Top Diets & Fasting vs Fatty Liver: What’s Best?

We previously wrote about how the Mediterranean diet was voted (by a panel of 69 doctors and nutritionists) as best for liver regeneration (followed by Flexitarian, Vegan, DASH, MIND).

Here is that article, for reference: Which Diet? Top Diets Ranked By Experts

Those diets in the “followed by” section are not surprising to see there either, since the Mediterranean diet is mostly plant-based anyway with very little meat and some fermented dairy, and DASH and MIND are variations of the Mediterranean in any case; see: Four Ways To Upgrade The Mediterranean Diet

So, what happens when we take various diets and various kinds of intermittent fasting into account?

Dietary approaches vs MASLD

First, a note on terminology, because there has been a rebrand: what used to be called non-alcoholic fatty liver disease (NAFLD) is now called metabolic dysfunction-associated steatotic liver disease (MASLD).

Attentive readers may have noticed that there appears to be a D missing from the acronym. We noticed that too, and were not able to find any explanation of why it’s not MDASLD.

However, you can read about why the change was made, and how the decision was agreed upon, here: A multisociety Delphi consensus statement on new fatty liver disease nomenclature

Now, onto the science. A team of researchers, Dr. Katarzyna Zablocka-Sowinska et al., investigated, well, the title of the paper explains it:

The Impact of Dietary Interventions on Metabolic Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Comorbid Conditions, Including Obesity and Type 2 Diabetes

They found:

• Mediterranean diet: unsurprisingly, was found to significantly reduce weight, BMI, waist circumference, and improve glucose control, insulin sensitivity, and inflammation. Early evidence also shows improved liver enzyme levels and reduced MASLD severity.
• DASH diet: a modified version of the Mediterranean diet originally aimed at lowering blood pressure (whence the name, dietary approaches to stop hypertension), DASH also helped reduce weight and improved glucose and lipid metabolism in MASLD patients.
• Lacto-ovo-vegetarian diet—in other words, what’s usually just called vegetarianism (as opposed to veganism)—was associated with improved body measurements and liver function, which the researchers considered to be likely due to high nutrient density and reduced processed food intake, as well as the obvious reduction in saturated fats and other well-established meat-related health risks.
• Intermittent fasting: approaches like alternate-day fasting and time-restricted feeding (especially the 16:8 method) led to improved body composition, fasting glucose, triglycerides, LDL-C, inflammation, and liver health.

About those different kinds of fasting, check out: Intermittent Fasting, Intermittently?

We haven’t given numbers there because a lot of metrics were measured for each one and we don’t want to pad the page with tables of data that can be found in the linked paper anyway, but it’s worth noting that the Mediterranean diet and intermittent fasting show the strongest benefits for MASLD management by far, while DASH and vegetarianism provided more modest metabolic and liver health improvements (compared to control).

We are curious as to how a purely plant-based diet (i.e. veganism) would have fared, and hypothesize it’d score more highly than vegetarianism on a like-for-like basis without other adaptations, but alas, that’ll have to remain a hypothesis until further research is done. Same deal with pescatarianism; we’d have liked to see that tested, too.

See also: The Diet That Reduces Postmenopausal Weight Gain, Hot Flashes, & More

Want to learn more?

Check out:

How To Unfatty A Fatty Liver

Take care!