Effects of mediterranean diet in patients with nonalcoholic fatty liver disease: a systematic review, meta-analysis, and meta-regression analysis of randomized controlled trials
Abstract
Abstract We conducted a meta-analysis to investigate the effects of the Mediterranean Diet (Med-Diet) on hepatic steatosis and insulin resistance in patients with nonalcoholic fatty liver disease (NAFLD). Six randomized controlled trials were selected for the meta-analysis (sample size: 250 participants). In the meta-analysis, there was no significant difference in body mass index and waist circumference between the Med-Diet and control groups. Med-Diet significantly reduced fatty liver index (FLI) compared with the control diet (standard mean difference [SMD]: –1.06; 95% CI: –1.95 to –0.17; p = 0.02). Med-Diet significantly reduced homeostasis model assessment of insulin resistance (HOMA-IR) compared with the control diet (SMD: –0.34; 95% CI: –0.65 to –0.03; p = 0.03). Similarly, a meta-regression analysis using age showed that Med-Diet significantly reduced FLI and HOMA-IR (95% CI: –0.956 to –0.237, p = 0.001 and 95% CI: –0.713 to –0.003, p = 0.048, respectively). This meta-analysis demonstrated that Med-Diet improved hepatic steatosis and insulin resistance in patients with NAFLD. Thus, Med-Diet is a beneficial pharmaconutritional therapy in patients with NAFLD.
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There is limited data on long-term dietary interventions in MASLD since study durations range from 2-24 months.
“There is limited data on long-term dietary interventions in MASLD since study durations range from 2-24 months. 283 -285”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [285]
The Mediterranean diet seems to have added value for liver lipid reduction and cardiometabolic health and may be easier to maintain in the long-term.
“However, the Mediterranean diet seems to have added value for liver lipid reduction and cardiometabolic health and may be easier to maintain in the long-term. 285,287”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [285]
Cites
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2010) · International Journal of Surgery · doi:10.1016/j.ijsu.2010.02.007 · Cited by 12,156 · see citing works
Wan, X., Wang, W., Liu, J., & Tong, T. (2014) · BMC Medical Research Methodology · doi:10.1186/1471-2288-14-135 · Cited by 11,735 · see citing works
Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., Harrison, S. A., Brunt, E. M., & Sanyal, A. J. (2018) · Hepatology · doi:10.1002/hep.29367 · Cited by 7,239 · see citing works
Self-citationEASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease
(2016) · Journal of Hepatology · doi:10.1016/j.jhep.2015.11.004 · Cited by 4,836 · see citing works
Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A., & Tiribelli, C. (2006) · BMC Gastroenterology · doi:10.1186/1471-230x-6-33 · Cited by 3,054 · see citing works
Sheka, A. C., Adeyi, O. A., Thompson, J., Hameed, B., Crawford, P. A., & Ikramuddin, S. (2020) · JAMA · doi:10.1001/jama.2020.2298 · Cited by 1,398 · see citing works
Borenstein, M., Hedges, L. V., Higgins, J. P. T., Rothstein, H. R., & Den, A. B. V. (2020) · International Coaching Psychology Review · doi:10.53841/bpsicpr.2020.15.2.121 · Cited by 1,259 · see citing works
The Effect of Mediterranean Diet on Metabolic Syndrome and its Components
Kastorini, C.-M., Milionis, H. J., Esposito, K., Giugliano, D., Goudevenos, J. A., & Panagiotakos, D. B. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.09.073 · Cited by 1,087 · see citing works
Dinu, M., Pagliai, G., Casini, A., & Sofi, F. (2018) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2017.58 · Cited by 1,016 · see citing works
Stefan, N., Häring, H., & Cusi, K. J. (2018) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(18)30154-2 · Cited by 848 · see citing works
Ryan, M. C., Itsiopoulos, C., Thodis, T., Ward, G., Trost, N., Hofferberth, S., O’Dea, K., Desmond, P. V., Johnson, N. A., & Wilson, A. M. (2013) · Journal of Hepatology · doi:10.1016/j.jhep.2013.02.012 · Cited by 778 · see citing works
Modulation of Insulin Resistance in Nonalcoholic Fatty Liver Disease
Khan, R. S., Bril, F., Cusi, K. J., & Newsome, P. N. (2018) · Hepatology · doi:10.1002/hep.30429 · Cited by 543 · see citing works
