Gastroenterologist Anuj Vikrant Sharma discusses his article, "Fatty liver disease is no longer reserved for older adults." He warns of a quiet epidemic of metabolic dysfunction-associated steatohepatitis (MASH), a serious liver condition now increasingly appearing in people in their 20s and 30s who may not appear outwardly unhealthy. Anuj explains that a primary, and often overlooked, driver is the gut-liver axis. The modern Western diet, high in ultra-processed, low-fiber foods, disrupts the gut microbiome, leading to a "leaky gut" that allows harmful substances to travel to the liver and cause inflammation and fat accumulation. The conversation explores why this connection explains the rise of MASH in younger, non-obese patients and makes a compelling case for a "gut-first" strategy. Listeners will learn why we need earlier screening and a renewed focus on food quality over calorie counting to prevent and reverse this silent but progressive disease before irreversible damage occurs.

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