METABOLIC-associated fatty liver disease (MASLD) has emerged as a major cause of chronic liver disease globally, strongly linked to poor dietary patterns and lifestyle factors. High consumption of ultra-processed foods, excessive calories, and low nutritional quality contribute to MASLD development, alongside metabolic syndrome and visceral fat accumulation. With limited pharmacological options, Mediterranean diet adherence has been highlighted as an effective approach to reducing intrahepatic fat content (IFC) and improving metabolic health.
Linking Liver Health and the Mediterranean Diet
Recent research has examined the dual benefits of dietary patterns that improve MASLD outcomes while reducing environmental impact. The Mediterranean diet (MD) emphasises plant-based foods, whole grains, legumes, fruits, nuts, and olive oil, with moderate fish consumption and limited red or processed meats. This approach not only lowers intrahepatic fat and inflammation but also reduces greenhouse gas (GHG) emissions, land use, and overall environmental footprint compared with Western dietary patterns.
In a six-month study, participants adhering closely to the Mediterranean diet achieved significant reductions in %IFC, correlating with lower GHG emissions and land use. Improvements in liver fat content were particularly notable among individuals with higher diet adherence, highlighting the diet’s ability to deliver metabolic benefits while supporting environmental sustainability. Interestingly, water use increased slightly due to higher consumption of plant-based foods such as nuts and fresh produce, illustrating the complexity of balancing health and ecological outcomes.
The study confirmed that reductions in visceral fat and greater Mediterranean diet adherence were strongly associated with improvements in MASLD indicators. These findings reinforce the concept that dietary quality plays a central role in managing liver disease and can be aligned with environmental objectives. By prioritising minimally processed, nutrient-dense foods and limiting ultra-processed products, the Mediterranean diet offers a practical framework for “pro-liver and pro-planet” dietary strategies.
This research highlights the potential of integrated dietary interventions that simultaneously target MASLD management and environmental sustainability. Promoting plant-forward, minimally processed diets can improve metabolic outcomes while reducing ecological pressure, demonstrating that nutrition strategies can benefit both personal and planetary health. Future studies should further explore optimised diet designs that balance liver health, caloric intake, and environmental impact to support long-term metabolic and ecological goals.
Reference
García S et al. Metabolic dysfunction-associated steatotic liver disease is linked to environmental sustainability: the role of the mediterranean diet. Nutrients. 2025;17(20):3206.
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