6 Tips to Follow the Mediterranean Diet When You Have MASH, According to an RD

Healthy food choices can help manage MASH, short for metabolic dysfunction-associated steatohepatitis. In some cases, a well-balanced diet may even help reverse liver damage caused by this severe form of nonalcoholic liver disease.

MASH develops when excess fat builds up in the liver, causing inflammation and damage to liver cells. Without treatment or lifestyle changes, MASH can progress to fibrosis, cirrhosis, and even liver failure. At this point, the condition is no longer reversible due to permanent liver damage and scarring. 

As of now, only one prescription medication is approved by the Food and Drug Administration (FDA) to treat MASH, making diet a key strategy for managing the condition.

As a dietitian, I’m a big fan of using the Mediterranean diet for this purpose. While no magical food or diet can cure MASH overnight, research shows that the Mediterranean diet can help improve mild-to-moderate MASH.

How Does the Mediterranean Diet Help Manage MASH?

Eating a well-balanced diet is essential for treating MASH. One treatment goal is weight loss, which can lower the amount of fat in the liver.

The Mediterranean diet is a style of eating that focuses on plant-based foods and healthy fats. It isn’t a strict diet. Instead, it is an overall eating pattern that offers serious potential for health benefits.

This diet emphasizes eating mostly plant-based foods such as fruits, vegetables, whole grains, legumes, nuts, and seeds, with a moderate intake of dairy products (mainly cheese and yogurt), fish, and poultry while limiting the consumption of red meat. It also includes a high intake of healthy fats, such as olive oil.

The Mediterranean diet is increasingly recognized as being helpful in treating liver conditions such as MASH, largely due to its beneficial effects on the liver, and aiding in weight loss and blood sugar regulation.

How to Make the Mediterranean Diet Work For You

Transitioning to a Mediterranean diet doesn’t have to be overwhelming. Think of it as adding healthy foods rather than eliminating specific foods.

If you’re the type of person who can make drastic changes to your diet and stick with it, go for it. Otherwise, starting with small, sustainable changes can make the transition easier. 

6 Ways to Help You Make Small Diet Changes

1. Swap butter or other oils for olive oil, or add a handful of nuts or seeds to your meals for healthy fats. 
2. Incorporate more vegetables into meals you already love. Look for simple side dishes or salads that pair well with your favorite meal.
3. Include more plant-based proteins, such as lentils and chickpeas. Try adding them to a Mediterranean-style salad with cucumbers, tomatoes, and feta.
4. Gradually replace red meat with fish or poultry. If you’re used to eating red meat, start by swapping it out once or twice a week.
5. Choose whole grains like quinoa, oats, wild rice, whole wheat pasta, or farro instead of refined grains like white rice, bread, and pasta..
6. Try making fruit your go-to dessert. Drizzle it with honey or pair it with Greek yogurt for a satisfying and nutritious treat. 

You might try making one or two changes at a time, and then add more once you’re ready. The goal is to add more nutrient-dense options, while limiting (not totally eliminating) less beneficial foods.

Managing MASH through lifestyle changes is all about making sustainable changes that support your overall health. The Mediterranean diet provides a flexible, balanced approach that can help reduce inflammation, aid in weight loss, and support liver health without requiring drastic restrictions.

You can take meaningful steps toward improving your liver health by gradually including plant-based foods, healthy fats, and lean protein in your meals.