{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:36:25Z","timestamp":1766050585287,"version":"3.48.0"},"reference-count":37,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,3,14]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Metabolic dysfunction-associated fatty liver disease (MASLD) is the hepatic manifestation of metabolic syndrome and the leading cause of chronic liver disease worldwide. Given that there is no pharmacological treatment for MASLD, it is imperative to understand whether lifestyle modifications may improve biochemical and pathological outcomes. One commonly proposed dietary modification is the Mediterranean diet; however, vegetarianism may also be a promising intervention. Vegetarianism has been shown to be associated with reduced morbidity and mortality in metabolic syndrome outcomes in coronary artery disease and diabetes; however, the relationship between vegetarian diet and MASLD is less clear. In this scoping review, we will provide a comprehensive overview of the current body of evidence related to a vegetarian diet and MASLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The aim of this scoping review is to describe and summarise the current body of evidence related to MASLD and a vegetarian diet. This review will be conducted using Arksey and O\u2019Malley\u2019s framework. The literature review will be conducted using the following databases: SCOPUS, Web of Science, CINAHL-Plus, Cochrane Library and Medline. No restriction will be made on publication date. Included studies will encompass clinical trials and observational designs that examine effects or association of vegetarian diet in adults (\u226516 years) and report on the incidence, prevalence or progression of MASLD. Grey literature, non-human studies and articles focusing on changes in a specific food or nutraceutical will be excluded. Articles must have an English-language abstract available to be considered for inclusion. Screening and data extraction will be conducted by two independent reviewers. The findings will be summarised with descriptive statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Approval from a medical ethics committee is not required for this review. Once the review is complete, the findings will be submitted to a peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-079750","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:10:14Z","timestamp":1712794214000},"page":"e079750","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Evidence related to a vegetarian diet and metabolic dysfunction-associated steatotic liver disease: protocol for a scoping review"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-1476","authenticated-orcid":false,"given":"Kasey","family":"Moss","sequence":"first","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Gitman","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M Ines","family":"Pinto Sanchez","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada"},{"name":"Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2874-8948","authenticated-orcid":false,"given":"Simon","family":"Oczkowski","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada"},{"name":"Division of Gastroenterology, McMaster University Department of Medicine, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saumya","family":"Jayakumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, UBC, Vancouver, British Columbia, Canada"},{"name":"Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantine Jason","family":"Karvellas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazia","family":"Selzner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9401-6868","authenticated-orcid":false,"given":"Joanna","family":"Dionne","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact, McMaster University Department of Medicine, Hamilton, Ontario, Canada"},{"name":"Farncombe Family Digestive Health Research Institute, McMaster University Department of Medicine, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"2025121300224944000_14.4.e079750.1","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.3350\/cmh.2022.0367","article-title":"MAFLD: how is it different from NAFLD","volume":"29","author":"Gofton","year":"2023","journal-title":"Clin Mol 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Available: https:\/\/www.todaysdietitian.com\/newarchives\/020314p26.shtml [Accessed 31 Mar 2023]."},{"key":"2025121300224944000_14.4.e079750.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.08.018"},{"key":"2025121300224944000_14.4.e079750.18","doi-asserted-by":"crossref","first-page":"100256","DOI":"10.1016\/j.jhepr.2021.100256","article-title":"Treatment of NAFLD with intermittent calorie restriction or low-Carb high-fat diet - a randomised controlled trial","volume":"3","author":"Holmer","year":"2021","journal-title":"JHEP Reports"},{"key":"2025121300224944000_14.4.e079750.19","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1097\/HEP.0000000000000323","article-title":"AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease","volume":"77","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"2025121300224944000_14.4.e079750.20","doi-asserted-by":"crossref","unstructured":"Dedehayir O , Riverola C , Velasquez S , et al . Diffusion of Vegan food innovations: a dual-market perspective.2019:1\u20139.","DOI":"10.1007\/978-3-319-71062-4_16-1"},{"key":"2025121300224944000_14.4.e079750.21","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2016.1138447"},{"key":"2025121300224944000_14.4.e079750.22","doi-asserted-by":"publisher","DOI":"10.3390\/nu13124408"},{"key":"2025121300224944000_14.4.e079750.23","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-0606"},{"key":"2025121300224944000_14.4.e079750.24","doi-asserted-by":"crossref","DOI":"10.1007\/s11892-018-1070-9","article-title":"Vegetarian diets and the risk of diabetes","volume":"18","author":"Olfert","year":"2018","journal-title":"Curr Diab Rep"},{"key":"2025121300224944000_14.4.e079750.25","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1886"},{"key":"2025121300224944000_14.4.e079750.26","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.112.044073"},{"key":"2025121300224944000_14.4.e079750.27","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"International Journal of Social Research Methodology"},{"key":"2025121300224944000_14.4.e079750.28","unstructured":"JBI . Scoping reviews - resources. Available: https:\/\/jbi.global\/scoping-review-network\/resources [Accessed 20 May 2023]."},{"key":"2025121300224944000_14.4.e079750.29","doi-asserted-by":"crossref","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-a web and mobile App for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst Rev"},{"key":"2025121300224944000_14.4.e079750.30","unstructured":"What percentage of Americans are vegetarian? Available: https:\/\/news.gallup.com\/poll\/267074\/percentage-americans-vegetarian.aspx [Accessed 20 May 2023]."},{"key":"2025121300224944000_14.4.e079750.31","unstructured":"Vegetarianism is on the rise \u2014 especially the part-time kind \u2013 the hill. Available: https:\/\/thehill.com\/changing-america\/sustainability\/3747206-vegetarianism-is-on-the-rise-especially-the-part-time-kind\/ [Accessed 20 May 2023]."},{"key":"2025121300224944000_14.4.e079750.32","unstructured":"1 in 10 Americans say they don\u2019t eat meat \u2013 a growing share of the population. 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