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To date, no published randomised controlled trials (RCTs) have provided a direct, head-to-head comparison between mobile (m)-health and structured, human-led dietitian coaching in the management of MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a single-centre, 12-month RCT, participants (\n                      <jats:italic>n<\/jats:italic>\n                      =297) were randomised into three arms: (1) minimal intervention therapy (MIT) (\n                      <jats:italic>n<\/jats:italic>\n                      =102), (2) lifestyle coaching (\n                      <jats:italic>n<\/jats:italic>\n                      =97), and 3) m-health (n=98). Steatosis was measured using the controlled-attenuation parameter (CAP\u2122), steatohepatitis by aspartate aminotransferase (AST), and fibrosis by vibration-controlled transient elastography (VCTE\u2122).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across all three study arms, an equally (\n                      <jats:italic>p<\/jats:italic>\n                      =0.998) significant reduction in CAP\u2122 was observed. The mean CAP\u2122 change was \u221223.94 dB\/m (95% CI [\u2212\u200936.70; \u221211.17],\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001) for the MIT group, \u221223.66 dB\/m (95% CI [\u2212\u200936.08;\u221211.23],\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001) for the lifestyle coaching group, and \u221221.96 dB\/m (95% CI: [\u2212\u200935.77;\u22128.15],\n                      <jats:italic>p<\/jats:italic>\n                      =0.002) for the m-health group. Over the 12-month period, guidance via m-health resulted in a significant decrease in mean serum AST levels (\u2212\u20092.81 U\/L (95% CI [\u2212\u20095.06;\u22120.57],\n                      <jats:italic>p<\/jats:italic>\n                      =0.014). None of the intervention methods had a significant effect on fibrosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study shows that all three lifestyle-guidance modalities produced comparable, significant reductions in liver steatosis over 12 months, with no significant differences between groups and no observed changes in liver stiffness. These findings support m-health as a feasible, scalable alternative in MASLD management, though multi-centre validation is warranted to confirm these outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trail registrations<\/jats:title>\n                    <jats:p>(clinicaltrials.gov NCT05792488).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12072-026-11153-w","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:25:30Z","timestamp":1791221130000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Randomised trial of lifestyle interventions for improving metabolic dysfunction-associated steatotic liver disease"],"prefix":"10.1007","author":[{"given":"Wouter","family":"Robaeys","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leen JM.","family":"Heyens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesbeth","family":"Bruckers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Penders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Struyve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ger H.","family":"Koek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven MA.","family":"Francque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-5664","authenticated-orcid":false,"given":"Geert KMM.","family":"Robaeys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"Suppl","key":"11153_CR1","doi-asserted-by":"publisher","first-page":"S32","DOI":"10.3350\/cmh.2024.0431","volume":"31","author":"ZM Younossi","year":"2025","unstructured":"Younossi ZM, Kalligeros M, Henry L. 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SF received grants from Research Foundation Flanders (FWO) (1802154N), Doctoral grant University of Antwerp, BOF, Antigoon ID: 44430, Belgian Association for the Study of the Liver, Research Foundation Flanders (FWO): 1802154N (Senior clinical investigator fellowship), Astellas, Falk Pharma, Genfit, Gilead Sciences, GlympsBio, Janssens Pharmaceutica, Inventiva, Merck Sharp & Dohme, Pfizer, Roche. Royalties or licenses: Flemish Institute for Biotechnology (VIB). Grand Challenges Program, University of Antwerp GOA 2018: ID 36572. Consulting fees: AbbVie, Actelion, Aelin Therapeutics, AgomAb, Aligos Therapeutics, Allergan, Alnylam, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, CSL Behring, Coherus, Echosens, Dr. Falk Pharma, Eisai, Enyo, Galapagos, Galmed, Gentech, Genfit, Genflow Biosciences, Gilead Sciences, Intercept, Inventiva, Janssens Pharmaceutica, Pro. Med. CS Praha, Julius Clinical, Madrigal, Medimmune, Merck Sharp & Dohme, Mursla, NGM Bio, Novartis, Novo Nordisk, Promethera, Roche, Siemens Healthineers, Weatherden. Payment or honoraria for lectures: AbbVie, Allergan, Bayer, Eisai, Genfit, Gilead, Lecturer fees, Janssen Cilag, Intercept, Inventiva, Merck Sharp & Dohme, Novo Nordisk, Promethera, Siemens. GR received research grants from AbbVie, Janssen Pharmaceuticals, MSD, consultancy agreements for AbbVie, BMS, Gilead Sciences and MSD, lecture fees from Siemens Healthineers, AbbVie and MSD. Authors WR, LH, LB, JP, and GK declare they have no financial interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}