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October 2025
In this presentation, Tina Gregg, NP-C, from GI Associates, shares practical, evidence-based strategies for nutrition and lifestyle management in MASLD and MASH. With nearly two decades of experience caring for patients with liver disease, Tina emphasizes that lasting improvement requires more than telling patients to “lose weight”—it calls for tailored, culturally sensitive, and sustainable dietary guidance. She explores data supporting the Mediterranean diet, DASH diet, low- and moderate-carbohydrate approaches, intermittent fasting, and plant-based eating, detailing how each can reduce liver fat, improve insulin sensitivity, and decrease inflammation. Tina also discusses how to adapt these principles for patients’ cultural preferences, socioeconomic barriers, and comorbidities such as diabetes, CKD, and hyperlipidemia. This session, part of the GHAPP MASLD & MASH Community Network, highlights how APPs can guide patients toward realistic dietary changes that enhance both liver and metabolic health.
Related Podcast
Diet and Nutrition: Tailoring Plans for Diverse Populations
July 2025
In this quick and practical video, Miu Lai Ng, a nurse practitioner at the hepatology clinic at Tufts Medical Center in Boston, shares simple, culturally sensitive, and cost-effective dietary tips to help patients manage fatty liver disease—also known as MASH (metabolic dysfunction–associated steatohepatitis). From avoiding white-colored refined carbs like sugar, white rice, and potatoes to smart swaps like oatmeal—rich in soluble fiber and low on the glycemic index—this video emphasizes realistic changes tailored to diverse backgrounds. Miu Lai Ng also covers powerful tools for sticking with a liver-friendly diet, including food tracking apps, photo logging, meal planning tools, and the importance of social support. Plus, she highlights the hidden dangers of liquid calories found in sodas, juices, and bubble tea, which spike liver fat and cost more than you think. Whether you're supporting a patient or managing MASH yourself, this video offers actionable advice that respects both culture and budget—because small changes can lead to big results for your liver and your life.
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HCC Surveillance: Implementation in Patients With Advanced Fibrosis/Cirrhosis From MASH
July 2025
Learn when and how to effectively screen for hepatocellular carcinoma (HCC) in patients at risk, especially those with metabolic dysfunction-associated steatotic liver disease (MASLD). In this informative video, Maribeth Capuno, an adult nurse practitioner at the Richmond Veterans Affairs Medical Center, shares her clinical approach to early HCC surveillance. While AASLD guidelines recommend screening only after cirrhosis has been diagnosed, Maribeth highlights the growing evidence that patients with stage 3 fibrosis can still develop liver cancer—and why she begins surveillance earlier. She discusses the recommended tools, including liver ultrasound every six months and alpha-fetoprotein testing, and explores practical workflow tips to ensure patients remain adherent. Learn how imaging modalities like MRI and CT with liver protocol, along with tools like LI-RADS and tumor board consultations, contribute to timely and accurate diagnosis. The video also emphasizes key risk factors—such as obesity, diabetes, viral hepatitis, and lifestyle behaviors—and how managing these can help prevent the progression to HCC.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this episode, Jordan Mayberry, MPAS, PA-C, a seasoned hepatology provider at UT Southwestern in Dallas, Texas, addresses some of the most frequently asked questions from patients diagnosed with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 12 years of clinical experience, Jordan explains the root causes of MASLD/MASH, including key cardiometabolic risk factors like obesity, diabetes, hypertension, and hyperlipidemia, as well as genetic predispositions—particularly in Hispanic populations. He emphasizes the importance of fibrosis assessment in guiding treatment decisions, explaining that patients with early-stage disease should focus on lifestyle changes, while those with more advanced fibrosis (stages F2–F3) may be candidates for pharmacologic therapy such as resmetirom (Rezdiffra). Jordan also explores how prognosis depends on fibrosis stage and long-term management of comorbidities, making early intervention and risk stratification essential. This episode offers practical insights for clinicians aiming to improve conversations and care strategies for patients living with MASLD or MASH.
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NITs: A Practical Overview: Navigating the Basics
July 2025
In this episode, Christie Morrison breaks down the fundamentals of non-invasive testing (NITs) for evaluating patients with fatty liver disease, including MASLD and MASH. She explains the key differences between steatosis (MASLD) and steatohepatitis (MASH), highlighting how non-invasive tests can replace liver biopsy for staging fibrosis. Christy reviews common tools like FIB-4, NAFLD fibrosis score, Enhanced Liver Fibrosis (ELF) score, transient elastography (FibroScan), and MR elastography, and outlines how to choose the right test based on patient factors such as co-morbidities, geography, access to labs, and imaging availability. The episode also emphasizes the importance of fibrosis risk stratification, interpreting FIB-4 cutoffs, and monitoring liver stiffness or ELF scores after initiating lifestyle or pharmacologic treatment—including newer therapies like resmetirom. This is a must-watch for APPs, GI clinicians, and primary care providers seeking to improve care pathways and outcomes in patients with metabolic liver disease through practical, accessible strategies for fibrosis detection and management.
