While anyone can develop metabolic dysfunction-associated steatotic liver disease (MASLD), Hispanic people have a higher risk of developing the condition. This condition causes fat to build up in your liver. Some studies suggest that almost half of all Hispanic people in the U.S. have MASLD.
Hispanic people are also more likely to develop complications with this disease, too. A 2024 study published in the World Journal of Diabetes found that this group is also at risk of developing type 2 diabetes, cirrhosis (scarring of the liver), liver cancer, and heart failure.
Because of this, it’s really important that Hispanic people with MASLD find a provider that they’re comfortable with, says Juan Pablo Arab, MD, a hepatologist at the Virginia Commonwealth University School of Medicine in Richmond, Virginia. “The words liver disease, or cirrhosis, carry a lot of stigma, especially in the Hispanic community, because people associate it with alcohol consumption,” he says. “But there are specific reasons the Hispanic population is more likely to develop it. If you have a doctor who is familiar with Hispanic culture and background, it can lead to better communication and ultimately, better health outcomes.”
The Importance of Culturally Appropriate Care With MASLD
Research suggests that there are a few reasons why Hispanic people with MASLD tend to have poorer outcomes. They include:
Genetic changes. Hispanic individuals are more likely to have certain gene mutations that lead to worse outcomes, such as PNPLA3 or TM6SF2, according to a 2025 study published in Clinical Gastroenterology and Hepatology.
Higher rates of overweight and obesity. Over 80% of Hispanic adults are either overweight or have obesity, according to the U.S. Department of Health and Human Services.
Fear of judgement. Many people with MASLD report feeling stigma around their condition. This can be worse in the Hispanic community, says Arab. “Oftentimes, patients don’t seek out treatment until their MASLD has become very advanced.”
Social determinants of health. This describes the conditions in the area where you were born and live. They include things like your socioeconomic status, access to health care, family support, and access to education. These may help explain why some people in the Hispanic community can have poorer outcomes than those in white communities, says Pedro Ochoa-Allemant, MD, a clinical fellow in gastroenterology and hepatology at Penn Medicine in Philadelphia, Pennsylvania. “If you don’t have easy access to good transportation, healthy food, or places to exercise, you won’t be able to get to doctor visits, eat right, or work out,” he says. All of these are important to help get your MASLD under control.
When people don’t get the right medical care, their MASLD can worsen to metabolic dysfunction-associated steatohepatitis (MASH), a more serious form of the disease that can lead to liver scarring and failure, says Arab.
How to Find the Right MASLD Provider
If you have MASLD, it’s important to see a hepatologist (liver specialist) regularly to help treat your condition and prevent it from getting worse. Ideally, you want your provider to:
Speak your language. Research suggests that if you have a doctor who can talk to you in the same language, you naturally trust them more and have better health outcomes. “It can help you feel more comfortable with your health care provider, so you’re more likely to ask questions, listen to their recommendations, and follow them,” says Ochoa-Allemant.
One good way to find this is through your community health center. If you live in a neighborhood with many other Hispanic people, most likely they’ll have doctors there that speak Spanish, he says. The centers usually accept Medicaid and/or offer a sliding fee discount program if you don’t have health insurance.
Do the right tests. Since Hispanic people are more likely to develop other conditions such as type 2 diabetes, heart disease, and liver cancer, it’s important to have a provider who will actively screen for them, says Joseph Gosnell, MD, chief resident in hepatology at the University of Texas Medical Branch in Galveston, Texas. “We also know that Hispanic patients are more likely to have certain gene mutations that can cause severe complications, so it’s a good idea if possible to test for them,” he says.
Meet you halfway. Since there are no specific treatments to cure MASH/MASLD, lifestyle, especially diet, is very important, says Arab. A Mediterranean style diet, which is rich in fruits, vegetables, whole grains, nuts, beans, and healthy fats like olive oil, fatty fish, and avocado, has been shown to help improve liver function.
This type of eating pattern can be very daunting for Hispanic people, says Arab. “When I tell my Hispanic patients to be careful with staples of their diet, like corn tortillas, that are high in carbohydrates, they tend to be resistant. But when I suggest alternatives, like filling them with high protein beans rather than meat, they’re more likely to listen. The key is to not just say no, but to provide alternatives. For example, alcohol may be bad for their liver, but a couple cups of coffee a day is good for it.”
