SynthesisBMC medicine2025
Effects of Mediterranean diet, exercise, and their combination on body composition and liver outcomes in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled 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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Effects of exercise interventions on metabolic and hepatic function markers in overweight or obese patients with MASLD: a systematic review and meta-analysis.BMC gastroenterology · 2025Pooled it
- The Mediterranean pyramid: 30 years later, still relevant.European journal of nutrition · 2026Review
- Heart-liver co-management in MASLD: expert perspectives and recommendations from a multidisciplinary cardiometabolic framework.Nature reviews. Gastroenterology & hepatology · 2026Review
- The MASLD-Cardio-Oncology Triangle: Dietary Patterns, Metabolic Remodelling and Implications for Cancer Therapy Tolerance.Nutrients · 2026Review
- MASLD and Cardiovascular Risk: Mechanisms and Implications for Clinical Practice.Current hypertension reports · 2026Review
- Review
- Review
- Processing Status, Rather Than Meat Source, Is Associated with Metabolic Dysfunction-Associated Steatotic Liver Disease Among US Adults.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- MASLD as a systemic metabolic disease: expanding the scope of cardiovascular-kidney-metabolic (CKM) syndrome.Science China. Life sciences · 2026Review
- Emerging Therapeutic Perspectives in Obese Patients with MASLD Leading to Compensated Advanced Chronic Liver Disease.Biomolecules · 2026Review
- Article
- Liver Fibrosis and the Risks of Impaired Cognition and Dementia: Mechanisms, Evidence, and Clinical Implications.Medical sciences (Basel, Switzerland) · 2026Review
- Rethinking the hepatoprotective potential of vegetarian diets in dysfunction-associated steatotic liver disease/metabolic-associated fatty liver disease: a critical narrative review.Frontiers in nutrition · 2026Review
- Body-composition phenotype axes provide additional explanatory information for cardiorespiratory fitness and liver-related metabolic risk within BMI strata.Frontiers in nutrition · 2026Article
- Silent inflammation: a hidden cause of liver fibrosis.Frontiers in pharmacology · 2026Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): New Perspectives on an Evolving Epidemic.Journal of clinical medicine · 2025Review
- Article
- Molecular mechanisms and clinical applications of gut microbiota-derived bioactive compounds in metabolic dysfunction-associated fatty liver disease.Frontiers in immunology · 2025Review
- Mediterranean diet adherence and tirzepatide: real-world evidence on adiposity indices and insulin resistance beyond weight loss.Frontiers in endocrinology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of liver-related morbidity and mortality. Lifestyle interventions like the Mediterranean diet (MD) and exercise are recommended for management, but the most effective lifestyle approach remains unclear.
methodsA comprehensive literature search was conducted in Embase, MEDLINE via Ovid, Cochrane Central, and Web of Science Core Collection from inception to April 1, 2025, without language restrictions. We included randomized controlled trials (RCTs) in adults with MASLD or metabolic dysfunction-associated steatohepatitis (MASH) assessing the MD and/or exercise interventions on anthropometric measures, liver enzymes, and indices or grades of liver steatosis and fibrosis. The mean difference and corresponding 95% confidence interval (CI) were pooled using a random-effects model. Risk of bias was assessed with ROB-2, and evidence certainty was evaluated using GRADE.
resultsFrom a total of 4806 search results, 37 unique RCTs met the inclusion criteria, from which 11 assessed the MD and 27 exercise, either aerobic, resistance, or in combination, and two RCTs assessed the effect of the MD and exercise combination. Meta-analyses showed that the MD in comparison with the control significantly reduced body weight [weighted mean difference (WMD = - 2.38 kg, 95% CI - 4.11 to - 0.66), body mass index (WMD = - 0.70 kg/m
conclusionsThe MD and aerobic exercise, whether alone or combined with resistance training, support weight loss and improve liver health in patients with MASLD/MASH. Standardized methods for measuring and reporting outcomes are essential to build robust evidence on the impact of lifestyle changes on clinical outcomes. TRIAL REGISTRATION: PROSPERO registration code. CRD42024577846.
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Registered trials
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 OpenQuestion graph.