Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide. It is characterized by excessive fat accumulation in the liver and is closely linked to obesity, insulin resistance, and an increased risk of cardiovascular and metabolic disorders.
If left unmanaged, MASLD can progress to more serious conditions, including cirrhosis and liver cancer.
A healthy diet is considered one of the key ways to maintain liver health. In particular, studies have linked the Mediterranean diet to reduced liver fat and improved metabolism.
Scientists recently set out to investigate the effects of one of the diet’s staples: tomatoes. A new randomized study found that daily consumption of fresh tomatoes and tomato sauce can significantly reduce liver fat in people with MASLD—even without noticeable weight loss.
How was the study conducted?
The POMOSANO study, conducted in Italy, involved 79 participants aged 18 to 65 with diagnosed MASLD. Their body mass index (BMI) did not exceed 30, meaning they were either of normal weight or overweight.
At the start of the study, all participants were confirmed to have elevated liver fat levels. To measure this, scientists used the CAP score, which is calculated via ultrasound.
Participants were randomly assigned to one of two groups.
For six weeks, the first group consumed the following daily:
200 g of fresh tomatoes (approximately one large or two medium-sized tomatoes);
50 g of tomato sauce (about 3–4 tablespoons).
The second group completely eliminated tomatoes from their diet for the same period.
All participants received the same dietary guidelines and were instructed to maintain their usual lifestyle and physical activity levels.
Before and after the experiment, researchers assessed liver fat content and body composition. Researchers also assessed liver stiffness, liver function, blood sugar and lipid levels, and markers of inflammation.
What did the results show?
Liver fat content decreased in both groups. However, the improvement was significantly more pronounced in participants who ate tomatoes daily.
The average reduction in the CAP score was:
35 dB/m in the tomato-consuming group;
18 dB/m in the group that excluded them.
Statistical analysis confirmed that the difference between the groups was significant. Notably, the reduction in liver fat occurred without significant weight loss; participants showed no significant changes in body weight, BMI, waist circumference, or body fat percentage.
There were also no notable differences between the groups regarding liver enzyme levels, blood sugar and fat levels, or markers of inflammation.
This suggests that the observed effect was specifically linked to tomato consumption rather than weight loss or a general improvement in metabolism.
However, the authors emphasize that these results should be considered preliminary. Larger, longer-term studies are needed to confirm the effect and understand its long-term significance for liver health.
Why might tomatoes be beneficial for the liver?
Tomatoes are rich in lycopene, an antioxidant that can help the body combat oxidative stress and potentially reduce fat accumulation in the liver.
The amount of tomatoes used in the study—approximately one large tomato and 3–4 tablespoons of tomato sauce per day—is easily incorporated into a standard diet.
This does not necessarily mean that tomatoes alone can cure the condition; rather, they can be part of a diet that supports liver health.
What does this mean for everyday life?
For individuals diagnosed with MASLD, reducing liver fat is indeed important. It is precisely its accumulation that can trigger inflammation, which over time may lead to liver damage and scarring.
Since the treatment of MASLD relies heavily on lifestyle changes, diet plays a crucial role. The Mediterranean diet has already been linked to improved liver health in people with this condition.
A new study adds another interesting finding to this body of evidence: ordinary tomatoes can be a beneficial part of such a diet. However, it is too early to conclude that tomatoes alone can cure fatty liver disease; larger, long-term studies are needed to confirm this effect.
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