Impact of weight loss and reduction of ultra-processed foods on liver fat content in MASLD: A randomized controlled trial
Bo S, Armandi A, Castelnuovo G, Goitre I, Bioletto F, Guariglia M, Diaz Del Campo NP, Dileo E, Ponzo V, Saba F, Rosso C, Caviglia GP, Bugianesi E
JHEP reports : innovation in hepatology · 0 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Ministero dell'Istruzione e del Merito
- Gobierno
- Ministero dell'Istruzione dell'Universita e della Ricerca
- Subvenciones
- Ministero dell'Istruzione e del Merito (D53D23014370006)
Según 2 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2026-06-22 · JHEP Rep · vol. 8 · número 9 · pág. 101929
- Editorial
- Elsevier BV
- Citado
- 1 cita · más que el 95% de estudios similares · 4.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 30 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY-NC-ND
- Áreas de investigación
- Liver Disease Diagnosis and Treatment · Nutritional Studies and Diet · Diet, Metabolism, and Disease
- Palabras clave
- non-alcoholic fatty liver disease, liver fat, ultra-processed foods, weight loss, Mediterranean diet, high-protein low-carbohydrate diet, controlled attenuation parameter, obesity, overweight, dietary intervention, body composition, adiposity, metabolic health, nutrition counseling, dietary habits, body mass index
- MeSH
- liver, humans, fatty liver, obesity, weight loss, diet, mediterranean, adult, middle aged, female, male, overweight, diet, carbohydrate-restricted, fast foods, non-alcoholic fatty liver disease, diet, high-protein
13 autores
- Simona Bo🇮🇹University of Turin
- Angelo Armandi🇮🇹University of Turin
- Gabriele Castelnuovo🇮🇹University of Turin
- Ilaria Goitre🇮🇹University of Turin
- Fabio Bioletto🇮🇹University of Turin
- Marta Guariglia🇮🇹University of Turin
- Nuria Pérez Diaz del Campo🇮🇹University of Turin
- Eleonora Dileo🇮🇹University of Turin
- Valentina Ponzo🇮🇹University of Turin
- Francesca Saba🇮🇹University of Turin
- Chiara Rosso🇮🇹University of Turin
- Gian Paolo Caviglia🇮🇹University of Turin
- Elisabetta Bugianesi🇮🇹University of Turin
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background & aims
Dietary interventions are a cornerstone of management for metabolic dysfunction-associated steatotic liver disease (MASLD). However, it remains unclear whether specific dietary patterns confer benefits beyond weight loss. We aimed to compare the effects of different dietary strategies on liver fat and metabolic health in patients with MASLD.
Methods
We conducted a 6-month, three-arm, parallel-group randomized controlled trial including patients with MASLD and overweight or obesity who were naïve to structured nutritional counselling. Participants were randomized to Mediterranean diet (MeD), low-carbohydrate, high-protein diet (LCHO), or standard nutritional recommendations. Liver fat content was assessed by controlled attenuation parameter (CAP). Secondary outcomes included changes in anthropometric and metabolic parameters, body composition, and ultra-processed food (UPF) consumption. Structural equation modelling was used to investigate pathways linking dietary allocation, weight loss, and UPF intake with changes in CAP.
Results
Of 173 enrolled participants, 148 (85.5%) completed the study. CAP decreased significantly within the LCHO and control groups (Δ -19.5 [-48.8 to 8.0], p = 0.004 and -11.0 [-32.0 to 12.0], p <0.001), with no significant between-group differences. All study arms achieved significant improvements in body weight, BMI, adiposity measures, metabolic profile, and dietary quality, including reductions in UPF intake. Structural equation modelling analyses showed no direct or total effect of dietary pattern on changes in CAP. In contrast, reductions in BMI and UPF consumption independently and significantly predicted CAP improvements: β = 14.34 (95% CI 10.55-18.13), and β = 0.64 (95% CI 0.25-1.03).
Conclusions
In patients with MASLD, weight loss and reductions in UPF intake, rather than diet type, were the main drivers of improvements in liver fat and metabolic health. These findings support a patient-centered dietary approach in MASLD management.
Clinical trial number
NCT073043336.
Impact and implications
This randomized controlled trial shows that weight loss and reductions in ultra-processed food intake, rather than the specific dietary pattern, are the primary factors associated with improvements in liver fat and metabolic health in MASLD. These findings challenge the emphasis on prescriptive dietary models and support a more flexible, patient-centered approach focused on sustainable weight reduction and improved dietary quality. Prioritizing reduction of ultra-processed foods may represent a practical and scalable strategy to enhance adherence and maximize long-term clinical benefit in routine care.
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