Researchers at the University of Oxford have discovered that the most common liver disease in the world, known as MASLD (Metabolic dysfunction-associated steatotic liver disease), follows a daily pattern—and the worst damage happens overnight.
This finding is important because it may help people understand how and when this liver disease develops and how to treat it better.
MASLD was previously called non-alcoholic fatty liver disease. It affects about 40% of adults worldwide and is more common in people who are overweight.
The disease is serious because it can lead to liver failure, liver cancer, and heart disease. A key feature of MASLD is insulin resistance, which means the body does not respond properly to insulin, making it easier for fat to build up in the liver.
In the new study, researchers used advanced tests, including blood checks, liver biopsies, and insulin sensitivity tests during both the day and night. They studied people with and without MASLD to find out how their metabolism changes over 24 hours.
The results showed that the liver creates more fat during the night, and insulin resistance gets worse—not just in the liver, but also in muscles and belly fat. Blood insulin levels also dropped at night, which makes it harder for the body to control sugar and fat levels. These changes create the perfect conditions for fat to build up in the liver while people sleep.
What was even more surprising was that these harmful nighttime changes didn’t go away even after people lost weight and reduced fat in their liver. This means the nighttime metabolism problems may be an early cause of the disease, not just a result of it.
The study also found that many people with MASLD ate a large part of their calories in the evening—more than 40% at dinner. Eating late in the day, when the body is less able to handle sugar and fat, may create a harmful “double hit” that makes the disease worse.
Lead researcher Dr. Thomas Marjot said this study may offer new ways to prevent and treat MASLD. For example, doctors could use this information to find the best time of day to exercise or take medicine. Avoiding large meals at night could also help reduce liver damage.
The study included a real-life patient, Rowan Waller, who learned he had MASLD after a routine check-up. He joined the study and made lifestyle changes, including a weight-loss program.
After losing 14 kg (about 2 stone), his metabolism improved, but the nighttime problems remained. He said the experience made him more aware of his eating and drinking habits, especially avoiding fatty foods at night.
Experts say this research shows how important the body’s daily rhythms are for liver health. Professor Rachel Upthegrove, a senior figure in the project, said the findings may also help us better understand other diseases like obesity and diabetes.
In summary, this study highlights that nighttime is a dangerous period for people with MASLD. It shows that eating late may make things worse and that managing when we eat, not just what we eat, could be key to protecting the liver. These new insights open the door for smarter treatment strategies focused on the body’s natural rhythms.
If you care about liver health, please read studies about simple habit that could give you a healthy liver, and common diabetes drug that may reverse liver inflammation.
For more information about health, please see recent studies about simple blood test that could detect your risk of fatty liver disease, and results showing this green diet may strongly lower non-alcoholic fatty liver disease.
The study is published in Cell Metabolism.
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