Special correlation between diet and MASLD: positive or negative?

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic and systemic metabolic liver disease characterized by the presence of hepatic steatosis and at least one cardiometabolic risk factor (CMRF). The pathogenesis of MASLD involves multiple mechanisms, including lipid metabolism disorders, insulin resistance, inflammatory responses, and the hepato-intestinal axis of metabolic dysfunction. Among these factors, diet serves as both an inducement and a potential remedy in the disease's development. Notably, a high-lipid diet exacerbates fat accumulation, oxidative stress, and inflammatory responses, thereby promoting the progression of MASLD. Consequently, dietary induction models have become vital tools for studying the pathological mechanisms of MASLD, providing a foundation for identifying potential therapeutic targets. Additionally, we summarize the therapeutic effects of dietary optimization on MASLD and elucidate the role of specific dietary components in regulating the hepato-intestinal axis, lipid metabolism, and inhibiting inflammatory responses. In conclusion, studies utilizing animal models of MASLD offer significant insights into dietary therapy, particularly concerning the regulation of lipid metabolism-related and hepatoenteric axis-related signaling pathways as well as the beneficial mechanism of probiotics in hepatoenteric regulation. By understanding the specific mechanisms by which different dietary patterns affect MASLD, we can assess the clinical applicability of current dietary strategies and provide new directions for research and treatment aimed at disease modification.

Keywords: Curative strategy; Dietary models; Dietary therapy; Hepato-intestinal axis; MASLD; Pathological mechanism.

Fig. 1

The pathological mechanisms of MASLD induced by a high-fat diet, including fat accumulation, mitochondrial dysfunction, inflammation, and hepato-intestinal axis disorders. Key pathways (AMPK, PPARs, SREBPs) are highlighted for their roles in regulating lipid metabolism, mitochondrial function, and inflammatory responses

Fig. 2

How dietary intake probiotics influences MASLD. A high-sugar, processed diet disrupts gut balance, promoting oxidative stress and MASLD. In contrast, dietary fiber and supplements (Akkermansia, Prohep, oat beta-glucan) restore gut balance, reduce inflammation, enhance fatty acid oxidation, and alleviate MASLD progression