If you’re of Hispanic or Latino heritage, especially Mexican American, you’re at a higher risk of metabolic dysfunction-associated steatohepatitis (MASH). It's a serious type of metabolic dysfunction-associated steatotic liver disease (MASLD) where your liver stores too much fat.
Without treatment, your liver may not work as well and you're at risk for liver cancer. But the liver can heal and you have the power to reverse your condition using exercise and diet.
Eating more healthy foods and trying to reach a weight that’s right for you are key parts of managing MASH. To do that, doctors often suggest a heart-healthy, or Mediterranean, diet that focuses on:
- Whole grains
- Lean proteins
- Fruits
- Vegetables
- Nuts and seeds
- Healthy fats such as extra-virgin olive oil
That doesn’t mean you have to give up traditional Mexican foods or skip out on family meals. In fact, you can continue to enjoy them while taking care of your liver health. Find out why MASH commonly happens in Hispanic and Latino communities, how you can take steps to eat healthier, and get your whole family on board.
Why MASH Is Common in Hispanic Communities
Researchers are still trying to better understand who gets MASH and why. A recent meta-analysis reports that in the U.S., 41 Hispanics out of 100 get MASLD, but 61 Hispanics out of 100 get MASH.
The reasons are complex
If you’re Hispanic or Latino, you’re at a higher risk for certain medical problems, such as:
- Diabetes
- Visceral (belly) fat
- High blood pressure
- High cholesterol
These medical conditions can mean your body doesn’t break down fats and sugar normally, also called metabolic problems. If your body can’t break down sugar, it’s often stored in the liver as fat. That’s because fat is a great source of energy for your body to use later.
But too much fat in your liver can cause inflammation and liver problems.
Heavily marketed fast foods and junk foods
It doesn't help that highly processed foods, fast foods, and junk foods are marketed toward Latinos and Hispanics. Many of these foods contain high levels of sugar that your liver stores as fat.
“A traditional Latin American diet is a great option to manage MASH. But like most of the world, the Latin American diet has been shifting to include more highly processed foods over the last few decades,” says Krista Linares, RD, founder of Nutrition con Sabor, a food zine for Latinas. “This is not unique to Latinos.”
Your genes may also play a part
Studies show that specific changes in your DNA (genes) can cause your liver to store more fat than normal. This means you’re born with the changes in your DNA — you inherit them from your mom or dad.
So far, scientists have found changes in four genes:
PNPLA3 gene: Depending on the change in this gene, your liver may lose the ability to get rid of extra fat or store too much.
GCKR gene: It helps control glucose, and changes in this gene can cause fat buildup in your liver.
Changes in one of these genes can cause liver disease like MASH. You’re more likely to have changes in these genes if you’re of Mexican heritage.
Make Lifestyle Changes for MASH
You can protect your liver health by switching up your eating habits. That may sound overwhelming, but it doesn’t mean that you need to give up all your favorite foods.
“A lot of classic Mexican dishes are very [right] for MASH, as is,” Linares says. “Mexican food has a lot of beans, whole grains (corn tortillas are whole grain), fruits, and vegetables.”
Think about a plate of chicken enchiladas with a side of beans and avocado. For a MASH diet, you’re getting:
- Lean protein from chicken
- Healthy vegetables from salsa
- Whole grains
- Plant-based fiber from beans
- Healthy oils from avocado
Here are some small, manageable changes you can make to your eating habits to help your liver. They’re simple enough to start today and stick with them for the long run.
Eat more vegetables at every meal
Linares says that some Latino clients express concern over how to manage their diets while eating cultural foods.
So she likes to point out healthy, MASH foods to focus on, such as:
- Beans
- Corn
- Root vegetables
Next, Linares suggests including familiar vegetables, such as:
- Zucchini
- Cucumber
- Peppers
- Tomato
- Onions
Customize your meal
Mexican food is a healthy option for everyone in the family. There are lots of vegetables to choose from. Take what you want and leave what you don’t.
“Something I love about Mexican food in particular is that you can customize it for each person — it’s easy to add, or not add, whatever you need,” Linares says.
On pozole night, maybe you load up on the vegetable toppings, and let others choose extra cheese and avocado.
“It lets everyone eat together while still individualizing [your] meals,” says Linares.
Watch your portion size
“Before finding substitutes, it’s more important, and sometimes easier to learn to eat smaller portions,” says Sandra Arévalo, RDN, a spokesperson for the Academy of Nutrition and Dietetics in New York.
