The Mediterranean diet, high in plants and low on meat and dairy, has been linked to a host of health benefits – including longer life and lower cancer risk. Now we can add another benefit to the list, according to a new study: protection against metabolic dysfunction-associated steatotic liver disease (MASLD).

MASLD affects around one in three of us worldwide, and occurs when too much fat builds up in the liver. It can lead to inflammation, cancer, and fibrosis, and is closely linked to other issues such as type 2 diabetes and obesity.

The new review study, led by a team from the University of Rovira i Virgili in Spain, looked at 13 previous trials and studies involving 926 participants and a variety of diet approaches. Each of the reviewed trials involved people with MASLD.

It was the Mediterranean diet that stood out in terms of its health benefits, with intermittent fasting also making a notable difference in terms of numerous key health markers. Several signs of MASLD in the liver were reduced by these diets.

"This review suggests that Mediterranean diet and intermittent fasting-based strategies may reduce body weight, improve glycemic control, and lower inflammation, with potential benefits for hepatic [liver] function," write the researchers in their published paper.

"Further long-term studies are needed to confirm these effects and underlying mechanisms, which will allow for the optimization of protocols and ensure their safety in MASLD."

It's important to note that while all the reviewed studies involved people with MASLD, the disease wasn't their primary focus. The researchers here are doing some joining of the dots when it comes to how certain biomarkers (such as glycemic control and inflammation levels) might link to MASLD outcomes.

In theory, the benefits that the research shows for the Mediterranean diet and intermittent fasting should reduce the severity of MASLD, or stop it from developing in the first place. But as the researchers acknowledge, we'll need longer-term studies looking at disease progression over time to be more sure.

"Despite the limited data on liver function outcomes, the results of this review provided early indication of the promising potential of Mediterranean diet-based interventions," write the researchers.

The Mediterranean diet emphasizes fruits, vegetables, whole grains, nuts, olive oil, fish, and poultry, while minimizing sugar, red meat, and processed foods. Its name comes from its region of origin, particularly countries like Greece and Italy.

It's an approach to eating that's been around for thousands of years, and which has previously been linked to reduced severity of fatty liver disease – though it's important not to assume direct cause and effect, with so many variables involved.

What's clear is that the Mediterranean diet is very good for us, and can keep our bodies functioning in a healthier way for a longer period of time. Scientists are still exploring how exactly it works, but it seems the effects extend to conditions in the liver too.

"MASLD is a complex condition with many factors implicated in its risk/development, including nutrition and immune-metabolic health status," write the researchers.

"Consequently, investigating the influence and effectiveness of dietary patterns in improving hepatic function, along with immuno-metabolism, can be important in MASLD management."

The research has been published in Nutrients.