Dietary interventions in metabolic dysfunction-associated steatotic liver disease: current evidence, research priorities, and clinical translation
Department of Environmental Medicine, Poznan University of Medical Sciences, Poznan, Poland
Collegium Medicum of Jan Kochanowski University, Kielce, Poland
Department of Infectious Diseases and Hepatology, Medical University of Silesia, Katowice, Poland
Clin Exp HEPATOL 2026; 12, 3:
Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked to excess adiposity, insulin resistance, and adverse dietary patterns. Dietary management is a potentially disease-modifying component of care, but no single standardized “MASLD diet” applies to all patients. This narrative review evaluates energy restriction, Mediterranean-style eating, low-carbohydrate, ketogenic, dietary approaches to stop hypertension (DASH), intermittent fasting, vegetarian, and plant-based approaches, together with practical food-based recommendations. The strongest evidence supports improved dietary quality and, in patients with excess body weight, a sustainable energy deficit that produces clinically meaningful weight loss. Mediterranean-style eating remains the best-supported named pattern, although evidence is stronger for liver fat and cardiometabolic outcomes than for histological or clinical liver outcomes. Management should prioritize minimally processed, predominantly plant-based, fiber-rich foods and unsaturated fats while limiting sugar-sweetened beverages, refined carbohydrates, ultra-processed foods, red and processed meat, and alcohol. Normal-weight MASLD, cirrhosis, and incretin-associated weight loss require individualized goals emphasizing metabolic control, nutritional adequacy, and muscle preservation.
Keywords
metabolic dysfunction-associated steatotic liver disease, dietary interventions, nutrition, Mediterranean diet, hepatology
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