METABOLIC Dysfunction-Associated Steatotic Liver Disease (MASLD) is a condition closely linked with obesity, insulin resistance, dyslipidaemia, and type 2 diabetes mellitus (T2DM). When MASLD coexists with diabetes, the two conditions reinforce each other, creating a cycle of worsening metabolic dysfunction. This combination not only accelerates liver fibrosis but also significantly raises the risk of cardiovascular disease and kidney complications.
Recent research highlights the pivotal role of insulin resistance in MASLD. Excess free fatty acids, driven by obesity and impaired insulin sensitivity, contribute to fat accumulation in the liver. In addition, factors such as oxidative stress, intestinal dysbiosis, and lipotoxicity aggravate the condition, leading to progression towards cirrhosis and even liver cancer.
The Role of High-Fibre Foods in MASLD and T2DM Management
A new randomised controlled trial has investigated the impact of dietary fibre supplementation on patients with T2DM and MASLD. Participants received additional fibre at doses of 12g and 24g per day. The results showed that those consuming 24g of fibre experienced notable improvements in liver fibrosis and glycaemic control. Interestingly, this improvement was not accompanied by significant reductions in body mass index (BMI), suggesting that fibre’s benefits extend beyond weight management.
Dietary fibre exerts multiple beneficial effects: it enhances satiety, reduces postprandial blood glucose spikes, lowers insulin secretion, and improves intestinal health. Previous studies also support its role in reducing liver enzyme levels and improving markers of metabolic health. However, outcomes vary depending on fibre type, dosage, and study duration, underlining the need for further long-term trials.
Clinical Implications and Future Directions
These findings suggest that incorporating high-fibre diets into treatment plans could be a valuable adjunctive strategy for managing MASLD in patients with diabetes. A daily dose of 24g appears most effective for improving liver and metabolic health. Nonetheless, clinicians must consider overall caloric intake to prevent unintended weight gain.
Future studies should focus on longer follow-up periods, larger sample sizes, and the use of digital tools to improve dietary reporting accuracy. Exploring the differential effects of fibre types may further refine dietary recommendations.
Reference
Chen XS et al. Impact of a high dietary fiber cereal meal intervention on the progression of liver fibrosis in T2DM with MASLD. Front Endocrinol (Lausanne). 2025;16:1623136.