Fedchuk, L., Nascimbeni, F., Pais, R., Charlotte, F., Housset, C., Ratziu, V., & the LIDO Study Group (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12963 · Cited by 502 · see citing works
A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses
Esposito, K., Maiorino, M. I., Bellastella, G., Chiodini, P., Panagiotakos, D., & Giugliano, D. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008222 · Cited by 501 · see citing works
Kawaguchi, T., Takenoshita, M., Kabashima, T., & Uyeda, K. (2001) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.231370798 · Cited by 373 · see citing works
Self-citationBranched-chain amino acids as pharmacological nutrients in chronic liver disease
Kawaguchi, T., Izumi, N., Charlton, M., & Sata, M. (2011) · Hepatology · doi:10.1002/hep.24412 · Cited by 333 · see citing works
Self-citationThe Role of Insulin Resistance and Diabetes in Nonalcoholic Fatty Liver Disease
Fujii, H., Kawada, N., & Japan Study Group of NAFLD (JSG-NAFLD) (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21113863 · Cited by 300 · see citing works
Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases
Mirabelli, M., Chiefari, E., Arcidiacono, B., Corigliano, D. M., Brunetti, F. S., Maggisano, V., Russo, D., Foti, D. P., & Brunetti, A. (2020) · Nutrients · doi:10.3390/nu12041066 · Cited by 272 · see citing works
Fatty liver index and mortality: The cremona study in the 15th year of follow-up
Calori, G., Lattuada, G., Ragogna, F., Garancini, M. P., Crosignani, P., Villa, M., Bosi, E., Ruotolo, G., Piemonti, L., & Perseghin, G. (2011) · Hepatology · doi:10.1002/hep.24356 · Cited by 253 · see citing works
Gepner, Y., Shelef, I., Komy, O., Cohen, N., Schwarzfuchs, D., Bril, N., Rein, M., Serfaty, D., Kenigsbuch, S., Zelicha, H., et al. (2019) · Journal of Hepatology · doi:10.1016/j.jhep.2019.04.013 · Cited by 236 · see citing works
Properzi, C., O'Sullivan, T. A., Sherriff, J. L., Ching, H. L., Jeffrey, G. P., Buckley, R. F., Tibballs, J., MacQuillan, G. C., Garas, G., & Adams, L. A. (2018) · Hepatology · doi:10.1002/hep.30076 · Cited by 227 · see citing works
The globalization of nonalcoholic fatty liver disease: Prevalence and impact on world health
Rinella, M. E., & Charlton, M. (2016) · Hepatology · doi:10.1002/hep.28524 · Cited by 221 · see citing works
Self-citationKatsagoni, C. N., Papatheodoridis, G. V., Ioannidou, P., Deutsch, M., Alexopoulou, A., Papadopoulos, N., Papageorgiou, M.-V., Fragopoulou, E., & Kontogianni, M. D. (2018) · British Journal of Nutrition · doi:10.1017/s000711451800137x · Cited by 167 · see citing works
Abenavoli, L., Greco, M., Milic, N., Accattato, F., Foti, D., Gulletta, E., & Luzza, F. (2017) · Nutrients · doi:10.3390/nu9080870 · Cited by 144 · see citing works
Periostin: An emerging biomarker for allergic diseases
Izuhara, K., Nunomura, S., Nanri, Y., Ono, J., Takai, M., & Kawaguchi, A. (2019) · Allergy · doi:10.1111/all.13814 · Cited by 144 · see citing works
Self-citationMediterranean diet and hepatocellular carcinoma
Turati, F., Trichopoulos, D., Polesel, J., Bravi, F., Rossi, M., Talamini, R., Franceschi, S., Montella, M., Trichopoulou, A., Vecchia, C. L., et al. (2013) · Journal of Hepatology · doi:10.1016/j.jhep.2013.10.034 · Cited by 140 · see citing works
Misciagna, G., del Pilar Díaz, M., Caramia, D. V., Bonfiglio, C., Franco, I., Noviello, M. R., Chiloiro, M., Abbrescia, D. I., Mirizzi, A., Tanzi, M., et al. (2017) · The Journal of nutrition, health and aging · doi:10.1007/s12603-016-0809-8 · Cited by 134 · see citing works
Ding, C., Zhao, Y., Shi, X., Zhang, N., Zu, G., Li, Z., Zhou, J., Gao, D., Lv, L., Tian, X., et al. (2016) · Scientific Reports · doi:10.1038/srep28734 · Cited by 115 · see citing works
Nonalcoholic Steatohepatitis After Liver Transplantation
Cotter, T. G., & Charlton, M. (2019) · Liver Transplantation · doi:10.1002/lt.25657 · Cited by 109 · see citing works
Self-citationPintó, X., Fanlo‐Maresma, M., Corbella, E., Corbella, X., Mitjavila, M. T., Moreno, J. J., Casas, R. M., Estruch, R., Corella, D., Bulló, M., et al. (2019) · Journal of Nutrition · doi:10.1093/jn/nxz147 · Cited by 101 · see citing works
