High-protein diets and metabolic dysfunction-associated steatotic liver disease: A double-edged sword in liver health

Metabolic dysfunction-associated steatotic liver disease (MASLD) is among the most prevalent chronic liver conditions globally and is closely linked with a range of metabolic disorders. Recently, the high-protein diet (HPD) has garnered attention for its potential benefits in weight management and metabolic health; however, its impact on MASLD remains a subject of debate. This article provided a systematic review of epidemiological studies, clinical trials, and foundational research concerning the role of HPD in MASLD. It examined the mechanisms by which HPD influences liver metabolism, inflammatory responses, and gut microbiota in patients with MASLD and assessed their clinical efficacy. The review revealed that HPD exerts dual effects on MASLD, contingent upon the protein source and consumption levels, and plant-based proteins conferred metabolic advantages. Therefore, it is advised that patients with MASLD prioritize plant-based proteins while moderating animal protein intake. Future research should aim to elucidate the mechanisms underlying HPDs and deploy personalized nutrition approaches that integrate genomic, proteomic, metabolomic, and microbiome profiles to predict individual responsiveness to specific protein sources, thereby enabling precision dietary algorithms for MASLD prevention and treatment.