Energy balance
Weight loss of 7-10% is required to improve histological disease activity and features of MASLD, while 3-5% weight loss stabilizes or improves fibrosis in normal-weight patients.
If you have MASLD, aim for a 7-10% reduction in body weight if you are overweight or obese, or 3-5% if you are normal weight. This is achieved by creating a daily calorie deficit of 500-1,000 kcal. Even if you cannot reach the higher target, losing just 5% of your body weight is highly likely to stabilize or improve liver fibrosis.
In a meta-analysis of eight randomised controlled trials (RCTs), participants with weight loss ≥7% improved histological disease activity... 10% weight loss was associated with an improvement in all features of MASLD, including portal inflammation and fibrosis. However, it is important to note that those patients losing 5% of their body weight stabilised or improved fibrosis in 94% of the cases... current updated American Gastroenterology Association clinical practice recommendations suggest a target weight loss of 3–5% in this group of patients.
Why this rating
Supported by meta-analyses of RCTs and prospective trials with liver biopsies.
Source
Treatment Options and Continuity of Care in Metabolic-associated Fatty Liver Disease: A Multidisciplinary Approach
Carmen Lara et al. · European Cardiology Review · 2024
DOI 10.15420/ecr.2023.34
More from this paper
- Adherence to a Mediterranean diet improves liver steatosis and metabolic parameters, and is the only diet pattern recommended as potential therapy for MASLD by major scientific societies.Good
- Moderate-to-vigorous physical activity (150-200 minutes/week) reduces intrahepatic lipid and improves MASLD outcomes, with vigorous exercise offering full benefits for steatohepatitis and fibrosis.Good
- Excessive fructose consumption (e.g., >7 sugary drinks/week) is associated with hepatic fibrosis independent of calorie intake, and fructose-restricted diets decrease liver triglycerides.Good
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