Immunonutrition: Another Player on the MASLD Field.

Immunonutrition is a nutritional strategy where the bioactive properties of nutrients from the diet are used to modulate metabolic pathways, inflammation signals, and oxidative stress regulators. Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic degenerative disease with increasing prevalence over the past decade. In MASLD, where inflammation and oxidative stress play key roles in the progression of liver disease, immunonutrition becomes even more important. The impact of different dietary patterns has been studied in the MASLD context; however, current guidelines emphasize the Mediterranean Diet, which, in terms of included food groups, provides a high level of immunonutrients. Nonetheless, adherence, monitoring, and implementation based on geographic areas, availability, and economic factors make this type of diet ultimately less accessible. The main benefit of the diet pattern is in maintaining the positive effects of new pharmacological treatments, alongside physical activity, which are crucial to prevent recurrence. A diet strategy designed for MASLD needs to be adapted to local food availability and should promote the inclusion of immunonutrients. In the treatment of MASLD, dietary recommendations should be individualized based on the sociodemographic, clinical, and nutritional characteristics of the patients.