Evaluation of the Effects of Extra Virgin Olive Oil Consumption on Hepatic Steatosis Parameters and on Glucose and Lipid Metabolism in Subjects With MASLD.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the most widespread non-communicable chronic diseases worldwide and the leading cause of liver-related mortality and morbidity. It currently affects about 38% of the global adult population and between 7% and 14% of the pediatric population, and projections indicate that its prevalence will continue to rise, exceeding 44% by 2040.

The term MASLD was recently introduced to replace the former nomenclature for steatotic liver disease (non-alcoholic fatty liver disease, NAFLD) and to emphasize the close relationship between "fatty liver" and metabolic syndrome, as reported in the 2023 multisociety Delphi consensus statement.

MASLD is defined by the accumulation of triglycerides in the liver in the absence of significant alcohol intake or other causes of steatosis, together with at least one of the following cardiometabolic risk factors: obesity, type 2 diabetes mellitus, dyslipidemia, or arterial hypertension. Its pathophysiology is multifactorial and involves both modifiable and non-modifiable factors: liver damage results from the combined effect of metabolic dysfunction, unhealthy diet, physical inactivity, and genetic predisposition.

At present, there is no strong consensus on pharmacological therapy for the management of MASLD. For this reason, lifestyle modification, with a focus on diet and physical activity, still represents the first-line intervention for the prevention and management of MASLD. Recent studies identify diet as a primary modifiable factor in the clinical approach to MASLD, highlighting the key role of diet quality and eating habits in modulating various metabolic processes. Most of the scientific evidence agrees in identifying the Mediterranean diet as the dietary pattern most strongly associated with health benefits, with protective effects against several non-communicable chronic diseases.

The Mediterranean diet is a traditional dietary pattern followed by populations living in countries bordering the Mediterranean Sea. Its benefits are mainly attributable to the characteristic foods it includes, which are rich in nutrients, antioxidant compounds, and dietary fiber. The Mediterranean diet is based on high consumption of fruits, vegetables, whole grains, legumes, nuts, and extra virgin olive oil, moderate intake of fish and poultry, and low intake of red meat and processed products.