Advances in Metabolic Liver Diseases and Nutritional Management of Liver Disease

Abstract

Metabolic liver diseases (MLD) are a group of hepatic disorders directly or indirectly caused by metabolic dysregulation, with a global prevalence of 32. 6% as of 2024. The core pathophysiological features include energy imbalance, insulin resistance, and chronic inflammation, which together drive progression to fibrosis and hepatocellular carcinoma. With the rising global burden of obesity, diabetes, and metabolic syndrome, MLD have become the leading cause of chronic liver disease worldwide. Nutritional intervention, as the cornerstone of MLD management, offers unique therapeutic potential by targeting metabolic derangements. This review systematically summarizes the pathological mechanisms of MLD subtypes—including metabolic dysfunction‑associated fatty liver disease (MAFLD), alcoholic liver disease (ALD), and hereditary disorders such as Wilson’s disease—and evaluates evidence‑based nutritional strategies, including Mediterranean diet, ketogenic diet, high‑protein intake, and antioxidant supplementation, to provide a practical reference for clinical practice.