Types of Diet for the Treatment of MASLD

Effective management of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) begins with fibrosis risk stratification, but long-term success hinges on a multidisciplinary approach to lifestyle and medical interventions. In this in-depth session, we explore the evidence behind dietary changes, exercise recommendations, and pharmacologic options for patients with MASLD and MASH (Metabolic Steatohepatitis). Backed by randomized controlled trials and clinical guidelines, the Mediterranean diet remains the most strongly supported for improving liver stiffness, insulin sensitivity, and reducing steatosis. We also cover the role of intermittent fasting—including alternate-day fasting, 5:2 plans, and 16:8 time-restricted eating—and how each can support sustainable weight loss, a key factor in fibrosis regression.

Processed foods, added sugars, and sugar-sweetened beverages are closely linked to increased calorie intake and visceral fat. This session highlights NIH research showing how ultra-processed diets can lead to rapid weight gain, reinforcing the importance of whole-food, farm-to-table dietary approaches. We also discuss physical activity guidelines—150 minutes of moderate aerobic activity per week with resistance training is critical for maintaining muscle mass, preventing sarcopenia, and supporting overall metabolic health, especially in patients on GLP-1 receptor agonists or other pharmacologic weight-loss therapies.

For patients unable to achieve targets through lifestyle alone, we review pharmacologic options such as GLP-1 RAs, SGLT2 inhibitors, and pioglitazone, which have shown benefits in reducing steatosis and inflammation. For those with advanced fibrosis, surgical or endoscopic weight-loss interventions may offer additional benefits, including improvements in fibrosis and reductions in liver-related mortality. Whether your patient is obese or lean with visceral adiposity, a personalized, evidence-based treatment plan is essential. This session is a comprehensive guide for hepatologists, endocrinologists, and primary care clinicians looking to optimize MASLD management through diet, exercise, and advanced therapeutics.

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