What the study actually found

A small randomized controlled trial published in the journal Nutrients investigated whether eating tomatoes could reduce fat accumulation in the liver of people with metabolic dysfunction-associated liver disease (MASLD). The study enrolled 79 adult participants who had MASLD and at least one cardiometabolic risk factor, such as high blood pressure or obesity. Those assigned to the tomato group consumed 200 grams of raw tomatoes and 50 grams of tomato sauce every day for six weeks, while the control group followed a tomato-free diet.

Both groups saw a decline in hepatic steatosis (liver fat) over the study period, but the reduction was statistically greater in the tomato-consuming group. Crucially, there were no significant differences between the groups in liver stiffness, liver enzymes, lipid profiles, body mass index, or other metabolic markers. The researchers concluded that tomato intake may reduce hepatic fat accumulation independently of major changes in body weight or overall adiposity.

However, the authors stress that this was an exploratory study, meant to generate hypotheses for future research rather than change clinical practice. The findings have not yet been replicated in larger, longer-term trials, and the study’s design had several important constraints that limit its immediate relevance to most patients.

What to make of the tomato study

Key limitations that temper enthusiasm

The study excluded participants with a body mass index over 30, meaning many typical MASLD patients—those with obesity—were not included. Most participants were men, and the age cap was 65, so results may not apply to women or older adults. The six-week intervention period was too short to assess whether the fat reduction is sustained or translates into improved liver function.

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Additionally, because the tomato group ate both raw tomatoes and tomato sauce, it is impossible to know which component—or what specific micronutrient like lycopene—might be responsible. The authors note they did not measure circulating levels of lycopene or carotenoids, so the biological mechanism remains speculative. The reliance on self-reported dietary adherence also introduces potential bias.

Expert reactions: ‘Cannot conclude meaningful disease improvement’

Dr. Randa Abdelmasih, an endocrinologist and obesity specialist at UTMB not involved in the study, told Medical News Today that while the imaging changes were interesting, “the study showed improvement in liver fat but no significant improvements in liver stiffness, fibrosis scores, liver enzymes, insulin resistance, inflammatory markers, lipid profile, or body composition. Therefore, we cannot conclude that tomato consumption meaningfully alters disease progression or improves clinically relevant outcomes.” She also emphasized that the highly selected population limits generalizability, as most clinical MASLD patients have obesity, type 2 diabetes, or more advanced disease.

Dr. Jonathan Jennings, a board-certified internist, pointed out that the inclusion criteria required only one cardiometabolic risk factor, treating hypertension and diabetes as equally weighted, even though type 2 diabetes is a stronger driver of MASLD. Both experts stressed that sustained weight loss of about 10% remains the intervention with the strongest evidence for improving steatohepatitis and fibrosis.

What this means for patients with fatty liver

  • The study was exploratory and does not prove that tomatoes treat or reverse MASLD. The improvement was seen only in imaging—liver stiffness, enzymes, and metabolic markers did not budge. This means tomato consumption alone is unlikely to replace established therapies.
  • Sustained weight loss remains the most evidence-backed intervention. According to Dr. Abdelmasih, a loss of roughly 10% of body weight has been shown to improve liver inflammation and scarring. Any dietary change should support that goal.
  • Tomatoes can be part of a healthy diet, but they are not a magic bullet. They fit well within a Mediterranean-style eating pattern, but patients should be mindful of calories in tomato-based sauces and potential reflux issues for those with GERD.
  • Talk to your doctor. If you have MASLD, discuss dietary strategies in the context of your overall risk factors rather than focusing on a single food. The researchers themselves call this “hypothesis-generating” work that needs much more evidence before it can guide advice.