Call to action: integrating steatotic liver disease into public health strategies in Canada.

Abstract

Steatotic liver disease (SLD), formerly known as fatty liver disease, is the most common chronic liver condition, affecting one in three people in the Americas, including Canada. Characterized by excess fat in the liver, SLD can progress from a benign state to advanced fibrosis and cirrhosis and is strongly linked to increased risks of cardiovascular disease, extra-hepatic cancers, and premature mortality. Despite its rising prevalence, SLD remains largely absent from Canada's public health agenda. With Canada's aging population, growing rates of obesity and type 2 diabetes, and ethnocultural diversity, the need for a coordinated public health response is urgent. We outline Canada's distinct SLD epidemiology and highlight critical gaps in surveillance, policy, clinical guidelines, screening, and public awareness. We also propose actionable strategies grounded in implementation science to guide the scale-up of effective interventions, thereby strengthening Canada's preparedness and mitigating long-term impacts.