Make sure you know what a portion size looks like. One helpful tip is to use a 4-ounce ice cream scoop to serve carbohydrates like:
- Corn
- Pasta
- Grains or rice
- Peas
- Mashed potatoes
The ice cream scoop is the same as a half-cup serving, and it’s faster! For cheese, keep it to the size of a mini chocolate bar for each meal. And your meat should be about the size of a deck of cards. You can have unlimited veggies.
To start cutting back, if you usually eat six tortillas at a meal, “go down to three or four, then to one or two,” Arévalo says.
And you don’t need to watch what others put on their plate. Focus on your own.
Cut back on soda
If you and your family usually drink soda, “try only having one cup per meal and water between meals,” says Arévalo.
Then, use a smaller cup than usual and dilute your soda with plenty of ice. You could also switch to diet soda or sparkling water instead.
Experiment with different cooking methods
“I recommend eating the foods that you like. Just don’t fry them,” Arévalo says.
Explore other ways of preparing meals, too.
“You significantly lower the fat in your diet when you grill, bake, sauté, steam, or boil your foods,” says Arévalo.
Plan Ahead for Family Gatherings
When you have MASH, a healthy eating plan is key when you’re around family. That’s because food can play a big part in getting the family together.
“Latin families are all about food, and food is love,” Arévalo says. “You can’t reject food abuela prepares.”
Practice portion control
If you have MASH, you can still enjoy all your favorite foods — or even second helpings, just watch the amount each time.
“Eat a little bit of everything. Just make sure that you eat less than what you are used to,” Arévalo says.
Bring a healthy dish or salad to share with others
You can also be a role model for the family by adding a healthy version of your favorite dish.
“That way, you can fill yourself on that, and still have a little bit of the other foods you like without going hungry,” Arévalo says.
Eat ahead of time
If you fill up on healthy foods at home, you’re not as hungry at the party. Arriving full to a family get-together can make it easier for you to resist temptation.
Have some of your favorite foods
It’s important to still eat your favorite foods. Completely avoiding our favorite foods can create cravings, and that can mean overeating.
“Then, when we get to eat what we’ve been craving, we overdo it,” Arévalo says. “Just have a little bit and complete your meal with something healthy, like a salad or steamed vegetables.”
What to Do When You’re Too Busy (Or Don’t Like) To Cook
“My favorite easy meals when I don’t want to cook but still want something nutritious are tostadas and quesadillas,” Linareas says. “Both of these take about five minutes, and can be assembled with leftovers or store-bought ingredients.”
To easily throw together a nutritious, complete MASH meal, keep these on hand:
- Whole wheat tortillas
- Beans
- Salsa
“Ready-to-eat meals are not the solution,” Arévalo says. “These are usually high in fat and salt to make them tastier and last longer.”
Instead, shop for foods that will help you save time, such as:
- Canned beans that are low-sodium (or rinse to lower the salt content), instead of dried beans
- Bagged salads
- Vegetables, already peeled and diced
- Frozen vegetables
When you do have time to make your favorite foods, “make it a family affair,” says Arévalo. Whether it’s Saturday or Sunday, get the family together in the kitchen to cook.
“If there is something Latinos love, it’s to be surrounded by family," says Arévalo. "When kitchens are full of people, it is a party! Throw a cooking party as often as you can.”
How to Talk About MASH
Deciding if and when to share your MASH diagnosis can feel hard. It’s okay to talk about your condition in different ways, based on who you’re talking to.
If you’re concerned about how some family members might react, you could say, “I have a problem with my digestive system and need to watch what I eat.” If they press you, you might say, “I’d rather not get into the details.”
You can go into more detail with the people you trust to support your new eating habits. After you tell them, you can share online resources about MASH. Until a few years ago, it was called nonalcoholic steatohepatitis (NASH).
So, keep in mind that some people may not be familiar with the new name or just want to learn more so they can better support you.
Where to Get More Support
Get help for your new habits from outside your family as well. You could talk to a registered dietitian or nutritionist, or join a MASH support group. You can meet others who are making similar lifestyle changes at fatty liver support groups.
Ask your doctor for suggestions, or connect with a trusted liver health nonprofit such as the American Liver Foundation.
Taking small steps toward change to create your new health habits helps you improve your liver health. Over time, you might inspire your family to make some liver-friendly eating changes, too.
