NAFLD needs new attention in primary care

This issue also covers counseling patients about exercise, COVID-19 vaccines and vaccination, and reflections by College leaders about their terms of office during the pandemic.

The bad news about nonalcoholic fatty liver disease (NAFLD) is that its rates are increasing rapidly in the U.S. The good news is that once it is detected, lifestyle modifications, such as losing weight, can help arrest its progress and prevent further liver damage. To help stop NAFLD, though, physicians need to be looking for it. Our story offers an overview on diagnosis, including use of the Fibrosis-4 (FIB-4) Index, and suggestions for treatment and management. In addition, learn about the movement to change the disease name from NAFLD to MAFLD, in part to shift focus from alcohol to metabolism.

Telling patients to move more and counseling them about the benefits of exercise have long been recommended, but such advice often goes unheard, especially given the challenges posed by a continuing pandemic. Our story looks at new recommendations on avoiding sedentary time and covers additional ways to entice patients to exercise, including emphasizing immediate benefits over long-term goals and the fact that only 20 minutes of movement a day can make a difference.

Two inside features in this issue deal with COVID-19 vaccines and vaccination efforts, topics of enormous interest and importance over the past few months. A story reports on a webinar hosted by the Primary Care Collaborative in which an expert panel, including ACP's EVP/CEO Darilyn V. Moyer, MD, FACP, discussed the role of primary care physicians in overcoming vaccine hesitancy and ensuring equitable distribution, including building trust and working with local leaders. A story from the American Academy of Allergy Asthma & Immunology's virtual annual meeting reviews what's known about allergic reactions to the mRNA COVID-19 vaccines and offers advice on managing concerns about anaphylaxis and related issues safely. Severe allergic reactions to the vaccines remain rare, the experts said, and most people can be vaccinated with appropriate referral to an allergist-immunologist when necessary.

Outgoing ACP President Jacqueline W. Fincher, MD, MACP, and Chair of the Board of Regents, Heather E. Gantzer, MD, MACP, began their terms last year in the thick of the pandemic and helped navigate the College through these turbulent times. They look back on a year in office that turned out quite differently from what they'd planned and outline the challenges and triumphs along the way.

What have you learned from the challenges of the past year? Let us know any time at


Jennifer Kearney-Strouse
Executive Editor