Time-Restricted Eating Matches Calorie Restriction in Reducing Liver Fat in MASLD, Study Finds

The study was led by Dr. Joo Hyun Oh from the Department of Internal Medicine, Eulji University College of Medicine, Seoul. They aimed to assess whether TRE could deliver similar benefits to calorie restriction (CR) in reducing liver fat and improving metabolic health.

TRE is a dietary pattern where food intake is limited to a specific time window each day, typically without calorie counting. Although it has gained popularity for its metabolic benefits, its role in managing MASLD remains unclear. This 16-week randomized controlled trial provided clinical evidence for its efficacy and safety.

The study enrolled 337 overweight or obese adults diagnosed with MASLD. Participants were randomly assigned to one of three groups: standard of care (SOC), calorie restriction (CR), or time-restricted eating (TRE), in equal proportions. Ultimately, 333 participants were included in the final analysis: 113 in the SOC group and 110 each in the CR and TRE groups.

The primary focus was to evaluate changes in liver fat using magnetic resonance imaging-proton density fat fraction (MRI-PDFF), a non-invasive and accurate imaging tool. Secondary outcomes included alterations in liver stiffness, body composition, lipid and glucose metabolism, and sleep quality.

The following were the key findings of the study:

• After 16 weeks, participants in the TRE group experienced a 25.8% reduction in liver fat.
• The reduction in liver fat in the TRE group was significantly greater than the 0.7% reduction seen in the standard care group.
• The liver fat reduction in the TRE group was nearly identical to the 24.7% reduction observed in the calorie restriction group.
• TRE also resulted in significant reductions in body weight, waist circumference, and body fat mass.
• These changes in body composition were comparable to those seen with calorie restriction.
• No serious adverse events were reported during the study.
• Liver stiffness, glucose regulation, and sleep quality showed similar outcomes in both the TRE and calorie restriction groups.

The study authors concluded that TRE can be an effective and safe strategy to manage MASLD, offering similar benefits to calorie restriction without requiring strict calorie counting. These findings suggest TRE may be a feasible long-term dietary approach for individuals with fatty liver disease, though further studies are needed to confirm its sustained benefits over time.

Reference:

Oh JH, Yoon EL, Park H, Lee S, Jo AJ, Cho S, Kwon E, Nah EH, Lee JH, Park JH, Ahn SB, Jun DW. Efficacy and safety of time-restricted eating in metabolic dysfunction-associated steatotic liver disease. J Hepatol. 2025 Jun 19:S0168-8278(25)02272-X. doi: 10.1016/j.jhep.2025.06.005. Epub ahead of print. PMID: 40543603.