Why the pattern appears in guidelines
EASL-EASD-EASO notes added value from Mediterranean-style eating for liver lipid reduction and cardiometabolic health [1]. AASLD similarly recognises Mediterranean-style patterns while noting that different dietary compositions can improve NAFLD/MASLD [2].
That means the pattern is a well-supported example, not the only mathematically correct diet.
Sources for this section: [1] EASL–EASD–EASO Clinical Practice Guidelines on MASLD · [2] AASLD Practice Guidance on the clinical assessment and management of NAFLD/MASLD
Translate by food role
A globally useful cookbook can translate olive oil to other predominantly unsaturated oils where appropriate, chickpeas to locally familiar legumes, and named fish to locally available options with similar culinary roles. The goal is not culinary impersonation; it is keeping the evidence-relevant pattern intact.
This also prevents unnecessary brand and geography assumptions. A reader should be able to use the principles in Australia, the United States, India or elsewhere with foods they can actually buy.
Sources for this section: [1] EASL–EASD–EASO Clinical Practice Guidelines on MASLD · [2] AASLD Practice Guidance on the clinical assessment and management of NAFLD/MASLD
Avoid a rigid macronutrient ideology
AASLD notes that several dietary compositions can improve NAFLD/MASLD. The evidence does not support turning the site into a low-fat-versus-low-carbohydrate culture war.
Recipe formulation should therefore concentrate on ingredient quality, fibre, unsaturated-fat choices and reduced refined sugar rather than enforcing one extreme carbohydrate or fat percentage.
Sources for this section: [2] AASLD Practice Guidance on the clinical assessment and management of NAFLD/MASLD
Keep clinical outcomes separate
A reader may enjoy and sustain this eating pattern without knowing whether their liver disease has changed. Diagnosis and fibrosis assessment use clinical history and testing, not a food diary or visual impression of weight [3].
The Guide can describe the pattern confidently while leaving liver staging and treatment response to clinicians.
Sources for this section: [3] Diagnosis of NAFLD & NASH
Sources
- EASL–EASD–EASO Clinical Practice Guidelines on MASLD
European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity. Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease. 2024. Verified 1 Sept 2026. - AASLD Practice Guidance on the clinical assessment and management of NAFLD/MASLD
Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835. Verified 1 Sept 2026. - Diagnosis of NAFLD & NASH
National Institute of Diabetes and Digestive and Kidney Diseases. Diagnosis of NAFLD & NASH (also referred to as MASLD/MASH). Verified 1 Sept 2026.
