Daily Tomato Consumption Linked to Greater Reduction in Liver Fat in MASLD: Exploratory Trial
核心洞察
A six-week randomized controlled trial found that daily consumption of raw tomatoes and tomato sauce led to a greater reduction in hepatic steatosis measured by CAP compared to a tomato-free diet in adults with MASLD (搜索).
The median CAP decline was 35 dB/m in the tomato intervention group versus 18 dB/m in controls, with an adjusted difference of −26.63 dB/m (p = 0.003).
No significant changes were observed in body weight, BMI, liver stiffness, lipid profiles, or liver enzymes between groups after the intervention period.
A six-week exploratory randomized controlled trial published in Nutrients has found that daily consumption of tomatoes—both raw and as sauce—was associated with a significantly greater reduction in hepatic steatosis among adults with metabolic dysfunction-associated steatotic liver disease (MASLD (搜索)), compared to a tomato-free control diet.
The single-center Italian trial, known as the POMOSANO Study, enrolled 79 adult participants with MASLD (搜索) and a body mass index (BMI) of 30 kg/m² or lower. Participants were randomized to either a tomato-free control diet or a daily intervention of 200 grams of raw tomatoes plus 50 grams of tomato sauce, with all tomato products sourced from a certified producer using standardized hydroponic cultivation.
The primary marker of interest was the controlled attenuation parameter (CAP), an ultrasound-based transient elastography measure that estimates hepatic fat accumulation. Both groups saw declines in CAP values over the six-week period, but the reduction was notably greater in the tomato intervention group. The median decline was 35 dB/m in the tomato group compared to 18 dB/m in controls, with an adjusted difference in CAP change between groups of −26.63 dB/m (p = 0.003).
"Tomato consumption may reduce hepatic fat accumulation independently of major changes in body weight, total and abdominal adiposity," the study authors concluded. Indeed, body weight, BMI, waist circumference, total body fat, and visceral adiposity remained largely stable throughout the intervention, with no significant differences between groups at follow-up.
No Significant Metabolic or Fibrosis Changes
Beyond hepatic steatosis, the researchers assessed a range of secondary outcomes. No significant changes were observed in liver stiffness, the fibrosis-4 (FIB-4) index, or FIB-4 risk categories during the intervention period. Similarly, after six weeks, there were no significant differences between groups in glucose metabolism, lipid profiles, inflammatory markers, liver enzymes, or hematological parameters.
Study Limitations and Expert Caution
The authors and independent commentators emphasized several important limitations. The intervention lasted only six weeks, precluding any conclusions about long-term benefits. The study also excluded participants with a BMI over 30 kg/m², a population that represents a substantial portion of MASLD (搜索) patients in clinical practice.
Randa Abdelmasih, MD, DipABOM, an endocrinologist and obesity specialist at the University of Texas Medical Branch who was not involved in the study, noted: "The study demonstrates a modest reduction in hepatic steatosis over only six weeks in a highly selected population of adults with MASLD (搜索) and BMI of 30 kg/m² or more. Most patients we see in clinical practice have obesity (BMI over 30 kg/m²), type 2 diabetes, or more advanced metabolic disease, so the generalizability of these findings is limited."
Jonathan Jennings, MS, MD, a board-certified internist with Medical Offices of Manhattan, also not involved in the research, raised concerns about the inclusion criteria: "The inclusion criteria required only one cardiometabolic risk factor, and it could be any risk factor. I am concerned that not all risks are equal, and people with multiple factors are at higher risk than those with a single risk factor. Type 2 diabetes is more likely to lead to MASLD (搜索) than high blood pressure but the study evaluates them as equal risk factors."
Additional limitations include reliance on self-reported dietary adherence, the single-center design, and the fact that researchers did not measure circulating levels of lycopene and carotenoids—bioactive compounds hypothesized to mediate any potential benefit of tomatoes on liver health. Abdelmasih also pointed out that since the intervention combined raw tomatoes and tomato sauce, it is "difficult to determine which component or combination was responsible for the observed effect."
Context for MASLD (搜索) Management
MASLD (搜索) is the most prevalent chronic liver disease worldwide, closely associated with obesity, insulin resistance, and cardiometabolic dysfunction. Hepatic fat accumulation, along with oxidative and inflammatory stress, can contribute to progression toward fibrosis, cirrhosis, and hepatocellular carcinoma. Current management emphasizes lifestyle modification, with dietary intervention as a central component.
The Mediterranean diet has been linked to reduced hepatic steatosis and improved metabolic outcomes in MASLD (搜索). However, most guidelines focus on overall dietary patterns and weight loss, with limited insight into the effects of specific dietary components. Tomatoes, rich in carotenoids—particularly lycopene—as well as other antioxidant and anti-inflammatory phytochemicals, represent a candidate food of interest.
The study authors described their findings as hypothesis-generating, given the exploratory design, modest sample size, short duration, and indirect assessment of liver fat. Further research with longer follow-up, broader patient populations, and direct measurement of circulating tomato-derived compounds will be needed to confirm and extend these results.