A 12-MONTH randomised trial suggests that two healthy dietary patterns, a polyunsaturated fatty acid–rich diet and a healthy Nordic diet, can significantly reduce liver fat in people with prediabetes or type 2 diabetes, even without intentional energy restriction. The findings have practical implications for managing metabolic dysfunction-associated steatotic liver disease (MASLD) in routine clinical care.
Excess liver fat is closely linked to insulin resistance, dyslipidaemia, and cardiovascular risk. While replacing saturated fat with polyunsaturated fatty acids (PUFA) is known to reduce hepatic fat, less is known about the long-term effects of broader dietary patterns. This study compared a novel “anti-lipogenic” PUFA-based diet, a low-fat healthy Nordic diet (HND), and usual care.
Liver Fat Reduced With PUFA and Nordic Diet
The trial enrolled 150 adults with prediabetes or type 2 diabetes, randomised to one of three ad libitum diets for 12 months. Compared with usual care, both the long-chain PUFA (LCPUFA) diet and the healthy Nordic diet achieved modest but significant reductions in liver fat (–1.46% and –1.76%, respectively). No significant difference was observed between the two intervention diets, suggesting that both approaches are effective for hepatic fat reduction.
For clinicians, the key message is that meaningful improvements in liver fat can be achieved without prescribing calorie restriction or weight-loss targets, an important consideration for long-term adherence.
Nordic Diet Offers Broader Metabolic Benefits
Although liver fat reduction was similar, the healthy Nordic diet demonstrated additional metabolic advantages. Participants following the HND experienced greater reductions in body weight and HbA1c than those on the PUFA or usual care diets. The HND also uniquely lowered triglycerides, inflammatory markers, and liver enzymes, pointing to broader improvements in cardiometabolic and hepatic health.
Both the PUFA and Nordic diets reduced LDL cholesterol to a similar extent, reinforcing their potential role in cardiovascular risk reduction alongside liver fat improvement. Serious adverse events were rare and evenly distributed across groups, supporting the overall safety of these dietary strategies.
Clinical Relevance for MASLD and Type 2 Diabetes
These findings suggest that a healthy Nordic diet may be a particularly feasible and effective option for patients with type 2 diabetes and MASLD, delivering benefits across glycaemic control, lipid profiles, inflammation, and liver biochemistry. A PUFA-rich, plant-forward diet also appears effective for reducing liver fat and LDL cholesterol, offering flexibility in dietary counselling.
Reference
Fridén M et al. Effects of an anti-lipogenic low-carbohydrate high polyunsaturated fat diet or a healthy Nordic diet versus usual care on liver fat and cardiometabolic disorders in type 2 diabetes or prediabetes: a randomized controlled trial (NAFLDiet). Nat Commun. 2025;16(1):11130.
