Mediterranean diet and metabolic outcomes in nafld/masld: A systematic review and meta-analysis of randomized controlled trials

• Valenzuela-Fuenzalida, Juan José
• Salazar-Arancibia, Tamara
• Laborie-Reyes, Benjamin
• Rodríguez-Ortiz, Francisco
• Loaiza Giraldo, Jessica Paola
• Salgado, Cristian
• Nova-Baeza, Pablo
• Orellana-Donoso, Mathias
• Moya, Maria P.
• Bruna Mejías, Alejandro
• Cifuentes-Suazo, Gloria
• Oyanedel-Amaro, Gustavo
• Valenti, Vitor E.
• Sanchis-Gimeno, Juan Alberto

• Mediterranean diet
• NAFLD
• MASLD
• Non-alcoholic fatty liver disease
• Metabolic dysfunction-associated steatotic liver disease
• Systematic review
• Meta-analysis
• Randomized controlled trials

Non-alcoholic fatty liver disease (NAFLD), recently redefined as metabolic dysfunction-associated steatotic liver disease (MASLD), is a leading cause of chronic liver disease worldwide. The Mediterranean diet (MD) is widely recommended for its metabolic benefits, but its specific impact on NAFLD/MASLD outcomes remains variable across trials. This systematic review and meta-analysis evaluated the effect of the Mediterranean diet on liver steatosis, liver enzymes, and metabolic markers in patients with NAFLD/MASLD. Larger, high-quality randomized trials with standardized dietary definitions and longer follow-up are required to clarify its therapeutic role in NAFLD/MASLD.