Interest in NAC is closely linked to the underlying biology of MASLD. The condition is associated with diet- and lifestyle-related metabolic dysfunction that leads to increased oxidative stress and inflammation, along with excess fat accumulation in the liver. As a precursor to glutathione and a well-known antioxidant, NAC helps counter oxidative stress and inflammation and may play a role in reducing the buildup of fat in the liver.

A recent double-blind, placebo-controlled pilot study¹ explored this hypothesis by enrolling 13 children ages 8-18 with obesity and MASLD. Participants were randomized to receive NAC (600 mg or 1,200 mg daily) or placebo for 16 weeks. Researchers used advanced imaging techniques to assess liver fat and liver stiffness, along with measurements of body composition and multiple markers of metabolic health, including liver enzymes, insulin, glucose, inflammatory markers, and insulin resistance. Measurements were taken before and after the intervention period.

After 16 weeks, NAC supplementation was associated with improvements in liver fat and liver stiffness, as well as favorable changes in biomarkers related to inflammation, oxidative stress, and insulin resistance. Significant reductions in liver enzyme levels were also observed. NAC was generally well tolerated among study participants. Although limited by its small sample size, this study highlights the potential supportive role of NAC in liver and metabolic health for children who may struggle to maintain long-term dietary and lifestyle changes.

Ultra-Processed Foods: A Growing Threat to Global Health

Ultra-processed foods (UPFs) are designed to be cheap, convenient, and hard to resist, but new research suggests they may carry serious hidden costs to our long-term health. A recent Lancet study² found consistent evidence linking high UPF consumption to major negative health outcomes.

UPFs contain little to no whole food and ingredients that wouldn’t be found in any home kitchen, like hydrogenated oils, high-fructose corn syrup, and artificial flavors and preservatives. They also undergo intensive processing that alters nutrient structures, damages fats, and leaves the final product bearing little resemblance to its original ingredients. While many UPFs are obvious “junk foods,” like packaged snacks and candy, staples such as sliced bread, breakfast cereal, and flavored yogurt may also fall into this category. In the U.S., more than half of adult calories—and over 60 percent in children—come from UPFs³.

To assess the impact of UPFs on health, the authors conducted a rigorous systematic review and meta-analysis of more than 100 long-term studies, making it one of the most comprehensive evaluations to date. What they found was that high consumption of UPFs is associated with a higher risk of developing a multitude of chronic conditions, including obesity, type-2 diabetes, hypertension, cardiovascular disease, chronic kidney disease, Crohn’s disease, and depression, as well as a higher risk of death from all causes.

The researchers hypothesize that UPFs harm health by degrading diet quality: creating nutrient imbalances, promoting overeating through engineered flavors and textures, reducing intake of protective plant compounds, and increasing exposure to harmful compounds formed during processing, leached from packaging, or added as ingredients.

They also highlight a troubling global trend: UPFs are spreading worldwide, displacing traditional diets, and fueling the growing burden of chronic disease. Together, these findings underscore the urgent need for strategies that reduce UPF consumption and encourage a return to minimally processed, nutrient-dense foods—steps that could powerfully support long-term health for individuals and communities alike.

References

1. Babu Balagopal, P., Kohli, R., Uppal, V., Averill, L., Shah, C., McGoogan, K., Di Guglielmo, M., Goran, M., & Hossain, M. J. (2024). Effect of N‐acetyl cysteine in children with metabolic dysfunction‐associated steatotic liver disease—A pilot study. Journal of Pediatric Gastroenterology and Nutrition, 79(3), 652–660. https://doi.org/10.1002/jpn3.12312
2. Monteiro, C.A., Louzda, M.L.C., Steele-Martinez, E., et al. (2025). Ultra-processed foods and human health: The main thesis and the evidence. The Lancet. Advance online publication. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)0156…
3. Centers for Disease Control and Prevention. (2023). Data brief no. 536: Ultra-processed Food Consumption in Youth and Adults: United States, August 2021–August 2023. National Center for Health Statistics. Retrieved December 1, 2025, from https://www.cdc.gov/nchs/products/databriefs/db536.htm