Nutrients as epigenetic modulators in metabolic dysfunction-associated steatotic liver disease

To improve understanding of the multifaceted nature of metabolic dysfunction-associated steatotic liver disease (MASLD), the American Association for the Study of Liver Diseases, in collaboration with the European Association for the Study of the Liver and the Latin American Association for the Study of the Liver, proposed a broader and more flexible definition, highlighting the role of underlying metabolic dysfunction. MASLD represents the most common chronic liver disease worldwide; however, the impact of the disease goes beyond its epidemiological aspects. Currently, the impact on patients and healthcare systems, due to hepatic and extrahepatic complications, is significant. Recent evidence has demonstrated that epigenetic regulation plays a key role in the development and progression of MASLD. This highly sophisticated regulatory system includes DNA methylation, histone modification, chromatin remodeling, and modulation of non-coding RNA, without causing changes in the primary DNA sequence. Diet, particularly the Westernized diet (characterized by high levels of processed foods, fats, and sugars, but deficient in vitamins and minerals), contributes to the pathogenesis of MASLD through epigenetic modulation at multiple levels. Given the association between diet, epigenetics, and MASLD, this review aims to present some micronutrients and their importance in the prevention and/or treatment of metabolically dysfunction-associated steatotic liver disease.