Combining nutraceuticals and a mediterranean diet for managing metabolic dysfunction associated with steatotic liver disease.

This study was performed by Cano Contreras , who explored the effects of alpha-lipoic acid (ALA) and Silybum marianum (SM) supplementation combined with a mediterranean diet (MD) on metabolic dysfunction-associated steatotic liver disease (MASLD). The randomized controlled design and use of transient elastography provide methodological strengths, whereas the focus on a Mexican cohort addresses a critical gap in regional MASLD research. Although improvements in visceral fat and controlled attenuation parameters (CAP) were observed, key metabolic markers, including transaminases and lipid profiles, showed no significant changes, raising concerns about the intervention's comprehensive metabolic impact. The reliance on CAP and the absence of mechanistic biomarker analysis limit insights into the antioxidant and anti-inflammatory pathways of ALA and SM. Future research should explore synergistic effects with other nutraceuticals, such as vitamin E and polyphenols, and include extended follow-up and patient stratification to assess long-term benefits and personalized therapeutic outcomes. Addressing these limitations could solidify the role of nutraceuticals in MASLD management and enable the development of more effective and sustainable interventions.