Kim, J. H., Moon, J. S., Byun, S. J., Lee, J. H., Kang, D. R., Sung, K., Kim, J. Y., & Huh, J. H. (2020) · Cardiovascular Diabetology · doi:10.1186/s12933-020-01025-4 · Cited by 99 · see citing works
HCC Development Is Associated to Peripheral Insulin Resistance in a Mouse Model of NASH
De Minicis, S., Agostinelli, L., Rychlicki, C., Sorice, G. P., Saccomanno, S., Candelaresi, C., Giaccari, A., Trozzi, L., Pierantonelli, I., Mingarelli, E., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0097136 · Cited by 97 · see citing works
Abenavoli, L., Greco, M., Nazionale, I., Peta, V., Milić, N., Accattato, F., FOTI, D. P., Gulletta, E., & Luzza, F. (2015) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.2015.1004312 · Cited by 88 · see citing works
Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis and Hepatocellular Carcinoma
Massoud, O. I., & Charlton, M. (2017) · Clinics in Liver Disease · doi:10.1016/j.cld.2017.08.014 · Cited by 84 · see citing works
Self-citationChikowore, T., Pisa, P., van Zyl, T., Feskens, E. J. M., Wentzel‐Viljoen, E., & Conradie, K. R. (2017) · Nutrients · doi:10.3390/nu9010009 · Cited by 71 · see citing works
Discovery of an Orally Effective Factor IX-Transferrin Fusion Protein for Hemophilia B
Xie, C., Wang, Z. K., Su, Y., Wang, J., & Shen, W. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms21010021 · Cited by 69 · see citing works
Younossi, Z. M. (2018) · Hepatology · doi:10.1002/hep.30125 · Cited by 66 · see citing works
Aller, R., Sigüenza, R., Pina, M. J. B., Laserna, C., Antolín, B., Burgueño, B., Durà, M., Izaola, O., Primo, D., & de Luis, D. A. (2020) · Endocrine · doi:10.1007/s12020-020-02268-7 · Cited by 51 · see citing works
Asbaghi, O., Choghakhori, R., Ashtary‐Larky, D., & Abbasnezhad, A. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.03.003 · Cited by 50 · see citing works
Hondru, G., Laillou, A., Wieringa, F. T., Poirot, E., Berger, J., Christensen, D. L., & Roos, N. (2019) · Nutrients · doi:10.3390/nu12010012 · Cited by 44 · see citing works
Cueto-Galán, R., Barón-López, F. J., Valdivielso, P., Pintó, X., Corbella, E., Gómez‐Gracia, E., & Wärnberǵ, J. (2017) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2017.04.030 · Cited by 40 · see citing works
Association Between Fatty Liver Index and Risk of Breast Cancer: A Nationwide Population-Based Study
Park, J. H., Choi, I. S., Han, K., Park, H., Kim, K. H., & Kim, J.-S. (2020) · Clinical Breast Cancer · doi:10.1016/j.clbc.2020.02.004 · Cited by 36 · see citing works
Bae, S. J., Kim, J. E., Choi, H. J., Choi, Y. J., Lee, S. J., Gong, J. E., Seo, S., Yang, S. Y., An, B., Lee, H. S., et al. (2020) · Molecules · doi:10.3390/molecules25112662 · Cited by 36 · see citing works
Zhang, Y., Liu, H., Jia, W., Qi, J., Zhang, W., Zhang, W., Liang, G., Zhang, Y., & Chen, H. (2019) · Molecules · doi:10.3390/molecules25010025 · Cited by 32 · see citing works
Barnaba, L., Intorre, F., Azzini, E., Ciarapica, D., Venneria, E., Foddai, M. S., Maiani, F., Raguzzini, A., & Polito, A. (2020) · Nutrition · doi:10.1016/j.nut.2020.110813 · Cited by 27 · see citing works
Cotter, T. G., Li, D., Holmen, J. R., Gilroy, R. K., Krong, J., & Charlton, M. (2020) · Journal of Gastroenterology · doi:10.1007/s00535-020-01684-w · Cited by 19 · see citing works
Self-citationThe good, the bad, and the ugly facets of insulin resistance
Kumar, K. V. S. H. (2020) · Medical Journal Armed Forces India · doi:10.1016/j.mjafi.2019.07.001 · Cited by 18 · see citing works
Choi, Y. J., Lee, D. H., & Han, K. (2020) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2018.022 · Cited by 16 · see citing works
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Rinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S., Barb, D., Kleiner, D. E., & Loomba, R. (2023) · Hepatology · doi:10.1097/hep.0000000000000323 · Cited by 2,667 · see citing works
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
Cusi, K., Isaacs, S., Barb, D., Basu, R., Caprio, S., Garvey, W. T., Kashyap, S., Mechanick, J. I., Mouzaki, M., Nadolsky, K., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.03.010 · Cited by 1,021 · see citing works
(2024) · Obesity Facts · doi:10.1159/000539371 · Cited by 510 · see citing works
Advancements in the treatment of non-alcoholic fatty liver disease (NAFLD)
