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    Artificial Intelligence-Based Diets: A Role in the Nutritional Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease?
    (Wiley, 2025) Karahan, Tugce Ozlu; Kenger, Emre Batuhan; Yilmaz, Yusuf
    Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern. Effective management of this condition relies heavily on lifestyle modifications and dietary interventions. In this study, we sought to evaluate the dietary plans for MASLD generated by ChatGPT (GPT-4o) according to current guideline recommendations. Methods: ChatGPT was used to create single-day meal plans for 48 simulated patients with MASLD, tailored to individual characteristics such as age, gender, height, weight and transient elastography parameters. The plans were assessed for appropriateness according to disease-specific guidelines. Results: The mean energy content of the menus planned by ChatGPT was 1596.9 +/- 141.5 kcal with a mean accuracy of 91.3 +/- 11.0%, and fibre content was 22.0 +/- 0.6 g with a mean accuracy of 88.1 +/- 2.5%. However, they exhibited elevated levels of protein, fat and saturated fat acids. Conversely, the carbohydrate content was lower. ChatGPT recommended weight loss for obese patients but did not extend this advice to normal-weight and overweight individuals. Notably, recommendations for a Mediterranean diet and physical activity were absent. Conclusions: ChatGPT shows potential in developing dietary plans for MASLD management. However, discrepancies in macronutrient distributions and the omission of key evidence-based recommendations highlight the need for further refinement. To enhance the effectiveness of AI tools in dietary recommendations, alignment with established guidelines must be improved.
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    Effects of Intermittent Fasting on Liver Steatosis and Fibrosis, Serum FGF-21 and Autophagy Markers in Metabolic Dysfunction-Associated Fatty Liver Disease: A Randomized Controlled Trial
    (Mdpi, 2025) Karahan, Tugce Ozlu; Akyuz, Elvan Yilmaz; Karadag, Demet Yilmaz; Yilmaz, Yusuf; Eren, Fatih
    Background: This randomized controlled study sought to determine the effect of intermittent fasting on anthropometric measurements, fibroblast growth factor (FGF)-21, and autophagy markers, as well as on hepatic steatosis and fibrosis levels in overweight or obese patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Methods: Patients were randomly assigned into two groups: received a dietary treatment involving 22-25 kcal/kg/day of energy for 8 weeks and followed the same dietary intervention and a 16:8 pattern. The extent of hepatic steatosis and fibrosis was determined using transient elastography on a FibroScan (R) device. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), determined by transient elastography, reflect hepatic steatosis and fibrosis, respectively. In duplicate, serum levels of FGF-21, Beclin-1, and ATG-5 were determined using enzyme-linked immunosorbent assay. Results: The study included 48 patients with a mean age of 48.2 +/- 1.4 years (27 female and 21 male). Improvements in anthropometric measurement and CAP and LSM levels and a decrease in serum FGF-21 levels were found in both groups (p < 0.05). Changes in the CAP and FGF-21 levels were higher in the energy + time-restricted diet group (p < 0.05). Autophagy-related protein (ATG)-5 levels increased only in the energy + time-restricted diet group [(0.74 (0.46-1.29) ng/mL vs. 0.95 (0.73-1.32) ng/mL, p = 0.03]. Conclusions: Intermittent fasting was potentially practical in the management of MAFLD. In particular, changes in FGF-21 and ATG-5 levels indicate the potential of intermittent fasting to regulate metabolic processes and autophagy. However, methodological limitations should be taken into consideration when interpreting the study results.