Energy balance
Fasting interventions significantly reduce liver health biomarkers (ALT and liver stiffness) in individuals with MASLD compared to control diets.
For those with MASLD, structured fasting approaches (like Alternate Day Fasting, 5:2 diets, or Time-Restricted Eating) have been shown in meta-analyses to significantly lower liver enzymes (ALT) and reduce liver stiffness compared to control diets. These benefits are linked to improvements in insulin resistance and triglyceride levels. Most effective studies lasted 3 months, so long-term sustainability needs more research, but the short-term liver health gains are robust.
In studies on fasting interventions ALT (MD = − 12.47 IU/L; 95% CI − 22.03,− 2.92; p = 0.01; n = 6) and liver stiffness (MD = − 0.24 kPa; 95% CI − 0.46, − 0.03; p = 0.03; n = 4) were reduced compared to controls.
Why this rating
Meta-analysis of 6 RCTs with moderate certainty of evidence (GRADE), though heterogeneity was high for ALT.
Source
The impact of dietary interventions on liver health biomarkers in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD): a systematic literature review and meta-analysis of randomized controlled trials
Ute Stern et al. · European Journal of Nutrition · 2026
DOI 10.1007/s00394-025-03870-z
More from this paper
- The Mediterranean Diet (MedDiet) significantly improves liver health biomarkers (ALT, liver stiffness, and MRI-PDFF) in individuals with MASLD.Good
- Low-Carbohydrate High-Fat (LCHF) and Ketogenic diets do not significantly alter ALT levels in individuals with MASLD compared to control diets.Moderate
- Omega-3 fatty acid supplementation does not significantly alter ALT levels in individuals with MASLD.Moderate
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