Tomatoes effective against fatty liver diseases

An Italian research project has showed that eating tomatoes every day for just six weeks could help reduce the fat accumulated in the liver, opening up to the perspective of the “precision nutraceutical”

The results of the POMOSANO randomized clinical trial conducted by IRCCS  in Italy was published in August in the medical journal Nutrients. 

The study specifically addresses metabolic dysfunction-associated steatotic liver disease (MASLD), a highly prevalent chronic condition commonly known as fatty liver disease. Conducted as a rigorous, single-centre randomized controlled trial, the project investigated whether isolating and increasing a single dietary component could significantly alleviate the accumulation of fat within liver tissue. The results ultimately yielded groundbreaking evidence that simple, targeted dietary modifications can play a pivotal role in managing metabolic liver disorders.

The strict methodology of this six-week trial involved recruiting seventy-nine adult participants diagnosed with the condition who maintained a body mass index at or below thirty. Researchers split the cohort into two distinct groups using a control group to precisely track physiological changes over time. The intervention group incorporated a specific daily regimen consisting of two hundred grams of raw tomatoes alongside fifty grams of cooked tomato sauce. To ensure consistency and safety, the provided tomato sauce was prepared with extra virgin olive oil and standard seasoning, ensuring it was free from added sugars or artificial preservatives. Meanwhile, the control group strictly adhered to an entirely tomato-free diet, avoiding all fresh tomatoes, juices, pastes, and ketchup for the duration of the study.

To maximize compliance and trace dietary adherence, researchers required participants to complete rigorous daily food logs and return all unused food packaging. By utilizing specialized medical equipment to track the controlled attenuation parameter via transient elastography, scientists could accurately measure liver fat percentage before and after the experimental window. Blood samples were also collected at baseline and at week six to monitor metabolic parameters, liver enzymes, and systemic inflammatory markers.

The primary findings demonstrated an impressive, statistically significant reduction in hepatic steatosis within the intervention group compared to the control group. Remarkably, this reduction in liver fat occurred independently of any major weight loss or changes in total caloric intake, as participants were instructed to maintain their baseline physical activity and overall lifestyle habits. 

In their final published conclusions, the researchers behind the trial highlighted that “daily consumption of raw tomatoes and tomato sauce reduced hepatic steatosis in adults with MASLD, supporting tomato-rich dietary strategies as a potential nutritional approach for MASLD management.“ This specific finding offers a refreshing perspective for patients who find drastic weight loss protocols difficult to sustain over long periods.

Scientists attribute this targeted liver protection to the natural bioactives found within tomatoes, most notably the antioxidant lycopene. The inclusion of both raw and cooked tomato elements in the trial protocol was intentional, as food processing and heat break down plant cell walls to make lycopene significantly more bioavailable for human absorption. Furthermore, the healthy fats from the olive oil used in the sauce further enhanced the intestinal absorption of this fat-soluble compound. Lycopene acts directly on hepatic lipid metabolism while simultaneously shielding delicate liver tissues from cellular damage and local inflammation.

While secondary outcomes like liver stiffness, body composition, and overall blood metabolic biomarkers remained largely unchanged during the short six-week window, the drop in actual organ fat remains a substantial victory. The research team noted that these initial findings serve as an excellent hypothesis-generating foundation. Larger, long-term confirmatory studies will be necessary to determine if the recorded reduction in fat is permanently sustained. Nevertheless, the trial confirms that incorporating specific, lycopene-rich whole foods provides an accessible, science-backed tool to proactively combat chronic liver fat buildup.

Reference: Tatoli, R.; Donghia, R.; Carella, N.; Cerabino, N.; Di Chito, M.; Zappimbulso, M.; Pesole, P.L.; Stabile, D.; Ferro, A.; Pascale, G.; et al. Effect of Tomato Consumption on Liver Steatosis in MASLD: A Randomized Controlled Trial (POMOSANO Study). Nutrients 2026, 18, 2476.

Full text:  https://doi.org/10.3390/nu18152476