NFL legend Dan Marino , best known for his record-breaking career as quarterback for the Miami Dolphins, has revealed that, nearly two decades ago, he was diagnosed with a serious liver condition known as metabolic dysfunction-associated steatohepatitis (MASH), formerly called nonalcoholic fatty liver disease (NAFLD).



Marino shared that during a routine checkup in 2007, he noticed only mild fatigue and a decline in his fitness, but tests revealed fat buildup in his liver. Although alarming, doctors told him the condition can be reversed through changes in lifestyle.



Marino, now 64, has since adopted lifestyle changes, including diet, weight management, regular exercise, biking, and walking. Now, the NFL legend is speaking publicly to raise awareness, showing that early detection and consistent care can make a big difference.





What Dan Marino’s diagnosis means



Dan Marino, the former Dolphins star and NFL legend, disclosed that he was diagnosed in 2007 with metabolic dysfunction-associated steatohepatitis (MASH), a liver disease he kept relatively private until now. He said he experienced only mild fatigue at the time and had largely reduced his workout routine after retirement, which prompted a routine checkup.



Now, MASH is a liver disease in which fat builds up in the liver, causing inflammation, and in some cases damage, even when a person drinks little or no alcohol. As per Marino, doctors told him that the condition is reversible if he improves his diet, loses weight, and becomes consistent in exercise. He now monitors his liver regularly (ultrasounds, etc.), follows a healthier diet (suggested the Mediterranean diet), and exercises – walking, biking, training with friends.





Understanding MASH: What it is



MASLD and MASH: First, some terminology. MASLD stands for metabolic dysfunction-associated steatotic liver disease. It is the broader category that includes cases where excess fat accumulates in the liver. When this fat buildup progresses to inflammation and damage of liver cells, it’s called MASH (metabolic dysfunction-associated steatohepatitis). MASH is basically a more serious stage of MASLD, and sometimes may lead to fibrosis (scarring).



Notably, MASH was known previously as NASH (Nonalcoholic Steatohepatitis), and MASLD was called NAFLD (Nonalcoholic Fatty Liver Disease ). The newer terms better reflect the metabolic causes.








Early symptoms: What to watch out for



Because MASH often develops slowly, many people have few or no symptoms in the early stages. Some early signs or non-specific symptoms to watch out for:




Fatigue, feeling more tired than usual, even with rest.

Weakness or loss of energy.

Mild discomfort or mild ache in the upper right abdomen (where the liver is).

Sometimes swelling of the belly or legs occurs in more advanced cases.



As MASH advances, more serious signs may appear: yellowing of the skin or eyes (jaundice), swelling of legs or abdomen due to fluid (ascites), easy bruising, loss of appetite, unexpected weight loss, or confusion or other signs of liver dysfunction.



However, Marino shared that he didn’t have obvious advanced symptoms when he was diagnosed; he only experienced prolonged fatigue.





Risk factors: Who is the most vulnerable



Some of the key risk factors for developing MASLD and progressing to MASH include:




Obesity or overweight, especially excess fat around the belly.




Insulin resistance or type-2 diabetes.




High cholesterol or high triglycerides (blood lipids).




High blood pressure and features of metabolic syndrome (a group of conditions including high blood sugar, high fats, obesity, etc.).




Sedentary lifestyle, poor diet (high in processed foods, sugar, saturated fats). Marino himself credits post-retirement diet changes as contributing.




Age and genetic predisposition also play roles. As people age, metabolism slows; genetic variations can increase risk.








Prevention and management



Because MASLD/MASH develops gradually, prevention is very possible. Important preventive measures include:




Lifestyle modification: Maintaining a healthy weight is crucial. Losing even 5-10% of body weight (if overweight) can reduce fat in the liver and improve inflammation.




Healthy diet: Mediterranean-style diet (lots of vegetables, fruits, whole grains, legumes, healthy fats) works wonders. Besides, reduce consumption of processed foods, cut back on sugary foods, refined carbohydrates, and excess saturated fat.




Regular physical activity: Moderate aerobic exercise plus strength training is the holy grail. Exercise helps reduce liver fat even before major weight loss.




Monitoring and regular checkups: you have risk factors (obesity, diabetes, high cholesterol). Because symptoms are often mild or absent in early stages, regular medical checkups can catch warning signs. Tests may include blood tests (such as liver enzymes), imaging (like ultrasound), and sometimes more advanced evaluations. Early detection can help catch things before serious damage.




Medication or medical intervention: Currently, there are no universal medications approved for all stages; however, depending on associated conditions (such as diabetes, high cholesterol, and high blood pressure), doctors may prescribe treatments to manage these conditions. Furthermore, some newer drugs are being trialed.





For many people, especially when detected early, MASLD and even MASH can be halted or reversed through lifestyle changes. However, if left untreated, MASH can progress to fibrosis (scarring), cirrhosis (severe and possibly irreversible damage), liver failure, or liver cancer.