You can read more about the name change on our blog.