The Gut-Liver-Heart Axis: Nutritional Interventions for MASLD and Cardiometabolic Risk

The recent nomenclature shift from Non-Alcoholic Fatty Liver Disease (NAFLD) to Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) appropriately centers systemic metabolic dysfunction as the primary driver of hepatic steatosis. Because of this shared metabolic pathophysiology, the liver does not exist in isolation; it is deeply interconnected with both the gastrointestinal tract and the cardiovascular system. In fact, the leading cause of morbidity and mortality in patients with MASLD is not end-stage liver disease, but cardiovascular events. The "Gut-Liver-Heart Axis" has therefore emerged as a critical framework for understanding the progression from simple steatosis to systemic meta-inflammation, lipotoxicity, and atherogenesis.The goal of this Research Topic is to compile cutting-edge clinical, translational, and foundational research exploring how dietary interventions, specific nutrients, and dietary patterns impact MASLD. While a major focus of this collection is the synergistic mitigation of both hepatic steatosis and cardiometabolic risk across the gut-liver-heart axis, we broadly welcome research focusing purely on nutritional interventions in MASLD, as well as secondary cardiovascular outcomes. By bridging hepatology, cardiology, and nutritional science, we aim to provide a comprehensive resource that translates dietary research into clinical practice.We welcome submissions of Original Research, Clinical Trials, Systematic Reviews, Mini-Reviews, and Meta-Analyses. To encompass a broad and impactful range of research, we invite manuscripts covering, but not limited to, the following themes:• Dietary Patterns and Disease Progression: The impact of whole-diet approaches (e.g., Mediterranean diet, ketogenic diets, intermittent fasting, plant-based diets) on hepatic steatosis and MASH resolution, alongside cardiometabolic objectives such as improving insulin sensitivity, managing hypertension, and correcting dyslipidemia.• Targeting the Microbiome: Nutritional modulation of the gut microbiome (via prebiotics, probiotics, synbiotics, or fiber) and its subsequent impact on liver histology, as well as cardiovascular risk markers like endothelial dysfunction and arterial stiffness.• Precision Nutrition and Nutrigenomics: Personalized dietary strategies for MASLD patients based on genetic predispositions, metabolic phenotyping, or distinct clinical profiles (e.g., lean MASLD vs. MASLD with concurrent type 2 diabetes or metabolic syndrome).• Macronutrient Quality: Mechanistic or clinical insights into how specific dietary components (e.g., ultra-processed foods, fructose, specific fatty acid profiles) drive or mitigate liver-specific inflammation and systemic cardiometabolic drivers like visceral adiposity and atherogenesis.• Nutraceuticals and Bioactive Compounds: The therapeutic potential of polyphenols, antioxidants, omega-3 fatty acids, and other functional foods in modulating fibrotic pathways in the liver, as well as their effects on broader cardiovascular and metabolic endpoints.• Epidemiological Insights: Large-scale population studies evaluating the association between dietary habits, the prevalence of MASLD, and long-term cardiometabolic outcomes, including major adverse cardiovascular events (MACE).By integrating clinical nutrition, hepatology, and cardiometabolic science, this Research Topic will provide a comprehensive evidence base to advance targeted dietary therapies, optimize systemic risk management, and halt disease progression for the growing global population affected by MASLD and concurrent cardiovascular disease. Topic editors: Abdulrahman Ismaiel, Giuseppe Guido Maria Scarlata, Simona Grad Source: https://www.frontiersin.org/research-topics/81306/the-gut-liver-heart-axis-nutritional-interventions-for-masld-and-cardiometabolic-risk