Jessica Davis, MD, transplant hepatologist and director of liver transplant at the DC VA Medical Center with academic appointments at Georgetown University, shares evidence-based answers to common lifestyle and treatment questions from those newly diagnosed with MASLD.

So I think, in terms of unique questions, I have gotten asked about different diets. Like, “Is there a particular diet or supplement that’s beneficial for MASLD?” There’s no one diet that’s been research-proven to be better for MASLD than others.

In general, I recommend that people follow the Mediterranean diet. There’s a bunch of resources on it if you Google it. I like this one because it’s flexible, so it’s easier to adhere to over the long term. And then it has amazing data for heart disease, diabetes, other metabolic problems. So it’s healthy for your liver and a bunch of other things that you may be at risk for.

I also get asked, as I mentioned, “Is there some supplement I should take or something I should do?” And my answer in general to that is, “No, there’s no evidence that any supplement helps MASLD.”

And in fact, I’m wary of over-the-counter supplements because they’re not regulated by the FDA, so they don’t have as much safety in terms of knowing that what’s in the bottle is really what it says it is. And then they don’t have much safety testing in general compared to a medication.

Finally, I also get asked about certain types of exercise or exercise regimens. And again, there’s no specific one type of exercise that’s better than others. The ideal amount of exercise to get if you have MASLD is 150 minutes of moderate-intensity exercise a week. So, in other words, 30 minutes, five days a week, hard enough to get you out of breath.

And then we also recommend that you incorporate strength training at least twice a week as part of your exercise regimen.

That being said, you don’t want perfect to be the enemy of good, so just because you can’t get to that ideal goal doesn’t mean you shouldn’t do whatever you can. Even small steps of activity really add up over the long time, and this is a long game that we’re playing.

So the last thing I’ll say about sort-of unique advice I try to make sure people have is that I really want people to make changes that are sustainable over the long term, both in terms of how they’re eating and how their activity levels are changing.

I’m very wary when people come to see me and then say, “OK, I’m going to go on this drastic diet. I’m going to start working out every day.” Because it just seems unlikely to me that that will really be a habit that they sustain over time. So I encourage my patients to look at what they’re doing, where they’re starting, and kind of pick off one thing at a time to improve on.

So, for example, if you usually have two sodas a day, maybe you could start with one soda a day, and then if, once you get used to that, then go down to no soda. So any little habit that you think should get better, chipping away at it is more likely to sustain you over the long term than trying to make a 180 change overnight.