Nutrition in MASLD: a patient focused, evidence-based clinician’s guide

TY - JOUR

T1 - Nutrition in MASLD

T2 - a patient focused, evidence-based clinician’s guide

AU - Pekarska, Katrina

AU - Brennan, Paul N.

AU - Ivancovsky Wajcman, Dana

AU - Towey, Jennifer

AU - Cox, Leah

AU - Weatherby, Katie

AU - McPherson, Stuart

AU - Stine, Jonathan

AU - Willemse, Jose

AU - Li, Wenhao

AU - Alazawi, William

AU - Lazarus, Jeffrey V.

AU - Parker, Richard

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2025.

PY - 2025/11/30

Y1 - 2025/11/30

N2 - The prevalence and burden of MASLD is very high globally, especially in socially deprived areas. This trend parallels the increasing incidence of type 2 diabetes mellitus and obesity. While MASLD is influenced by multiple factors, including genetics, metabolism, and the environment, key modifiable contributors include nutrition, sedentary behaviour, physical activity and sleep quality. The widespread shift towards consumption of ultra-processed food highlights growing concerns around food insecurity and nutritional quality. This review, produced by a multinational team, focuses primarily on the role of nutrition in the prevention and management of MASLD. While physical activity remains a vital component of lifestyle modification, the central emphasis of this review is placed on dietary factors. Herein we summarise recommendations made by international clinical practice guidelines and highlight the important role that both macro- and micronutrients play in liver health. We also evaluate five major dietary patterns in the context of MASLD, outlining the benefits and limitations of each to best support evidence-based patient counselling. We emphasise the importance of personalised and culturally sensitive nutritional advice. Practical tools are provided, including a nutrient focused summary of beneficial foods, and culturally adaptable Mediterranean diet modifications suitable for South and Southeast Asian, African, and socioeconomically disadvantaged populations. A sample menu is included to support implementation of the tools in diverse clinical settings.

AB - The prevalence and burden of MASLD is very high globally, especially in socially deprived areas. This trend parallels the increasing incidence of type 2 diabetes mellitus and obesity. While MASLD is influenced by multiple factors, including genetics, metabolism, and the environment, key modifiable contributors include nutrition, sedentary behaviour, physical activity and sleep quality. The widespread shift towards consumption of ultra-processed food highlights growing concerns around food insecurity and nutritional quality. This review, produced by a multinational team, focuses primarily on the role of nutrition in the prevention and management of MASLD. While physical activity remains a vital component of lifestyle modification, the central emphasis of this review is placed on dietary factors. Herein we summarise recommendations made by international clinical practice guidelines and highlight the important role that both macro- and micronutrients play in liver health. We also evaluate five major dietary patterns in the context of MASLD, outlining the benefits and limitations of each to best support evidence-based patient counselling. We emphasise the importance of personalised and culturally sensitive nutritional advice. Practical tools are provided, including a nutrient focused summary of beneficial foods, and culturally adaptable Mediterranean diet modifications suitable for South and Southeast Asian, African, and socioeconomically disadvantaged populations. A sample menu is included to support implementation of the tools in diverse clinical settings.

KW - lifestyle

KW - liver disease

KW - nutrition

KW - exercise

KW - sleep

UR - https://www.scopus.com/pages/publications/105023579866

U2 - 10.1136/flgastro-2025-103183

DO - 10.1136/flgastro-2025-103183

M3 - Review article

AN - SCOPUS:105023579866

SN - 2041-4137

JO - Frontline Gastroenterology

JF - Frontline Gastroenterology

ER -