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MASLD AI 03:40 AM
September 2025
Elizabeth Goacher, PA-C, Duke University, leads a practical, peer-to-peer session on lifestyle management for MASLD/MASH, translating evidence into clear, clinic-ready advice for APPs and primary care. She covers how to identify at-risk patients, use a simple FIB-4→VCTE/ELF pathway to rule out advanced fibrosis, and then center treatment on sustainable weight loss (goal 7–10%), calorie restriction, and a Mediterranean-style diet (more plants, whole grains, lean seafood, fewer added sugars and saturated fats). Elizabeth explains why fructose and highly processed foods drive hepatic fat and inflammation, how to tailor nutrition to culture and access, and how to turn “exercise” into an achievable plan—progressing from walking to 150–200 minutes/week of moderate aerobic activity or 75–125 minutes of vigorous exercise, plus resistance training for central adiposity and insulin resistance. She shares motivational interviewing tips (small, specific goals; non-stigmatizing language; frequent follow-up) and reminds clinicians that lifestyle therapy improves not just liver outcomes, but also diabetes, hypertension, and cardiovascular risk—making it the foundation of MASLD/MASH care.
Related Podcast
Misconceptions About Liver Health With Jill Olmstead
September 2025
Join Jill Olmstead, DNP from Providence Health in Southern California for an eye-opening GHAPP MASLD Community Network Insight on the biggest misconceptions about liver health. In this session, Jill explains why fatty liver disease is not “normal” or harmless, but a serious metabolic disorder linked to obesity, prediabetes, diabetes, and high cholesterol. She highlights how fat in the liver causes cellular injury, leading to fibrosis and even cirrhosis if untreated. Jill also addresses the common myth that alcohol is safe in moderation—reminding patients that alcohol is a liver toxin and no amount is risk-free, despite outdated beliefs about red wine being heart-protective. This educational talk empowers providers and patients alike to recognize fatty liver disease early, manage risk factors, and adopt lifestyle changes that protect long-term liver health. Watch more from the MASLD & MASH Community Network to stay informed on advances in fatty liver disease education and care.
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Lifestyle Management With Christie Morrison
September 2025
In this MASLD Community Network session, Christie Morrison, NP with Oshi Health and TDDC (GI Alliance), reviews a real patient case to highlight how lifestyle changes can help manage metabolic dysfunction–associated steatotic liver disease (MASLD) and MASH. She explains how non-invasive tests like FIB-4 scores and FibroScan results guide risk assessment, and why weight loss, healthy diet, and regular exercise are key to slowing or reversing liver damage. Using a culturally sensitive approach, Christie shows how to tailor recommendations for patients while addressing common risk factors such as obesity, diabetes, and high blood pressure. She also covers the role of calorie reduction, resistance training, and Mediterranean-style eating in improving liver health. This practical talk is designed for APPs, GI providers, and healthcare professionals looking for simple strategies to help patients prevent progression to fibrosis and cirrhosis.
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Non-Invasive Testing With Sherona Bau
July 2025
In this engaging and highly informative GHAPP MASLD Community Network session, Sherona Bau, PA-C, walks attendees through a practical overview of non-invasive testing (NIT) for evaluating liver health in patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Drawing on real-world clinical experience, Sherona explains why non-invasive testing is essential for identifying fibrosis risk in a population where liver steatosis is prevalent in up to 30% of U.S. adults. Through the case of a 65-year-old Hispanic male named Albert, Sherona demonstrates how to interpret and apply tools such as FIB-4, FibroScan (VCTE and CAP score), ELF (Enhanced Liver Fibrosis) test, and MR Elastography (MRE). She highlights their respective strengths, limitations, clinical cut-offs, and insurance-related considerations. The session also covers when to order tests, how to assess data quality (e.g., IQR/median ratio in VCTE), and when to escalate care to hepatology or cardiology. Whether you are a primary care provider, endocrinologist, or hepatology specialist, this talk delivers practical algorithms and decision-making pathways for managing MASLD, improving early detection of fibrosis and cirrhosis, and integrating cardiovascular risk assessment into liver care. Sherona also emphasizes the importance of alcohol use history, metabolic syndrome risk factors, and annual NIT follow-up in patients at risk for disease progression.
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Non-Invasive Testing With Janet Gripshover
July 2025
In this in-depth and practical discussion, Janet Gripshover, NP from Cedars-Sinai in Los Angeles, explores the evolving role of non-invasive testing (NITs) in the diagnosis and risk stratification of MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Drawing from real-world experience and a case study involving a 65-year-old patient with multiple cardiometabolic risk factors, she breaks down the latest 2025 approaches to fibrosis assessment—highlighting the use of FIB-4, ELF score, vibration-controlled transient elastography (FibroScan®), and MR elastography. Gryover also emphasizes how combining tests across modalities can improve accuracy and patient care while avoiding the risks of liver biopsy. Learn how liver stiffness, lab values, and clinical history all intersect to guide care and treatment decisions in patients with fatty liver disease. This session is part of the MASLD/MASH Community Network and is ideal for providers, specialists, and anyone interested in the forefront of liver disease management.
