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liver disease oh okay today Id like to discuss the metabolic Associated fatty liver disease also called non-alcoholic fatty liver disease and I will use these terms interchangeably first Id like to review the history wont move um are you able to advance it okay now its moving okay um I have no disclosures so metabolic fatty liver disease um is present but its hiding in plain sight it was very difficult to identify one of the most important references from my perspective is a book by sifu Prasad on ending medical reversal it deals with how do you measure so-called surrogates and its crucial in our understanding of what we can do to help people with this disease and just about every other disease they ask the question why do we recommend practices which after 50 years proved to be harmful and the best example I would think of would be the low-fat diet that Ansel Keys recommended which led to massive obesity type 2 diabetes and shortened lifespan and the answer is that we rely on f