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HCC Surveillance: Implementation in Patients with Advanced Fibrosis/Cirrhosis from MASH
July 2025
In this expert-led session, Elizabeth Alqueza, PA-C, from Beth Israel Deaconess Medical Center in Boston, discusses the critical importance of hepatocellular carcinoma (HCC) surveillance in patients with steatotic liver disease, including MASLD and MASH. HCC is a leading cause of cancer-related death worldwide, and early detection is vital for improving survival outcomes. Using a real-world case study, Elizabeth highlights risk factors such as obesity, type 2 diabetes, and advanced fibrosis—and underscores the growing role of MASH in HCC development, even in the absence of cirrhosis. She outlines best practices for staging, the importance of early referral to hepatology, and AASLD-recommended surveillance protocols using ultrasound and AFP testing every 6 months. The video also explores systemic barriers to screening and actionable strategies to improve adherence, such as EMR alerts, streamlined imaging protocols, and improved coordination between primary care and hepatology. This presentation is essential viewing for healthcare professionals managing patients with liver disease, offering practical tools to enhance HCC detection and optimize long-term outcomes.
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Motivational Interviewing: Practical Techniques For Lifestyle Adherence
November 2025
In this engaging session from the GHAPP MASLD Community Network, Erin Tanner, DNP, from Gastro Health in Birmingham, Alabama, discusses how motivational interviewing can empower patients with fatty liver disease to make meaningful lifestyle changes. Drawing from over 14 years of experience in hepatology and gastroenterology, Erin explains how a collaborative, patient-centered approach can improve adherence to diet, exercise, and weight management plans. Using the RULE framework—Resist the righting reflex, Understand motivation, Listen with empathy, and Empower the patient—she demonstrates practical ways to foster trust and promote behavior change without judgment. Erin also introduces the SMART goals method (Specific, Measurable, Achievable, Relevant, Time-bound), guiding clinicians on how to set realistic, personalized goals that patients can achieve and sustain. Through reflective listening, affirmation, and consistent follow-up, providers can help patients overcome ambivalence, build confidence, and stay motivated on their journey to better liver and metabolic health.
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MASH/MASLD in Type 2 Diabetes: Concurrent Medication Management
August 2025
In this video, April Morris, FNP, shares her expertise on the close connection between type 2 diabetes and fatty liver disease (MASLD/MASH). With over 16 years of experience in hepatology and endocrinology, she explains why patients with type 2 diabetes are at a higher risk of developing MASH due to shared risk factors like insulin resistance and obesity. April highlights how improving glycemic control, lowering A1C, weight loss, and lifestyle modifications can significantly reduce liver fat, inflammation, and fibrosis progression. She discusses the benefits of modern diabetes medications—including GLP-1 receptor agonists such as semaglutide and tirzepatide, SGLT2 inhibitors, and metformin—and how they not only improve blood sugar and weight management but also support liver, kidney, and heart health. Importantly, she notes that most diabetes medications remain safe for patients with liver disease unless advanced decompensated cirrhosis is present, where caution with metformin may be necessary due to lactic acidosis risk. April emphasizes that treating diabetes aggressively and reaching an A1C target around 7% can slow or even prevent progression of liver fibrosis. For APPs and providers, the takeaway is clear: effective diabetes management is one of the most powerful tools to improve liver outcomes.
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Non-Invasive Testing With Jordan Mayberry
July 2025
In this educational session, Jordan Mayberry, PA-C from UT Southwestern, presents a practical overview of non-invasive testing for diagnosing and staging metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic-associated steatohepatitis (MASH). Using a real-world patient case, Jordan discusses how clinicians can leverage key tools—such as FIB-4, ELF testing, FibroScan (VCTE), and MRI elastography—to assess fibrosis and stratify risk in patients with MASLD. She explains the benefits, limitations, and clinical applications of each modality, including guidance on when and how to use them in everyday practice. Whether you're a hepatology specialist or a provider managing patients with cardiometabolic risk factors, this talk delivers a clear, step-by-step approach to incorporating non-invasive liver assessment into your workflow. Viewers are also invited to explore the GHAPP MASLD/MASH Community Network for ongoing education, resources, and clinical insights.
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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
July 2025
In this episode, Patrick Horne, NP at the University of Florida (UF Health), explores the impact of health disparities and socioeconomic inequality on the diagnosis and management of MASH (metabolic-associated steatohepatitis) and MASLD (metabolic dysfunction-associated steatotic liver disease). With a focus on rural and underserved populations, Patrick discusses how limited access to quality healthcare, healthy food, exercise options, and non-invasive testing (NITs) like FibroScan or MRI elastography can delay diagnosis and worsen outcomes. He shares practical, empathetic strategies for individualizing care, such as using accessible tools like FIB-4 or APRI, promoting low-cost physical activity like walking or swimming, and providing culturally sensitive nutrition advice tailored to financial and geographic realities. Patrick emphasizes the provider’s role as a patient advocate and coach, helping patients navigate barriers and create sustainable lifestyle modifications. This episode offers key insights for clinicians working to close gaps in care and promote equity in liver disease management.
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GHAPPcast: Recognizing the Severity of MASH
January 2025
Thank you to Madrigal for sponsoring this episode of GHAPPcast. In this episode of GHAPPcast, nurse practitioners Patrick Horne and April Morris from discuss the complexities of identifying and managing patients with metabolic-associated steatohepatitis (MASH). They explore clinical approaches, including the use of bloodwork, family history, and advanced diagnostic tools such as FibroScan, to recognize patients at risk. Patrick and April emphasize the importance of lifestyle interventions like diet and exercise alongside new medical therapies, while also offering practical tips for clinicians on patient monitoring and treatment management. Tune in for valuable insights into managing MASH in clinical practice.
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