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©The Author(s) 2025.
World J Hepatol. Aug 27, 2025; 17(8): 107909
Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.107909
Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.107909
Table 1 Summary of myths and facts
Myth | Main message |
All carbohydrates are harmful | The type of carbohydrate matters. Complex carbohydrates rich in fiber are protective, while excessive consumption of simple sugars, especially fructose, is associated with increased hepatic lipogenesis |
Fats should be eliminated from the diet | The quality of fat is more important than quantity. Monounsaturated and polyunsaturated fats have anti-inflammatory and hepatoprotective effects, while trans fats and saturated fats should be minimized |
Only the number of calories matters, not the quality of food | Isocaloric diets with different nutritional compositions have distinct effects on liver health. Diet quality impacts steatosis regardless of caloric balance |
Any weight loss already improves MASLD | Although modest weight loss (3%-5%) can reduce hepatic steatosis, a reduction of ≥ 7%-10% is necessary to achieve regression of inflammation and fibrosis |
People with normal weight don't need to worry about their diet | MASLD can also affect individuals with normal BMI ("lean MASLD"), representing up to 20% of cases and equally susceptible to disease progression |
Intermittent fasting is contraindicated | Strategies such as intermittent fasting can promote weight loss, improve insulin sensitivity, and reduce liver fat when properly guided and monitored |
Supplements and "superfoods" can cure MASLD | There is no dietary supplement or isolated food with robust evidence of efficacy in reversing MASLD; none can replace a comprehensive dietary and behavioral approach |
Herbal teas and supplements are always safe and help "cleanse" the liver | Most herbal substances lack scientific evidence of efficacy and may cause liver toxicity. Many cases of acute hepatitis and liver failure are associated with "natural" supplements |
Coffee is harmful for people with fatty liver | Black coffee has hepatoprotective effects and may slow disease progression. Drinking 2-3 cups per day is potentially beneficial for most patients with MASLD |
Iron-rich foods should be avoided when ferritin is elevated in MASLD | Elevated ferritin levels in MASLD patients usually reflect inflammation and insulin resistance rather than true iron overload. Dietary iron restriction is rarely indicated |
Red meat can be consumed freely in MASLD | Excessive consumption of red meat, especially when processed or prepared at high temperatures, has been associated with worsening hepatic steatosis and inflammation |
Gluten and lactose must be eliminated from the diet in MASLD | The exclusion of gluten and lactose is not routinely recommended unless the patient has a confirmed diagnosis of celiac disease, lactose intolerance, or non-celiac gluten sensitivity |
There is a "safe" dose of alcoholic beverage | Even small amounts of alcohol can have a harmful effect on the liver in patients diagnosed with hepatic steatosis. Total abstinence is recommended for individuals with hepatic steatosis |
- Citation: Fernandes SA. Myths and facts about the role of diet in metabolic dysfunction-associated steatotic liver disease. World J Hepatol 2025; 17(8): 107909
- URL: https://www.wjgnet.com/1948-5182/full/v17/i8/107909.htm
- DOI: https://dx.doi.org/10.4254/wjh.v17.i8.107909