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NITs: A Practical Overview: Navigating the Basics
July 2025
Join Ellie Gonyeau, a nurse practitioner at Beth Israel in Boston, for an insightful podcast episode on metabolic dysfunction-associated steatotic liver disease (MASLD) and MASH, and how to effectively use non-invasive testing (NITs) to evaluate and manage patients with fatty liver disease. Ellie breaks down the differences between MASLD and MASH—explaining why distinguishing simple steatosis from inflammatory liver injury matters for long-term outcomes. She covers first-line serum-based tools like FIB-4 and ELF score, as well as imaging-based modalities including FibroScan and MR elastography, helping clinicians understand when and how to apply each test. With practical tips on interpreting fibrosis risk thresholds, stratifying patients with metabolic comorbidities, and educating primary care teams, this episode emphasizes the power of early identification, appropriate triage, and collaborative care to prevent disease progression. Whether you're working in general GI, primary care, or hepatology, this episode equips you with tools to make liver disease detection more proactive and patient-centered.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Scott Springer, PA-C, from Erie County Medical Center in Buffalo, NY, addresses one of the most common misconceptions in liver health—trusting over-the-counter supplements and detox products to improve liver function. Drawing from his experience in both hepatology and addiction medicine, Scott emphasizes that many non-prescribed products marketed for liver support are not only ineffective but can actually cause liver harm. He cautions against relying on unregulated supplements and urges patients to consult medical professionals before taking anything for liver health. One surprising and evidence-based recommendation he makes: drink coffee. Filtered coffee, in particular, has been shown to support liver health and may reduce the risk of liver disease progression. Scott recommends two to three cups per day, without added sugar or excess dairy—especially for patients with MASLD or MASH. This video offers practical, research-backed advice for patients and providers alike, highlighting what truly helps (and what may harm) the liver.
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Diet and Nutrition: Tailoring Plans for Diverse Populations
October 2025
In this episode, Allison Moser, NP, from Rush University Medical Center, dives into one of the most impactful aspects of MASH (Metabolic Dysfunction–Associated Steatohepatitis) management — diet and nutrition. While weight loss is often the starting point, Allison explains why sustainable liver health depends on personalized, culturally sensitive, and practical nutrition strategies. Learn how evidence-based eating patterns like the Mediterranean diet and plant-based diets can reduce hepatic steatosis, improve insulin sensitivity, and lower inflammation, even without weight loss. Allison shares actionable food swaps for diverse cultures, affordable ways to eat healthy when access is limited, and tailored recommendations for patients with comorbidities like diabetes, CKD, and cardiovascular disease. She also discusses the major role of added sugars, processed foods, and sugary or diet beverages in driving liver damage — and how to help patients make realistic, stepwise changes that last. Whether you’re an APP, NP, PA, or clinician treating patients with MASH or MASLD, this episode offers practical, evidence-based tools to improve nutrition counseling, build patient trust, and support long-term liver health.
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Lifestyle Management With Robin Soto
July 2025
Join Robin Soto, NP from UC San Diego Health, for a practical and case-based discussion on lifestyle management in patients with MASLD and MASH (Metabolic dysfunction-associated steatotic liver disease and steatohepatitis). In this presentation, Robin walks through the diagnosis and management of a representative patient case, highlighting how to assess fibrosis risk using non-invasive tools like FIB-4 and FibroScan, and emphasizing the critical role of lifestyle intervention. Learn how diet, exercise, and behavioral counseling can slow or reverse liver disease progression—especially in patients with cardiometabolic risk factors such as type 2 diabetes, obesity, and hyperlipidemia. Robin also addresses real-world barriers to dietary change, including cultural preferences, food accessibility, and socioeconomic challenges, while offering practical strategies for behavior change and patient engagement. This session is part of the GHAPP MASLD/MASH Community Network and includes educational resources on MASH and promotional information about Rezdiffra, a new treatment option for patients with advanced disease. Whether you're a hepatology provider or managing liver disease in primary care, this presentation offers essential, real-world guidance to support your clinical decision-making.
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Differentiating Between F3 and F4
July 2025
In this comprehensive discussion, HoChong Gilles, a nurse practitioner with 25 years of hepatology experience at the Richmond VA Medical Center, explores the critical importance of accurately distinguishing between F3 (advanced fibrosis) and F4 (cirrhosis) in patients with MASH (metabolic-associated steatohepatitis). While both stages carry increased risks of liver-specific and overall mortality, Gilles explains that F3 may still be reversible with lifestyle changes or pharmacotherapy, whereas F4 signals irreversible liver damage with heightened risk of complications like portal hypertension, hepatic encephalopathy, and liver cancer. Viewers will gain a deeper understanding of how non-invasive tests—like FIB-4, ELF, FibroScan, and MRE—perform in identifying fibrosis stage, including their limitations and overlaps. Gilles also outlines when to consider liver biopsy, especially in cases with discordant test results, atypical features, or clinical uncertainty. This video emphasizes how staging accuracy informs eligibility for therapies, surveillance strategies like HCC screening, and overall prognosis. Learn how to approach this nuanced distinction in clinical practice and why F3 vs. F4 isn't just semantics—it's a turning point in patient care.
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Podcast: PCP Screening for MASH/MASLD: Identifying At-Risk Patients
July 2025
In this essential podcast episode from the GHAPP MASLD/MASH Community Network, Summer Collier, NP at UC San Diego Health, dives into the critical role that primary care providers and advanced practice providers play in recognizing and managing MASLD (Metabolic dysfunction-associated steatotic liver disease) and its progressive form, MASH (Metabolic-associated steatohepatitis). With MASLD affecting a growing number of patients—many undiagnosed—Summer walks through practical strategies for early identification, starting with high-risk individuals such as those with type 2 diabetes, obesity, or metabolic syndrome. She highlights the use of the FIB-4 index as a quick, validated, and guideline-recommended first-line screening tool, and explains how to interpret FIB-4 results to stratify risk and determine next steps, including ELF testing, FibroScan®, or referral to GI/hepatology. Summer also offers actionable workflow tips to integrate liver screening into routine primary care, like embedding FIB-4 calculators in EMRs or incorporating assessments into annual diabetes visits. This episode is a must-listen for clinicians seeking to prevent liver fibrosis progression and liver cancer through early, proactive care.
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