Li, R., Zou, J., Ran, W., Qi, X., Chen, Y., Cui, H., & Guo, J. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1087260 · Cited by 338 · see citing works
Lifestyle interventions in nonalcoholic fatty liver disease
Younossi, Z. M., Zelber-Sagi, S., Henry, L., & Gerber, L. H. (2023) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-023-00800-4 · Cited by 281 · see citing works
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Cusi, K. J., Hilliard, M. E., Isaacs, D. M., et al. (2022) · Diabetes Care · doi:10.2337/dc23-s004 · Cited by 233 · see citing works
Haigh, L., Kirk, C., El Gendy, K., Gallacher, J., Errington, L., Mathers, J. C., & Anstee, Q. M. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.06.037 · Cited by 209 · see citing works
Eslam, M., Fan, J., Yu, M., Wong, V. W., Cua, I. H., Liu, C., Tanwandee, T., Gani, R. A., Seto, W., Alam, S., et al. (2025) · Hepatology International · doi:10.1007/s12072-024-10774-3 · Cited by 186 · see citing works
Self-citationElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Cusi, K. J., Ekhlaspour, L., Fleming, T. K., Hilliard, M. E., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc24-s004 · Cited by 167 · see citing works
Mellemkjær, A., Kjær, M. B., Haldrup, D., Grønbæk, H., & Thomsen, K. L. (2023) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2023.11.012 · Cited by 109 · see citing works
Del Bo’, C., Perna, S., Allehdan, S., Rafique, A., Saad, S., AlGhareeb, F., Rondanelli, M., Tayyem, R. F., Marino, M., Martini, D., et al. (2023) · Nutrients · doi:10.3390/nu15102250 · Cited by 80 · see citing works
Fatty liver index (FLI): more than a marker of hepatic steatosis
Kaneva, A. M., & Bojko, E. R. (2023) · Journal of Physiology and Biochemistry · doi:10.1007/s13105-023-00991-z · Cited by 60 · see citing works
MASLD treatment—a shift in the paradigm is imminent
Machado, M. V. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1316284 · Cited by 51 · see citing works
Guirguis, E. H., Dougherty, J., Thornby, K., Grace, Y., & Mack, K. (2024) · Annals of Pharmacotherapy · doi:10.1177/10600280241259528 · Cited by 52 · see citing works
Impact of Dietary Fiber on Inflammation in Humans
Kabisch, S., Hajir, J., Sukhobaevskaia, V., Weickert, M. O., & Pfeiffer, A. F. H. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26052000 · Cited by 50 · see citing works
Dietary patterns in non-alcoholic fatty liver disease (NAFLD): Stay on the straight and narrow path!
Katsiki, N., Stoian, A. P., & Rizzo, M. (2022) · Clínica e Investigación en Arteriosclerosis · doi:10.1016/j.arteri.2021.10.001 · Cited by 40 · see citing works
Kamada, Y., Takahashi, H., Shimizu, M., Kawaguchi, T., Sumida, Y., Fujii, H., Seko, Y., Fukunishi, S., Tokushige, K., Nakajima, A., et al. (2021) · Journal of Gastroenterology · doi:10.1007/s00535-021-01833-9 · Cited by 40 · see citing works
Self-citationWajcman, D. I., Isakov, N. F., Grinshpan, L. S., Salomone, F., Lazarus, J. V., Webb, M., Shibolet, O., Kariv, R., & Zelber‐Sagi, S. (2022) · Nutrients · doi:10.3390/nu14173533 · Cited by 39 · see citing works
Xiao, Y., Zhang, X., Yi, D., Qiu, F., Wu, L., Tang, Y., & Wang, N. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1225946 · Cited by 36 · see citing works
Torres-Peña, J. D., Larriva, A. P. A.-D., Alcala-Diaz, J. F., López‐Miranda, J., & Delgado‐Lista, J. (2023) · Nutrients · doi:10.3390/nu15061483 · Cited by 35 · see citing works
Personalizing Nutrition Strategies: Bridging Research and Public Health
Clemente‐Suárez, V. J., Peris-Ramos, H. C., Redondo-Flórez, L., Beltrán-Velasco, A. I., Martín-Rodríguez, A., David-Fernandez, S., Sepulveda, R. A. Y., & Tornero-Aguilera, J. F. (2024) · Journal of Personalized Medicine · doi:10.3390/jpm14030305 · Cited by 35 · see citing works
Abad, J., Llop, E., Arias-Loste, M. T., Burgos-Santamaría, D., Martínez Porras, J. L., Iruzubieta, P., Graus, J., Ruiz-Antorán, B., Sánchez Yuste, M. R., Romero-Gómez, M., et al. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.10.027 · Cited by 35 · see citing works
Ivancovsky Wajcman, D., Byrne, C. J., Dillon, J. F., Brennan, P. N., Villota-Rivas, M., Younossi, Z. M., Allen, A. M., Crespo, J., Gerber, L. H., & Lazarus, J. V. (2026) · Hepatology · doi:10.1097/hep.0000000000001058 · Cited by 33 · see citing works
Nutrition as Therapy in Liver Disease.
