Chronic liver disease (CLD) is a significant global health problem. Epidemiological trends do not show improvement in CLD incidence but rather a shift in etiologies, with steatotic liver disease (SLD) from metabolic dysfunction and alcohol becoming increasingly important causes. Consequently, there is a pressing need to develop a comprehensive public health approach for SLD. To that end, we propose a public health framework for preventing and controlling SLD. The framework is anchored on evidence linking physical inactivity, unhealthy dietary patterns, alcohol use, and obesity with both incidence and progression of SLD. Guided by the framework, we review examples of federal/state, community, and individual-level interventions with the potential to address these determinants of SLD. Ultimately, mitigating SLD's burden requires primary risk factor reduction at multiple socioecological levels, by scaling up the World Health Organization's "best buys", in addition to developing and implementing SLD specific control interventions.

中文翻译：

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关于减轻慢性肝病全球负担的公共卫生观点。

慢性肝病（CLD）是一个重大的全球健康问题。流行病学趋势并没有显示慢性肝病发病率的改善，而是病因发生了变化，代谢功能障碍和酒精引起的脂肪肝病 (SLD) 成为越来越重要的原因。因此，迫切需要针对 SLD 制定全面的公共卫生方法。为此，我们提出了预防和控制 SLD 的公共卫生框架。该框架的基础是缺乏身体活动、不健康的饮食模式、饮酒和肥胖与 SLD 的发生和进展之间的联系。在该框架的指导下，我们回顾了联邦/州、社区和个人层面干预措施的例子，这些干预措施有可能解决这些 SLD 的决定因素。最终，减轻SLD的负担需要通过扩大世界卫生组织的“最佳购买”，以及制定和实施针对SLD的具体控制干预措施，在多个社会生态层面减少主要风险因素。