Did you know that a whopping 30 percent of the world’s population suffers from metabolic dysfunction-associated steatotic liver disease (MASLD)? As functional medicine practitioners, that should make us sit up and take notice! With such a large proportion of the world dealing with this issue, a significant portion of your patients are likely battling this condition, and we need to have answers for them.
Once named nonalcoholic fatty liver disease (NAFLD), MASLD occurs when fat builds up in the liver, leading to inflammation (hepatitis) and, if not treated, more serious liver diseases such as cirrhosis and hepatocellular carcinoma.
The Numbers on MASLD
With so many people worldwide suffering from MASLD, the statistics are grim. In the US alone, between 80 and 90 million people have the condition. And around 11 percent of these cases will progress to full-blown liver failure within 15 years of diagnosis.
Even more troublesome, within 10–20 years, fatty liver disease is predicted to surpass hepatitis C and alcoholic liver disease as the leading cause of liver transplantation.
The shocking reality that just over one in four people has MASLD spurred Dr. Yousef Elyaman to action. For the past three years, Dr. Elyaman has been obsessed with getting to the root cause of MASLD. Through his high-volume functional medicine practice, he has developed a systematic, evidence-based approach to identifying and treating fatty liver disease.
Dr. Elyaman is now bringing what he and his team have learned to the Kharrazian Institute in our latest Fatty Liver Disease Master Class. When you attend this master class, you will learn:
- How to assess fibrosis progression noninvasively.
- How SIBO, uric acid, and dysbiosis drive fatty liver and fibrosis.
- How to identify and assess the driving pathophysiologies of MASLD.
- Which supplements reverse steatosis, which ones worsen outcomes, and how to know which to use.
- How to reverse the disease rather than just manage decline.
Although the numbers are grim, the situation is far from hopeless. You can do a lot to diagnose and treat liver disease. In this post, we will highlight an effective, easy-to-implement treatment protocol you can use to help your patients dealing with fatty liver: the modified Mediterranean food plan. Dr. Elyaman has found this to be one of the most effective clinical management strategies for MASLD patients.
The Modified Mediterranean Food Plan
First described in 1975, the Mediterranean diet is inspired by the traditional eating habits of countries including Greece, Italy, and coastal France and Spain. Since then, it’s been widely recognized as one of the healthiest diet regimens, in no small part because of its anti-inflammatory properties.
Because the diet has been around for a long time, you likely have a good idea of what it entails:
- A plant-based foundation, with a focus on fruits, vegetables, legumes, nuts, and seeds.
- A high intake of healthy fats, such as olive oil and fatty fish.
- Whole grains like oatmeal, barley, quinoa, and brown rice.
- Minimal consumption of red meat, sugar, and other highly processed or refined foods.
But here’s where it gets interesting: Dr. Elyaman found that prescribing the Mediterranean diet—while making a few tweaks specifically designed for liver health—led to much better health outcomes for his MASLD patients.
For one, while the traditional Mediterranean diet often includes moderate consumption of wine, he advises MASLD patients to completely avoid alcohol due to the risk of liver poisoning.
Also, he advocates for consuming more protein than carbohydrates. Higher protein intake has a “thermic effect” that boosts metabolism and primes the body to gain muscle and lose fat, including liver fat.
Moreover, he aggressively focuses on eliminating refined sugar and processed fructose, such as fruit juices, from his patients’ diets. When fructose is consumed in high amounts outside of its natural form, it can lead to increased uric acid levels, which directly triggers fat storage in the liver.
This post just scratches the surface of how to treat MASLD. Dr. Yousef Elyaman’s full five-hour master class covers the complete functional medicine approach to reverse fatty liver disease.
Key Clinical Benefits of the Mediterranean Diet
Dr. Elyaman regards the modified Mediterranean diet as the gold standard when it comes to managing fatty liver disease. While other food protocols can positively impact liver health, the modified Mediterranean diet comes with a number of benefits for MASLD patients:
- While many diets can reduce liver fat, the modified Mediterranean plan has been shown in studies to significantly improve liver fibrosis.
- This diet can reduce liver fat and improve liver insulin sensitivity even if the patient does not lose any weight.
- This food plan has a measurable positive impact on mental health, especially for patients who also suffer from depression.
- The diet has been associated with significant reductions in overall mortality, cardiovascular risk, and cancerous diseases.
Implementing the Mediterranean Diet with Your MASLD Patients
It’s important to note that not every MASLD patient should jump straight into the modified Mediterranean diet. Depending on the results of testing, you may need to have patients perform a supervised cleanse first.
Dr. Elyaman often recommends a 28-day cleanse to prepare for the Mediterranean diet. This cleanse is designed to remove the most common toxic foods and allergens. He also includes a series of shakes to improve phase two metabolism of the liver. Once this cleanse is done, the patient has a solid foundation for the Mediterranean diet to work upon.
He also strongly recommends combining this food plan with both cardiovascular and resistance training. This, of course, aligns with the traditional Mediterranean diet, which also treats daily movement as a nonnegotiable.
Dr. Elyaman offers one more caveat that may impact your patients with eating disorders: Be aware of your words. He prefers using the term “food plan” over “diet” to avoid triggering patients who may have a history of anorexia, bulemia, or other food-related disorders.
Fatty Liver Disease: Mechanisms, Metabolic Triggers, and Functional Strategies – Presented by Yousef Elyaman, MD, IFMCP
The modified Mediterranean diet is an incredibly powerful tool you can use to help your patients with MASLD. But it’s far from the only strategy Dr. Elyaman can teach you.
Dr. Yousef Elyaman’s Fatty Liver Disease Master Class distills three years of obsessive research into a systematic approach that identifies root causes and reverses fatty liver disease. Dr. Elyaman draws from his high-volume practice, complete with eight providers and an integrated lab, to provide you with the most accurate, up-to-date information about diagnosing and treating liver disease. He and his team have treated thousands of patients and know what actually works.
When you take this course, you’ll learn the seven unified driving pathophysiologies most doctors miss, master noninvasive fibrosis assessment, and implement evidence-based protocols for disease reversal. This isn’t theory. It’s what transforms patients in real practice.
Fatty liver disease is preventable and reversible, but only if you know the underlying mechanisms and address them systematically. Dr. Elyaman can show you how.
You can learn more about the master class and register here.
Frequently Asked Questions
Is the Mediterranean diet enough on its own to treat MASLD?
Usually, it’s not. While the Mediterranean diet improves inflammation and metabolic health, some modifications are required when treating liver patients. Key changes include removing alcohol, reducing fructose, and increasing protein.
Why does Dr. Elyaman’s modified Mediterranean diet emphasize higher protein intake?
Higher protein intake supports muscle mass, improves insulin sensitivity, and helps reduce fat storage in the liver. It also increases metabolic rate, which can improve liver markers even without weight loss.
Should all MASLD patients start this food plan right away?
Not always. Patients with toxin overload, gut dysbiosis, or impaired liver detoxification may need a structured, supervised cleanse first.
Where can I learn more about the modified Mediterranean diet and treating liver patients in general?
Dr. Elyaman covers how to identify these patients and implement a step-by-step clinical diagnosis and treatment approach in his Fatty Liver Disease Master Class, where he teaches the full system behind this protocol.