If your MASLD has progressed to MASH, you may need to add a medication called resmetirom (Rezdiffra) to your treatment plan to go along with your healthy lifestyle changes. It can help improve moderate to severe liver scarring in adults when combined with diet and exercise.
Be comfortable talking to your loved ones. When Arab sees Hispanic patients, especially men, there’s usually another family member like a spouse present. “I explain to my colleagues that Hispanics are very family-oriented, so they aren’t likely to go to the doctor alone. Health care providers need to talk not just to their patients, but to their loved ones, too. Usually, it’s the person accompanying them who’s most willing to listen.”
Motivate you. Arab recalls a Hispanic man he recently spoke with who had MASLD. “He was a heavy drinker, although he knew it could damage his liver more. I asked him what was really important for him, and he said to be able to walk his daughter down the aisle at her wedding. I used that information to make clear to him that he needed to change his behavior so that his liver could continue working and he could be strong enough to see his daughter get married.” It worked, and the man quit drinking. “You don’t want a doctor to shame you for your behaviors – you want a doctor who will work with you as a partner to help you find something meaningful to motivate you,” he says.
How to Work With Your Doctor
It takes two to manage MASLD. Here are some things you and your doctor can discuss to make sure you’re working together:
Get to a healthy weight. If you’re overweight or have obesity, even losing small amounts of weight – as little as 5% of your body weight – can help to reduce fat in your liver. If you also have type two diabetes, you can talk to your doctor about the newer class of weight loss drugs such as semaglutide, says Arab.
Manage your heart health. People with MASLD are more at risk to develop heart disease. Talk to your doctor about any risk factors you may have, like high blood pressure or cholesterol, says Gosnell, and ways to manage them.
Make sure you’re up-to-date on vaccines. People with MASLD should make sure that they’re vaccinated against both hepatitis A and B, to prevent more liver damage. Since liver disease may make you more vulnerable to respiratory infection complications, make sure that you’re vaccinated for flu, COVID-19, and pneumococcal disease too, says Arab.
Swap coffee for alcohol. People with MASLD are often surprised to hear it, but coffee is good for your liver. “Two to three cups a day helps to prevent liver fibrosis, or scarring,” says Arab. “I’m always talking to patients about the need to avoid alcohol, so if they know they can safely drink coffee it’s an appealing alternative.”
Limit table sugar. Foods and drinks that contain large amounts of sugar, like soft drinks and desserts, can worsen MASLD. An occasional sweet treat is OK, but too much can damage your liver.
Recap
Hispanic people are more likely to develop MASLD, a condition that can lead to serious health problems like type 2 diabetes, cirrhosis, and liver cancer.
It’s important for you to find a doctor that you trust and feel at ease with since cultural understanding and language barriers can impact the success of your treatment.
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Clinical Gastroenterology Hepatology: “Racial and Ethnic Disparities in Non-alcoholic Fatty Liver Disease Prevalence, Severity, and Outcomes in the United States: A Systematic Review and Meta-analysis - PMC.”
World Journal of Diabetes: “Disparate outcomes in Hispanic patients with metabolic dysfunction-associated steatotic liver disease/steatohepatitis and type 2 diabetes: Large cohort study - PMC.”
Clinical Gastroenterology and Hepatology: “Disparities for Hispanic Adults With Metabolic Dysfunction-associated Steatotic Liver Disease in the United States: A Systematic Review and Meta-analysis - Clinical Gastroenterology and Hepatology.”
Department of Health & Human Services: “Obesity and Hispanic Americans | Office of Minority Health.”
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Journal of Clinical and Experimental Hepatology: “Coffee and Liver Disease - PMC.”
Juan Pablo Arab, MD, hepatologist, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Pedro Ochoa-Allemant MD, gastroenterology and hepatology clinical fellow, Penn Medicine, Philadelphia, Pennsylvania.
Joseph Gosnell, MD, chief resident in hepatology, University of Texas Medical Branch, Galveston, Texas.
FDA: “FDA Approves First Treatment for Patients with Liver Scarring Due to Fatty Liver Disease.”
