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Intermittent fasting regimens for metabolic dysfunction-associated steatotic liver disease: a systematic review and network meta-analysis of randomized controlled trials

Network meta-analysis of eight RCTs (635 participants): 5:2 intermittent fasting improved liver stiffness (MD −0.32), time-restricted feeding improved controlled attenuation parameter (−39.83), and alternate-day fasting improved several anthropometric measures, with inconsistent signals across labs and IF templates.

Design

  • SR + network MA; databases through 10 Apr 2023
  • Included: 8 RCTs; n = 635 MASLD patients
  • PROSPERO: CRD42023418467

Standout continuous signals (abstract)

  • 5 : 2 diet → liver stiffness: MD −0.32 (95% CI −0.55 to −0.09; P < 0.01)
  • Time-restricted feeding → CAP steatosis score: MD −39.83 (95% CI −64.78 to −14.87; P < 0.01)
  • Alternate-day fasting: significant anthropometric shifts (lean mass, waist, fat mass, weight; P < 0.05) in abstract summary

Null / inconsistent domains

Authors report no significant pooled shifts for several liver enzymes, LDL-C, TG, HOMA-IR, FBG, BP, etc., across all IF templates—treat as regimen-specific evidence.

Publication

Abuelazm MT, Mohamed I, Naeem A, et al. Eur J Gastroenterol Hepatol. 2024 Apr 1;36(4):371–381. Epub 2024 Feb 23. PMID 38407890.

Outcomes

  • Liver Fat Content
    5:2 intermittent fasting improved liver stiffness (MD −0.32; 95% CI −0.55 to −0.09; P<0.01) vs other IF templates in network meta-analysis of 8 MASLD RCTs.
  • Liver Fat Content
    -39.83
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