{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:59:06Z","timestamp":1785560346227,"version":"3.56.0"},"reference-count":31,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disease for which lifestyle modification remains the main treatment. However, the role of specific dietary components is not fully understood. We investigated whether daily tomato consumption, a source of Mediterranean diet bioactive compounds, improves hepatic steatosis in adults with MASLD. Methods: In the randomized controlled POMOSANO trial, 79 adults with MASLD (BMI \u2264 30 kg\/m2) were assigned to a tomato intervention group (n = 42), consuming 200 g\/day of raw tomatoes and 50 g\/day of tomato sauce, or to a control group (n = 37) following a tomato-free diet. The intervention lasted 6 weeks. Hepatic steatosis was assessed by the FibroScan\u00ae controlled attenuation parameter (CAP). Secondary outcomes included anthropometric measures, body composition, liver stiffness, and metabolic and biochemical markers. Linear mixed-effects models were used to evaluate changes over time. Results: CAP decreased in both groups, with a greater reduction in the intervention group (median change: \u221235.00 vs. \u221218.00 dB\/m). The adjusted linear mixed-effects model confirmed that the change in CAP in the control group was \u03b2 = \u221212.81 (95% CI \u221225.55 to \u22120.08; p = 0.0490). Crucially, the treatment-by-time interaction was significant (\u03b2 = \u221226.63, 95% CI \u221244.00 to \u22129.25; p = 0.0030), demonstrating a significantly greater reduction in hepatic steatosis in the tomato intervention group compared to the control group. CAP values were also significantly lower in the intervention group at follow-up (p = 0.0433). The adjusted linear mixed-effects model confirmed a significant reduction in CAP over time (\u03b2 = \u221212.81, 95% CI \u221225.55 to \u22120.08; p = 0.0490) and a significant treatment-by-time interaction (\u03b2 = \u221226.63, 95% CI \u221244.00 to \u22129.25; p = 0.0030), indicating a greater reduction in hepatic steatosis in the intervention group. No significant between-group differences were observed for liver stiffness, FIB-4 index, body weight, body composition, or most metabolic and biochemical markers. Conclusions: Daily consumption of raw tomatoes and tomato sauce reduced hepatic steatosis in adults with MASLD, supporting tomato-rich dietary strategies as a potential nutritional approach for MASLD management.<\/jats:p>","DOI":"10.3390\/nu18152476","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:38:54Z","timestamp":1785411534000},"page":"2476","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Tomato Consumption on Liver Steatosis in MASLD: A Randomized Controlled Trial (POMOSANO Study)"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7891-6057","authenticated-orcid":false,"given":"Rossella","family":"Tatoli","sequence":"first","affiliation":[{"name":"Data Science Unit, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9140-673X","authenticated-orcid":false,"given":"Rossella","family":"Donghia","sequence":"additional","affiliation":[{"name":"Data Science Unit, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5634-3251","authenticated-orcid":false,"given":"Nicola","family":"Carella","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Cerabino","sequence":"additional","affiliation":[{"name":"Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2759-8347","authenticated-orcid":false,"given":"Martina","family":"Di Chito","sequence":"additional","affiliation":[{"name":"Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2995-8098","authenticated-orcid":false,"given":"Marianna","family":"Zappimbulso","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4675-2075","authenticated-orcid":false,"given":"Pasqua Letizia","family":"Pesole","sequence":"additional","affiliation":[{"name":"Core Facility Biobank, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0259-9799","authenticated-orcid":false,"given":"Dolores","family":"Stabile","sequence":"additional","affiliation":[{"name":"Core Facility Biobank, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Ferro","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Pathology, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pascale","sequence":"additional","affiliation":[{"name":"Radiology Unit, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4909-0436","authenticated-orcid":false,"given":"Endrit","family":"Shahini","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4659-4054","authenticated-orcid":false,"given":"Francesca","family":"Pavone","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8500-5537","authenticated-orcid":false,"given":"Luigi","family":"Fontana","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia"},{"name":"Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5140-8060","authenticated-orcid":false,"given":"Gianluigi","family":"Giannelli","sequence":"additional","affiliation":[{"name":"Scientific Direction, National Institute of Gastroenterology IRCCS \u201cSaverio de Bellis\u201d, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/S2468-1253(22)00062-0","article-title":"Global multi-stakeholder endorsement of the MAFLD definition","volume":"7","author":"Bugianesi","year":"2022","journal-title":"Lancet Gastroenterol. 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