Did you know that three in 10 Malaysian adults may have Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), yet most of them are not even aware of it?
MASLD, previously known as fatty liver, is caused by an excess of fat building up in the liver.
This silent accumulation of fat can eventually interfere with the liver’s ability to function, typically without noticeable symptoms.
MASLD has a strong relationship with metabolic issues such as obesity, high blood sugar, and unhealthy cholesterol levels.
The MASLD term emphasises the underlying metabolic dysfunction that causes liver fat buildup.
MASLD is becoming one of the most common chronic liver diseases in the world.
Poor diet quality, physical inactivity, excess calorie intake, insulin resistance, and elevated blood lipid levels can burden the liver, leading to fat deposition within liver cells.
Most people only find out that they have MASLD during a health check or when complications start to show up.
What Is The Relationship Between Diet And MASLD?
Diet plays an important role in preventing and managing MASLD. Our daily food choices significantly influence this condition.
Fat accumulates in the liver as a result of the body’s metabolism being overloaded by diets high in calories, sugary foods, refined carbs, high cholesterol and saturated fats.
A diet high in ultra-processed foods and sugary beverages will stress the liver over time. Then, it eventually affects metabolic function and causes inflammation in the liver.
The good thing is you can get rid of liver fat by modifying your diet and changing your lifestyle.
Calorie Restriction
Cutting back on calories can boost your liver function and help reduce fat buildup. You can achieve this by:
- Lowering your energy intake by about 500 calories, or simply cutting about a quarter of what you usually eat.
- Reducing dietary fat and total energy consumption promotes a better balance between food and body fat and stops new fat from forming up in the liver.
- A hypocaloric diet of 800 kcal is recommended, but this should be under the supervision of a dietitian.
- It is easier to stop or even reverse MASLD when you lose merely 7 to 10 per cent of your body weight, since it can improve insulin and blood sugar control, reduce inflammation, and improve liver health.
Balance your plate with a quarter-quarter-half plate, which also can satisfy your hunger without adding more fat:
- ½ plate: Non-starchy vegetables (green leafy vegetables like broccoli, cabbage) and fruits. Choose high-fibre fruits like guava (6.8 g/100 g) and pear (1.6 g/100 g).
- ¼ plate: Lean proteins (or high-fatty fish like mackerel or catfish, skinless lean part of chicken) or legumes (dhal, soybean, kidney beans).
- ¼ plate: Rice, noodles or cereals whereby wholemeal grains are more preferred.
- Aim for at least five servings of fruits and vegetables each day. They provide nutrition, fibre, and volume without adding extra calories.
- Reduce intake of fried, ultra-processed, and fast foods, which are high in calories and unhealthy fats.
- Replace fried foods with grilled, steamed, or air-fried options. You can also enjoy hearty soups made with lentils and legumes with a small plate of starters instead of a full main meal.
- Reduce the frequency of intake of sweetened beverages or sweet foods such as bubble tea and cake.
- Limit foods high in saturated fat, such as butter and coconut milk; substitute coconut milk with yoghurt.
Physical Activity
Aim for 75 to 100 minutes of vigorous activity (such as running or rapid cycling) or 150 to 300 minutes of moderate activity (such as brisk walking) every week to maintain your health.
Exercise alone is inadequate, unless performed at sufficient intensity. While any exercise is beneficial, research indicates that both aerobic and resistance training are more effective than performing just one type, as resistance training may have additional advantages for enhancing muscle and insulin.
This demonstrates that a balanced exercise programme is often superior to focusing on a single type of activity.
Here are the types of exercise/physical activity that you can do:
- Aerobic exercise: Swimming, cycling, walking, rowing.
- Resistance training: Pushups, planks, or using tools like kettlebells or dumbbells.
- Lifestyle physical activity: Increase walking steps, increase activity during the day such as climbing stairs instead of using the lift.
Do I Need Medication?
Newer medications like Mounjaro (tirzepatide) and Ozempic (semaglutide) can help lower liver fat, improve blood sugar, and weight loss. However, they are:
- Costly and require long term use.
- May have side effects like nausea, vomiting, abdominal bloating, constipation, or diarrhoea.
- Not a replacement for lifestyle changes.
Hence, most MASLD patients do not require this type of medication, as it can be improved by diet, exercise, and weight loss alone.
This type of medication is only considered when you are at advanced liver damage, or along with complications such as heart problems, type 2 diabetes, and significant obesity.
Nevertheless, studies show these work best when used in combination with diet and exercise, rather than relying on it alone.
In summary, a healthy diet and a combination of aerobic and resistance exercises can prevent and improve MASLD.
The newer type of medications are only required in more other severe situations. Your liver health can be significantly improved by making small and regular lifestyle adjustments.
Nur Zawana Abdul Razak is a Master’s student in clinical nutrition at the Faculty of Health Sciences, Universiti Kebangsaaan Malaysia. Dr Shanthi Krishnasamy is a senior lecturer and dietitian at the Faculty of Health Sciences, Universiti Kebangsaaan Malaysia.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of Ova.
