High-protein diets and metabolic dysfunction-associated steatotic liver disease: A double-edged sword in liver health

Figure 4 Clinical evidence of protein source and type on metabolic dysfunction-associated steatotic liver disease outcomes across study designs. High-protein diets, especially those rich in animal-derived proteins, worsen metabolic dysfunction-associated steatotic liver disease by accelerating hepatic lipid accumulation, disturbing hepatic iron homeostasis, and generating metabolic dysfunction-associated steatotic liver disease-inducing amino acid metabolites that alter intestinal flora composition, heightening overall mortality in patients with cirrhosis. On the contrary, other studies have found a high-protein diet improves insulin sensitivity and rebalances gut microbial ecology, conferring a beneficial hepatic metabolic profile. MASLD: Metabolic dysfunction-associated steatotic liver disease; T2D: Type 2 diabetes.