Shah, N., & Barritt, A. (2022) · Clinical Therapeutics · doi:10.1016/j.clinthera.2022.04.012 · Cited by 24 · see citing works
Giannakogeorgou, A., & Roden, M. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17848 · Cited by 30 · see citing works
Romero‐Gómez, M., Zelber‐Sagi, S., Martı́n, F., Bugianesi, E., & Soria, B. (2023) · BMJ · doi:10.1136/bmj-2023-075179 · Cited by 29 · see citing works
Grinshpan, L. S., Haim, Y. E., Wajcman, D. I., Isakov, N. F., Nov, Y., Webb, M., Shibolet, O., Kariv, R., & Zelber‐Sagi, S. (2024) · Hepatology Communications · doi:10.1097/hc9.0000000000000583 · Cited by 27 · see citing works
Suresh, M. G., Mohamed, S., Geetha, H. S., Prabhu, S., Trivedi, N., Ng, Z. C., Mehta, P. D., Brar, A. S., Sohal, A., Goyal, M. K., et al. (2026) · World Journal of Diabetes · doi:10.4239/wjd.v17.i2.113149 · Cited by 30 · see citing works
Dietary Antioxidants and Natural Compounds in Preventing Thrombosis and Cardiovascular Disease
Giurranna, E., Nencini, F., Bettiol, A., Borghi, S., Argento, F. R., Emmi, G., Silvestri, E., Taddei, N., Fiorillo, C., & Becatti, M. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252111457 · Cited by 27 · see citing works
Rinella, M. E., & Sookoian, S. C. (2026) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-026-01187-8 · Cited by 29 · see citing works
Kawaguchi, T., Kawaguchi, A., Hashida, R., Nakano, D., Tsutsumi, T., Kawaguchi, M., Koya, S., Hirota, K., Tomita, M., Tsuchihashi, J., et al. (2023) · Journal of Gastroenterology · doi:10.1007/s00535-023-02060-0 · Cited by 27 · see citing works
Self-citationJamil, A., Chivese, T., Elshaikh, U. A. M., & Sendall, M. C. (2024) · BMC Public Health · doi:10.1186/s12889-024-19378-w · Cited by 26 · see citing works
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Capone, F., Häseli, S. P., Liu, L., Strocchi, S., Langenberg, C., Lusis, A. J., Pietzner, M., Muoio, D. M., Rider, O. J., Raman, B., et al. (2026) · Nature Reviews Cardiology · doi:10.1038/s41569-026-01257-z · Cited by 32 · see citing works
Diaconu, C.-T., & Guja, C. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11175144 · Cited by 28 · see citing works
Dietary patterns in non-alcoholic fatty liver disease (NAFLD): Stay on the straight and narrow path!
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Role of MASLD in CVD: A review of emerging treatment options
Mollace, R., Longo, S., Nardin, M., Tavernese, A., Musolino, V., Cardamone, A., & Federici, M. (2024) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2024.111891 · Cited by 23 · see citing works
Zargar, A. H., Bhansali, A. K., Majumder, A., Maheshwari, A., Bhattacharyya, A., Dasgupta, A., Saboo, B., Sethi, B. K., Sanyal, D., Seshadri, K., et al. (2025) · Diabetes Obesity and Metabolism · doi:10.1111/dom.16496 · Cited by 25 · see citing works
Seidita, A., Cusimano, A., Giuliano, A., Meli, M., Carroccio, A., Soresi, M., & Giannitrapani, L. (2024) · Antioxidants · doi:10.3390/antiox13060731 · Cited by 21 · see citing works
Sarcopenia in MASLD—Eat to Beat Steatosis, Move to Prove Strength
Crișan, D., Avram, L., Morariu-Barb, A. M., Grapa, C. M., Hirişcău, E. I., Crăciun, R., Donca, V., & Nemeș, A. (2025) · Nutrients · doi:10.3390/nu17010178 · Cited by 20 · see citing works
From steatosis to cirrhosis: the role of obesity in the progression of liver disease
Nowak, K., Paluch, M., Cudzik, M., Syska, K., Gawlikowska, W., & Janczura, J. (2025) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-025-01754-x · Cited by 20 · see citing works
Hao, X., Song, H., Su, X. Y., Li, J., Ye, Y., Wang, C., Xu, X. D., Pang, G., Liu, W., Li, Z., et al. (2025) · Annals of Medicine · doi:10.1080/07853890.2025.2464223 · Cited by 17 · see citing works
Nutritional and Lifestyle Therapy for NAFLD in People with HIV
Cinque, F., Cespiati, A., Lombardi, R., Guaraldi, G., & Sebastiani, G. (2023) · Nutrients · doi:10.3390/nu15081990 · Cited by 19 · see citing works
Gut microbiota in non-alcoholic fatty liver disease: Pathophysiology, diagnosis, and therapeutics
Pandey, H., Goel, P., Srinivasan, V. M., Tang, D. W. T., Wong, S. H., & Lal, D. (2025) · World Journal of Hepatology · doi:10.4254/wjh.v17.i6.106849 · Cited by 17 · see citing works
Reytor-González, C., Annunziata, G., Campuzano-Donoso, M., Morales-López, T., Basantes-Tituaña, C., Fascì-Spurio, F., Verde, L., Muscogiuri, G., Barrea, L., Frías-Toral, E., et al. (2025) · Minerva Endocrinology · doi:10.23736/s2724-6507.24.04314-8 · Cited by 15 · see citing works
Approach to the Patient With Nonalcoholic Fatty Liver Disease
Belfort‐DeAguiar, R., Lomonaco, R., & Cusi, K. J. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac624 · Cited by 15 · see citing works
Wang, K., Xiang, S., He, Q., Liu, A., Huang, C., Yang, Z. Y., Li, R., Hu, J., Cai, R., Mi, N., et al. (2025) · Hepatology Communications · doi:10.1097/hc9.0000000000000791 · Cited by 13 · see citing works
