Bernardino Melvin, Tiribelli Claudio, Rosso Natalia
MASLD Unit, Fondazione Italiana Fegato, 34149 Trieste, Italy.
Department of Life Sciences, University of Trieste, 34100 Trieste, Italy.
Nutrients. 2025 Sep 11;17(18):2932. doi: 10.3390/nu17182932.
Metabolic dysfunction-associated steatosis liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver related morbidity and mortality affecting 38% of the adult global population. As of now, there is no clear consensus on a standardized pharmacological treatment for MASLD; therefore, lifestyle interventions particularly diet and exercise remain the first-line approach for both prevention and management. Extra virgin olive oil (EVOO), the primary source of fat in the Mediterranean diet. (MD) is widely recognized as a key contributor to its well-documented health benefits. As a central component of this dietary pattern, EVOO has demonstrated promising therapeutic potential due to its high phenolic content. The primary aim of this review is to synthesize existing human studies examining the effects of olive oil primarily EVOO on key pathological features of MASLD. A systematic search of human clinical and observational studies was conducted across major databases. Key outcomes assessed include hepatic steatosis, inflammation, oxidative stress, fibrosis, liver enzymes, and anthropometric measures. Study quality was evaluated using the Academy of Nutrition and Dietetics Quality Criteria Checklist. This review included 25 high-quality studies, 12 of which assessed olive oil alone and 13 evaluated the MD emphasizing extra virgin olive oil (EVOO). EVOO-rich interventions consistently improved hepatic steatosis, liver enzyme levels (ALT, AST), and inflammatory markers in MASLD patients, particularly when paired with calorie-restricted or MD patterns. Benefits were dose- and type-dependent, with EVOO showing superior effects compared to refined olive oils. Modest improvements in lipid profiles and insulin resistance were observed. Longer study durations and higher EVOO intake (>30-50 g/day) yielded greater improvements. Findings suggest EVOO may exert beneficial effects on liver health through its anti-inflammatory and antioxidant properties. Future studies on EVOO's role in MASLD should use well-characterized oils with known polyphenol and bioactive compound levels and include clear biomarkers of oxidative stress, inflammation, and liver health outcomes on humans. Overall, EVOO represents a promising, non-pharmacological strategy for MASLD prevention and management. Current evidence suggests that EVOO, particularly when rich in phenolic compounds, is a promising dietary strategy for managing MASLD due to its hepato-protective effects, especially within a Mediterranean diet framework. However, findings are limited by study heterogeneity and a lack of high-quality randomized controlled trials, highlighting the need for future research to refine optimal dosing, assess long-term outcomes, and clarify underlying mechanisms.
代谢功能障碍相关脂肪性肝病（MASLD），以前称为非酒精性脂肪性肝病（NAFLD），是肝脏相关发病率和死亡率的主要原因，影响着全球38%的成年人口。目前，对于MASLD的标准化药物治疗尚无明确共识；因此，生活方式干预，特别是饮食和运动，仍然是预防和管理的一线方法。特级初榨橄榄油（EVOO）是地中海饮食（MD）中的主要脂肪来源，因其对健康有益的诸多记录而被广泛认为是一个关键因素。作为这种饮食模式的核心组成部分，EVOO因其高酚含量而显示出有前景的治疗潜力。本综述的主要目的是综合现有的人体研究，探讨橄榄油（主要是EVOO）对MASLD关键病理特征的影响。我们在各大数据库中对人体临床和观察性研究进行了系统检索。评估的关键结果包括肝脂肪变性、炎症、氧化应激、纤维化、肝酶和人体测量指标。使用营养与饮食学会质量标准清单评估研究质量。本综述纳入了25项高质量研究，其中12项仅评估了橄榄油，13项评估了强调特级初榨橄榄油（EVOO）的地中海饮食。富含EVOO的干预措施持续改善了MASLD患者的肝脂肪变性、肝酶水平（ALT、AST）和炎症标志物，特别是与热量限制或地中海饮食模式相结合时。益处具有剂量和类型依赖性，与精炼橄榄油相比，EVOO显示出更优的效果。观察到脂质谱和胰岛素抵抗有适度改善。更长的研究持续时间和更高的EVOO摄入量（>30 - 50克/天）带来了更大的改善。研究结果表明，EVOO可能通过其抗炎和抗氧化特性对肝脏健康产生有益影响。未来关于EVOO在MASLD中作用的研究应使用具有已知多酚和生物活性化合物水平的特征明确的油，并纳入人类氧化应激、炎症和肝脏健康结果的明确生物标志物。总体而言，EVOO代表了一种有前景的、非药物性的MASLD预防和管理策略。目前的证据表明，EVOO，特别是富含酚类化合物时，由于其肝脏保护作用，尤其是在地中海饮食框架内，是管理MASLD的一种有前景的饮食策略。然而，研究结果受到研究异质性和缺乏高质量随机对照试验的限制，这突出了未来研究优化最佳剂量、评估长期结果和阐明潜在机制的必要性。
