The Role of Mediterranean, DASH, and Vegetarian Diets in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Sustainability and Alignment with SDGs

Abstract Over one-third of adults worldwide suffer from metabolic dysfunction-associated steatotic liver disease (MASLD), which has become the most prevalent chronic liver disease worldwide. The global prevalence of MASLD has increased by about 50% over the last three decades, from 25.3% in 1990–2006 to 38.2% in 2016–2019. Furthermore, MASLD is now the disease burden associated with unfavourable liver outcomes, such as cirrhosis, liver failure, and HCC, which is growing at the fastest rate. The growing prevalence of MASLD underlines the increasing need for lifestyle strategies that are not only effective but sustainable. This case study reviews the efficacy of common dietary patterns, namely, Dietary Approaches to Stop Hypertension (DASH), Mediterranean (MeD or MD), and vegetarian diets on MASLD, with proposed modes of action. It also includes a total assessment of the sustainability of each, projecting clinical outcomes as ecological and societal concerns. This study combines various dimensions to provide a thorough interpretation of nutrition-based strategies for managing a MASLD-oriented dietary approach, utilizing evidence-based, sustainable, and effective management strategies. Information © The Authors 2025