Różańska, D. (2024) · Nutrients · doi:10.3390/nu16234191 · Cited by 13 · see citing works
Cueto-Galán, R., Fontalba-Navas, A., Gutiérrez‐Bedmar, M., Ruiz‐Canela, M., Martínez‐González, M. Á., Alves, L., Babió, N., Fitó, M., Ros, E., Fiol, M., et al. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1518082 · Cited by 14 · see citing works
Bernhard, J., Galli, L., Speidl, W. S., & Krychtiuk, K. A. (2025) · Current Cardiology Reports · doi:10.1007/s11886-024-02185-5 · Cited by 15 · see citing works
Ntikoudi, A., Papachristou, A., Tsalkitzi, A., Margari, N., Evangelou, E., & Vlachou, E. D. (2025) · Diabetology · doi:10.3390/diabetology6040023 · Cited by 12 · see citing works
Non-invasive assessment of liver fibrosis in MASLD: the need of sex-adjusted scores
Novielli, F., Matteis, C. D., Moschetta, A., & Crudele, L. (2025) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2025.2557243 · Cited by 11 · see citing works
Tsamos, G., Kalopitas, G., Evripidou, K., Vasdeki, D., Koufakis, T., Kanavas, V., Antza, C., Germanidis, G. S., & Chourdakis, M. (2024) · Nutrients · doi:10.3390/nu16060857 · Cited by 11 · see citing works
Baratta, F., Cammisotto, V., Tozzi, G., Coronati, M., Bartimoccia, S., Castellani, V., Nocella, C., D’Amico, A., Angelico, F., Carnevale, R., et al. (2022) · Nutrients · doi:10.3390/nu14061209 · Cited by 10 · see citing works
Miano, N., Todaro, G., Marco, M. D., Scilletta, S., Bosco, G., Barbagallo, F. D. G., Scicali, R., Piro, S., Purrello, F., & Pino, A. D. (2024) · Nutrients · doi:10.3390/nu16121925 · Cited by 10 · see citing works
Ruiz‐Casas, L., Pedra, G., Shaikh, A., Franks, B., Dhillon, H. S., Fernandes, J. D. D. R., Mangla, K. K., Augusto, M., Schattenberg, J. M., & Romero‐Gómez, M. (2021) · Medicine · doi:10.1097/md.0000000000028165 · Cited by 10 · see citing works
Hsieh, M.-L., Su, T., Lin, Y., Chen, Y., Tung, C.-F., Huang, L., Wu, C.-H., Peng, Y., & Hsieh, V. C. (2026) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.70259 · Cited by 8 · see citing works
Álvares‐da‐Silva, M. R., Wajcman, D. I., de Oliveira, C. P. M. S., Rabie, S. M. S., Longo, L., Cruz, C. U., Yoshimura, S. M., Joveleviths, D., Ben‐Yehoyada, M., Grinshpan, L. S., et al. (2024) · European Journal of Clinical Nutrition · doi:10.1038/s41430-024-01416-w · Cited by 8 · see citing works
Gómez-Delgado, F., Romero‐Cabrera, J. L., & Pérez‐Martínez, P. (2022) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000960 · Cited by 8 · see citing works
Stern, U. M., Wagenpfeil, G., Weber, S. N., Alqahtani, S. A., Michel, M. S., & Schattenberg, J. M. (2026) · European Journal of Nutrition · doi:10.1007/s00394-025-03870-z · Cited by 9 · see citing works
What should we advise MAFLD patients to eat and drink?
Machado, M. V. (2021) · Metabolism and Target Organ Damage · doi:10.20517/mtod.2021.11 · Cited by 7 · see citing works
Akuta, N., Kogiso, T., Ikejima, K., Otsuka, M., Kawaguchi, T., Kawanaka, M., Takahashi, H., Tamaki, N., Nakagawa, H., 疋田隼人, et al. (2026) · Journal of Gastroenterology · doi:10.1007/s00535-026-02408-2 · Cited by 8 · see citing works
Self-citationCurrent Treatment Options, Including Diet, Exercise, and Medications
Noureddin, M., & Abdelmalek, M. F. (2023) · Clinics in Liver Disease · doi:10.1016/j.cld.2023.01.008 · Cited by 6 · see citing works
Guía de práctica clínica multidisciplinar de manejo de la esteatosis hepática metabólica
Romero‐Gómez, M., Escalada, J., Noguerol, M., Pérez, A., Carretero, J., Crespo, J., Mascort, J. J., Aguilar, I., Tinahones, F. J., Cañones, P., et al. (2025) · Gastroenterología y Hepatología · doi:10.1016/j.gastrohep.2025.502442 · Cited by 8 · see citing works
Barbería-Latasa, M., Martínez‐Urbistondo, D., & Martínez‐González, M. Á. (2025) · Medicina · doi:10.3390/medicina61101777 · Cited by 5 · see citing works
Williams, G. M., Hoedt, E. C., Duncanson, K., Gan, L. T., Prakoso, E., Talley, N. J., & Beck, E. J. (2025) · Nutrition & Metabolism · doi:10.1186/s12986-025-00939-8 · Cited by 5 · see citing works
Sualeheen, A., Tan, S., Daly, R. M., Georgousopoulou, E. N., Roberts, S. K., & George, E. S. (2025) · European Journal of Nutrition · doi:10.1007/s00394-025-03809-4 · Cited by 5 · see citing works
Extrahepatic manifestation of metabolic dysfunction-associated steatotic liver disease
Shenoy, A., Ahmed, A., & Kim, D. (2025) · Metabolism and Target Organ Damage · doi:10.20517/mtod.2025.73 · Cited by 4 · see citing works
Brouwer, W. P., Vonghia, L., Thiele, M. S., Schattenberg, J. M., Anastasiou, F., Beckmann, S., Bugianesi, E., Castéra, L., Caussy, C., Cordie, A., et al. (2026) · JHEP Reports · doi:10.1016/j.jhepr.2026.101798 · Cited by 5 · see citing works
Momeni, S., Hajizadeh‐Sharafabad, F., & Pashaei, M. R. (2025) · Nutrition Research · doi:10.1016/j.nutres.2025.03.005 · Cited by 4 · see citing works
Quelle alimentation proposer aux patients présentant une stéatohépatite non-alcoolique ?
