Evidence mapPaperPMID 41663075Full record

ArticleJournal of gastroenterology and hepatology2026

Mediterranean Diet Adherence Is Associated With Reduced Liver Fibrosis Risk in Metabolic Dysfunction-Associated Steatotic Liver Disease.

Meng-Lun Hsieh, Tung-Hung Su, Ying-Cheng Lin, Yen-Yang Chen, Chun-Fang Tung, Ling-Sung Huang, Cheng-Hao Wu, Yen-Chun Peng, Vivian Chia-Rong Hsieh

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Article in Journal of gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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  2. PreliminaryLife (Basel, Switzerland) · 2026
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Meng-Lun HsiehDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.ORCID https://orcid.org/0009-0009-5801-5428
Tung-Hung SuDivision of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Ying-Cheng LinDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Yen-Yang ChenDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Chun-Fang TungDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Ling-Sung HuangDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Feng Yuan Hospital Ministry of Health and Welfare, Taichung, Taiwan.
Cheng-Hao WuDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Yen-Chun PengDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Vivian Chia-Rong HsiehDepartment of Health Services Administration, China Medical University, Taichung, Taiwan.ORCID https://orcid.org/0000-0001-9635-0897

Funding

China Medical University CMU113-MF-114National Science and Technology Council, Taiwan NSTC 113-2410-H-039-004
6 · The paper itself

Abstract

BACKGROUND/

aimsBenefits of the Mediterranean diet (MD) in reducing hepatic steatosis among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) have been well established. This study aims to evaluate the relationship between MD adherence and liver fibrosis among the MASLD population.

methodsThis cross-sectional study analyzed data from the National Health and Nutrition Examination Survey 2017 to March 2020. Individuals with MASLD were identified based on the vibration-controlled transient elastography-defined steatosis. Participants' MD adherence was evaluated using the alternate Mediterranean diet (aMED) score, with higher scores indicating greater adherence. Risk of significant liver fibrosis was compared between low, moderate, and high aMED groups.

resultsOf 2672 MASLD participants, 27.2%, 42.3%, and 30.6% were categorized into low, moderate, and high aMED groups, respectively. After adjusting for the number of cardiometabolic risk factors (CMRFs), physical activity, and other covariates, participants in the high aMED group were associated with a lower risk of significant liver fibrosis compared with those in the low aMED group (aMED 5-9 vs. aMED 0-2: OR = 0.662, 95% confidence interval [CI]: 0.660-0.663; p for trend < 0.0001). In the sensitivity analyses, the protective association of higher MD adherence against the risk of significant liver fibrosis weakened with higher cardiometabolic burden (aMED 5-9: aOR 0.582, 95% CI: 0.580-0.584 [4-5 CMRFs] vs. aOR 0.383, 95% CI: 0.380-0.386 [1 CMRF]).

conclusionsIn MASLD patients, higher MD adherence was associated with lower risk of significant liver fibrosis. Our findings support the recommendation of the MD as a crucial lifestyle intervention to lower the risk of liver fibrosis in this population.

Indexed as

Diet, MediterraneanFatty LiverLiver CirrhosisMetabolic DiseasesPatient ComplianceAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedNutrition SurveysRiskRisk Factorsliver fibrosisMediterranean dietmetabolic dysfunction–associated steatotic liver diseaseNational Health and Nutrition Examination Surveyvibration‐controlled transient elastography

Identifiers

PMID41663075
PMCPMC12969249

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.