Personalized Dietary Feedback to Reduce Hepatic Steatosis in Patients With MASLD (PERSOMA)

Effect of Personalized Dietary and Lifestyle Feedback on Hepatic Steatosis in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Prospective, Randomized Controlled Trial

Metabolic dysfunction-associated steatotic liver disease (MASLD) and combined metabolic dysfunction and alcohol-associated liver disease (MetALD) are common chronic liver diseases associated with metabolic dysfunction and an increased risk of liver-related and cardiovascular complications. Lifestyle modification, particularly dietary changes and increased physical activity, represents a cornerstone of treatment. However, general lifestyle recommendations are often insufficient to achieve sustained improvements.

This prospective, randomized controlled trial aims to investigate whether personalized dietary and lifestyle feedback based on a structured questionnaire is more effective in reducing hepatic steatosis than generic lifestyle recommendations.

A total of 174 patients with MASLD or MetALD will be randomized 1:1 to receive either personalized or generic written feedback at baseline and after 2, 4, and 6 months. Changes in hepatic steatosis, assessed by the controlled attenuation parameter (CAP), will be evaluated over a six-month period.

Study Overview

• Status: Not yet recruiting
• Conditions: Steatotic Liver Disease; MetALD; MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease)
• Intervention / Treatment: Behavioral: Personalized Dietary Feedback; Behavioral: Generic Dietary Feedback

Detailed Description

This is a prospective, single-center, randomized controlled trial designed to evaluate the effectiveness of personalized dietary and lifestyle feedback compared with generic recommendations in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction and alcohol-associated liver disease (MetALD).

A total of 174 adult patients with MASLD or MetALD will be randomized in a 1:1 ratio to an intervention group receiving individualized feedback based on a structured dietary and lifestyle questionnaire or a control group receiving standardized written recommendations.

Participants will complete the questionnaire at baseline and after 2, 4, and 6 months, followed by the corresponding written feedback. Clinical, anthropometric, laboratory, and non-invasive liver assessments, including vibration-controlled transient elastography (VCTE) and controlled attenuation parameter (CAP), will be performed at baseline and after six months.

The primary objective is to compare hepatic steatosis between the two groups after six months, adjusting for baseline CAP values. Secondary objectives include assessing changes in body weight, metabolic parameters, liver stiffness, dietary habits, physical activity, and health-related quality of life.

The study aims to determine whether a simple, scalable, personalized feedback approach can improve lifestyle management in patients with MASLD or MetALD.

• Study Type: Interventional
• Enrollment (Estimated): 174
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Georg Semmler, MD PhD; Phone Number: +4314040047410; Email: georg.semmler@meduniwien.ac.at

Study Locations

• Austria
  • State of Vienna
    • Vienna, State of Vienna, Austria, 1090
      • Medical University of Vienna
      • Contact: Georg Semmler, MD PhD; Phone Number: +4314040047410; Email: sld@meduniwien.ac.at

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Age 18-80 years.
• Controlled attenuation parameter (CAP) >248 dB/m.
• Sufficient German language proficiency to independently complete the questionnaires.
• Written informed consent to participate in the study.

Exclusion Criteria:

• Other active chronic liver disease.
• Significant alcohol consumption, defined as ≥50 g/day in women or ≥60 g/day in men.
• Pregnancy or breastfeeding.
• Type 1 diabetes mellitus.
• Initiation or dose modification of GLP-1 receptor agonists or other weight-modifying pharmacological therapies within the previous three months.
• Planned bariatric surgery during study participation.
• Severe or unstable medical condition that, in the investigator's judgment, may interfere with study participation or interpretation of study results.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Personalized Dietary Feedback; Participants will receive personalized written dietary feedback based on their individual responses to a structured questionnaire. The feedback will include tailored recommendations regarding dietary habits. Updated personalized feedback will be provided at baseline and after 2, 4, and 6 months.	Behavioral: Personalized Dietary Feedback; Participants receive individualized written dietary feedback based on their responses to a structured dietary questionnaire. The feedback includes an assessment of individual dietary habits, a visual representation of dietary patterns, and personalized recommendations to improve food choices and dietary quality. Updated feedback is provided at baseline and after 2, 4, and 6 months based on repeated questionnaire assessments.
Active Comparator: Generic Dietary Feedback; Participants will receive standardized written dietary recommendations independent of their individual questionnaire responses. Generic feedback will be provided at baseline and after 2, 4, and 6 months.	Behavioral: Generic Dietary Feedback; Participants receive standardized written dietary recommendations based on general nutritional guidelines. The information is identical for all participants in the control group and is not tailored to individual dietary habits or questionnaire responses. The same generic dietary information is provided at baseline and after 2, 4, and 6 months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hepatic Steatosis at 6 Months, Assessed by Controlled Attenuation Parameter (CAP) Using Vibration-Controlled Transient Elastography (VCTE)	Hepatic steatosis will be quantified using the controlled attenuation parameter (CAP), measured in decibels per meter (dB/m) by vibration-controlled transient elastography (VCTE). The outcome measure is the CAP value at 6 months. The between-group difference at 6 months will be evaluated using analysis of covariance (ANCOVA), with baseline CAP included as a covariate. CAP is the only measurement reported for this outcome.	6 months (baseline CAP used for adjustment).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Body Weight from Baseline to 6 Months	Body weight will be measured in kilograms (kg). Change will be calculated as body weight at 6 months minus baseline body weight.	Baseline and 6 months
Percentage Change in Body Weight from Baseline to 6 Months	Percentage change in body weight will be calculated as [(body weight at 6 months - baseline body weight) / baseline body weight] × 100.	Baseline and 6 months
Change in Waist Circumference from Baseline to 6 Months	Waist circumference will be measured in centimeters (cm). Absolute change from baseline to 6 months will be reported.	Baseline and 6 months
Change in Hip Circumference from Baseline to 6 Months	Hip circumference will be measured in centimeters (cm). Absolute change from baseline to 6 months will be reported.	Baseline and 6 months
Change in Alanine Aminotransferase (ALT) from Baseline to 6 Months	Serum ALT will be measured in units per liter (U/L). Absolute change from baseline to 6 months will be reported.	Baseline and 6 months
Change in Aspartate Aminotransferase (AST) from Baseline to 6 Months	Serum AST will be measured in units per liter (U/L). Absolute change from baseline to 6 months will be reported.	Baseline and 6 months
Change in Gamma-Glutamyl Transferase (GGT) from Baseline to 6 Months	Serum GGT will be measured in units per liter (U/L). Absolute change from baseline to 6 months will be reported.	Baseline and 6 months

Collaborators and Investigators

• Sponsor: Medical University of Vienna
• Collaborators: University of Vienna

Study record dates

Study Major Dates

• Study Start (Estimated): November 1, 2026
• Primary Completion (Estimated): December 31, 2028
• Study Completion (Estimated): December 31, 2028

Study Registration Dates

• First Submitted: October 20, 2026
• First Submitted That Met QC Criteria: October 27, 2026
• First Posted (Actual): November 4, 2026

Study Record Updates

• Last Update Posted (Actual): November 4, 2026
• Last Update Submitted That Met QC Criteria: October 27, 2026
• Last Verified: October 1, 2026

More Information

Terms related to this study

• Keywords: SLD; MASLD; MetALD
• Other Study ID Numbers: 1770/2026

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

IPD Plan Description

Patient data can be shared upon reasonable request and after fulfilling all legal and data protection requirements from the EU.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No