André-Dumont, S., & Lanthier, N. (2022) · Nutrition clinique et metabolisme · doi:10.1016/j.nupar.2021.11.001 · Cited by 4 · see citing works
Nutritional and Fasting Strategies for the Management of MASLD / MASH : An Integrative Review
Tawk, D., Ghader, G., Khatib, Y., Attieh, P., Youssef, T., Othman, M., Harb, F., Azar, S. T., & Ghadieh, H. E. (2025) · JGH Open · doi:10.1002/jgh3.70315 · Cited by 3 · see citing works
Sun, L., Chen, H., Ou, Q., Liang, X., Wu, Q., Yu, X., Zhao, H., Huang, Q., Yi, Z., Tan, X., et al. (2023) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2023.104138 · Cited by 3 · see citing works
The consequences of poor dietary patterns on the proliferation of non-alcoholic fatty liver disease
Ahmed, A., Maham, K., Afzaal, M., Saleem, M. A., Nadeem, M., Saeed, F., Hussain, M., & Jbawi, E. M. A. (2024) · Cogent Food & Agriculture · doi:10.1080/23311932.2024.2325206 · Cited by 4 · see citing works
Va, I., Нисановна, С. А., Morozov, S. V., & Goncharov, A. (2025) · Advances in Therapy · doi:10.1007/s12325-025-03238-z · Cited by 3 · see citing works
Effect of mediterranean diet on non-alcoholic fatty liver disease (NAFLD)
Walczak, P., Walczak, K., Zdun, S., Nemeczek, S., MERKISZ, K., Grzybowski, J., Marciniak, A., Grzywna, N., JASKUŁA, K., & ORŁOWSKI, W. (2023) · Journal of Education Health and Sport · doi:10.12775/jehs.2023.13.03.008 · Cited by 3 · see citing works
George, E. S., Sualeheen, A., Freer, C. L., Georgeousopoulou, E. N., Roberts, S. K., Daly, R. M., & Tan, S. (2026) · British Journal Of Nutrition · doi:10.1017/s0007114526107351 · Cited by 2 · see citing works
Jarvis, H., Brennan, P., Casanovas, T., Casler, K., Desai, M., Evans, P. H., Dillon, J. F., Grattagliano, I., Hallsworth, K., Hebditch, V., et al. (2026) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(26)00015-4 · Cited by 3 · see citing works
Valenzuela‐Fuenzalida, J. J., Salazar-Arancibia, T., Laborie-Reyes, B., Rodriguez-Ortiz, F., Loaiza-Giraldo, J. P., Salgado, C., Nova-Baeza, P., Orellana-Donoso, M., Moya, M. P., Bruna-Mejías, A., et al. (2026) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2026.105017 · Cited by 3 · see citing works
Newberry, C. A., & Kumar, S. R. (2022) · Nutrition in Clinical Practice · doi:10.1002/ncp.10917 · Cited by 2 · see citing works
Leite, A. R., Dias, J., Godinho, T., Correia-Chaves, J., Borges‐Canha, M., Lourenço, I. M., Leite-Moreira, A. F., & Neves, J. S. (2024) · Endocrinology Insights · doi:10.1159/000541442 · Cited by 3 · see citing works
Yoko, U. E. B. A., Ikeda, K., Tabara, Y., Nakayama, T., Tanaka, D., Takahashi, Y., Kosugi, S., Setoh, K., Kawaguchi, T., Matsuda, F., et al. (2025) · Journal of Nutritional Science and Vitaminology · doi:10.3177/jnsv.71.25 · Cited by 2 · see citing works
Self-citationMoradi, S., Saber, A., Moradinazar, M., Heydarian, A., Cheshmeh, S., Sadeghi, F., & Pasdar, Y. (2024) · Journal of Kermanshah University of Medical Sciences · doi:10.5812/jkums-142759 · Cited by 1 · see citing works
Yamazaki, A., Takachi, Y., Takahashi, H., Hara, N., Ogawa, Y., Hyogo, H., Koseki, M., Hayakawa, M., Nakajima, A., Iwaki, M., et al. (2024) · Hepatology Research · doi:10.1111/hepr.14138 · Cited by 1 · see citing works
Recompensation in Cirrhosis: Biomarkers and Strategies
Ramírez-Quesada, W. E., Alvarado‐Tápias, E., Shalaby, S., & Hernández–Gea, V. (2025) · Seminars in Liver Disease · doi:10.1055/a-2542-9930 · Cited by 1 · see citing works
Multidisciplinary clinical practice guideline on the management of metabolic hepatic steatosis
Romero‐Gómez, M., Escalada, J., Noguerol, M., Pérez, A., Carretero, J., Crespo, J., Mascort, J. J., Aguilar, I., Tinahones, F. J., Cañones, P., et al. (2025) · Gastroenterología y Hepatología (English Edition) · doi:10.1016/j.gastre.2025.502442 · Cited by 1 · see citing works
