Evaluating the impact of the Dietary Approaches to Stop Hypertension diet versus a calorie-restricted diet on metabolic dysfunction-associated steatotic liver disease: A meta-analysis of randomized controlled trials.

AIM

Metabolic dysfunction-associated steatotic liver disease (MASLD) can lead to increased morbidity and mortality. Diets high in refined carbohydrates and saturated fats elevate MASLD risk. The Dietary Approaches to Stop Hypertension (DASH) diet has shown metabolic benefits. This meta-analysis evaluates the impact of the DASH diet on MASLD progression.

METHODS

A systematic search from 2016 to 2023 across PubMed, Embase, Web of Science, and Cochrane databases was conducted to identify studies reporting on the role of the DASH diet in MASLD. Standard meta-analysis methods were employed using a random-effects model. Heterogeneity was assessed by I statistics.

RESULTS

We identified five randomized controlled trials meeting inclusion criteria, involving 280 participants (140 in the DASH group and 140 in the control group). Mean ages were approximately 41 years, and the proportions of women were similar between groups. Compared with controls, the DASH diet group had a significantly reduced risk of grade 0 and 1 liver fibrosis (RR 1.21, 95% CI 1.04-1.41, p = 0.01). They also showed lower levels of aspartate aminotransferase (MD -4.81, 95% CI -6.98 to -2.64, p < 0.0001), alanine aminotransferase (MD -10.31, 95% CI -13.82 to -6.80, p < 0.00001), body mass index (MD -0.74, 95% CI -1.45 to -0.03, p = 0.04), and cholesterol-to-high-density lipoprotein ratio (MD -0.40, 95% CI -0.68 to -0.11, p = 0.006). No significant differences were found for weight, waist and hip circumference, total cholesterol, low-density lipoprotein, or high-density lipoprotein levels. Heterogeneity was low for most outcomes (I = 0%).

CONCLUSION

Based on our meta-analysis of five randomized controlled trials, the DASH diet may reduce MASLD progression. These findings suggest it could be an effective dietary intervention for MASLD management.