Li, S., Wu, J., Zhou, Y., Wang, C., Xie, L., Liu, S., Su, Y., He, W., Chen, H., Zhong, W.-W., et al. (2025) · World Journal of Hepatology · doi:10.4254/wjh.v17.i10.109898 · Cited by 1 · see citing works
Ni, Z., Wang, R., Miao, H., Wang, G., Lim, W. L. F., Zhang, S., Lam, S. M., & Shui, G. (2026) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2026.02.067 · Cited by 1 · see citing works
PLAKIDA, A. L., Юшковська, О., & Sierpińska, L. E. (2026) · World Journal of Hepatology · doi:10.4254/wjh.v18.i3.113284 · Cited by 1 · see citing works
Elghanam, Y., & Kim, E. (2026) · Archives of Pharmacal Research · doi:10.1007/s12272-026-01615-y · Cited by 1 · see citing works
Da, S., Gao, H., Wang, T., Wei, Q., Liu, A., & Ren, J. (2026) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2026.1789194 · Cited by 1 · see citing works
Intermittent fasting for the management of NAFLD: Is there enough evidence?
Cernea, S., & Ruţă, F. D. (2023) · Acta Marisiensis. Seria Medica · doi:10.2478/amma-2023-0001 · Cited by 1 · see citing works
Pirabbasi, E., Behbahani, H. B., Salimi, Z., Mansoori, A., Dehghanseresht, N., & Asadi, M. (2023) · Zahedan Journal of Research in Medical Sciences · doi:10.5812/zjrms-138464 · Cited by 1 · see citing works
Wang, K., Xiang, S., He, Q., Huang, C., Yang, Z. Y., Li, R., Liu, A., Cai, R., Mi, N., Liang, Z., et al. (2025) · Research Square · doi:10.21203/rs.3.rs-6026627/v1 · Cited by 1 · see citing works
Romero-Gómez, M., Escalada, J., Noguerol, M., Pérez, A., Carretero, J., Crespo, J., Mascort, J. J., Aguilar, I., Tinahones, F., Cañones, P., et al. (2026) · Gastroenterología y Hepatología · doi:10.1016/j.gastrohep.2025.502639 · Cited by 1 · see citing works
Epidemiological Evidence – Health Outcomes
Richard Hoffman PhD RNutr, F. R. S. A. (2022) · doi:10.1002/9781119826743.ch4
Tratamiento no farmacológico de la NAFLD/NASH
Rojo, M., & Pérez, J. N. (2023) · Diabetes práctica · doi:10.52102/diabet/pract.esteatosis.art6
Principles of Nutrition in Patients with Non-alcoholic Fatty Liver Disease
Mobasheri, N., Ghahremani, L., & Nazari, M. (2024) · IntechOpen eBooks · doi:10.5772/intechopen.1008363
Murray, J., Kefayat, A., Finlayson, M., Seenan, J. P., Hsu, R., & Din, S. (2025) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.1177/14782715251332318
Alhouei, B., & Doaei, S. (2025) · Food Science and Nutrition Cases · doi:10.1079/fsncases.2025.0014
- Authors
- Kawaguchi, T., Charlton, M., Kawaguchi, A., Yamamura, S., Nakano, D., Tsutsumi, T., Zafer, M., & Torimura, T.
- Affiliations
- Kurume University (JP)
- University of Chicago (US)
- Saga University (JP)
- Corresponding author
- Charlton, Michael
- ORCID
- Venue
- Seminars in Liver Disease
- Publisher
- Georg Thieme Verlag KG
- Published
- 2021-06-19
- Volume
- 41
- Issue
- 03
- Pages
- 225-234
- ISSN
- 0272-8087 (ISSN-L)
- 1098-8971
- OpenAlex
- W3171675307
- Cited by
- 122
- References
- 48
- Citations by year
- 2026: 29 · 2025: 36 · 2024: 21 · 2023: 19 · 2022: 14 · 2021: 3
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Seminars in Liver Disease (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Agency for Medical Research and Development (JP20fk0210040)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- Mediterranean diet, non-alcoholic fatty liver disease, hepatic steatosis, insulin resistance, fatty liver index, HOMA-IR, dietary intervention
- MeSH terms
- Humans, Insulin Resistance, Regression Analysis, Randomized Controlled Trials as Topic, Diet, Mediterranean, Non-alcoholic Fatty Liver Disease
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