Immunonutrition is a nutritional strategy where the bioactive properties of nutrients from the diet are used to modulate metabolic pathways, inflammation signals, and oxidative stress regulators. Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic degenerative disease with increasing prevalence over the past decade. In MASLD, where inflammation and oxidative stress play key roles in the progression of liver disease, immunonutrition becomes even more important. The impact of different dietary patterns has been studied in the MASLD context; however, current guidelines emphasize the Mediterranean Diet, which, in terms of included food groups, provides a high level of immunonutrients. Nonetheless, adherence, monitoring, and implementation based on geographic areas, availability, and economic factors make this type of diet ultimately less accessible. The main benefit of the diet pattern is in maintaining the positive effects of new pharmacological treatments, alongside physical activity, which are crucial to prevent recurrence. A diet strategy designed for MASLD needs to be adapted to local food availability and should promote the inclusion of immunonutrients. In the treatment of MASLD, dietary recommendations should be individualized based on the sociodemographic, clinical, and nutritional characteristics of the patients.

Background: Metabolic dysfunction–associated steatotic liver disease currently represents the leading cause of chronic liver disease worldwide. FibroScan and iLivTouch are 2 devices that employ similar principles to estimate liver steatosis and fibrosis, although few studies have directly compared their results. Aim: To evaluate the concordance of 2 transient elastography devices for the estimation of liver steatosis and fibrosis. Methods: A prospective study was conducted. Each participant underwent liver elastography with both devices consecutively under standardized conditions. Clinical, anthropometric, and biochemical variables were collected. The diagnostic accuracy of iLivTouch was calculated using FibroScan and noninvasive scores as references. Results: A total of 1004 patients were enrolled, with a median body mass index of 25.7 kg/m ² [IQR=23.6–28.7]. Median of attenuation values was 250 dB/m [IQR=214–291] with FibroScan, 262 dB/m [IQR=239–310] with iLivTouch. Median liver stiffness measurements were 4.1 kPa [IQR=3.4–4.8] for FibroScan and 6.2 kPa [IQR=5.5–7.1] for iLivTouch. Bland–Altman analysis revealed mean differences of −19.45±49.62 dB/m for steatosis and −2.43±2.51 kPa for stiffness. Using FibroScan (>269 dB/m) as the reference, iLivTouch ≥244 dB/m demonstrated 90% sensitivity for detecting liver steatosis. The correlation between the FAST scores of the 2 devices was very strong (rho=0.90, p ≤0.0001). Conclusion: iLivTouch serves as an effective alternative to assess liver fibrosis and steatosis in the general population, including overweight and obese individuals.

Background/Objectives: In the last decade, the prevalence of metabolic-associated fatty liver disease (17–46%) and non-alcoholic fatty pancreas disease (NAFPD) (16–33%) has increased due to their association with obesity, both predictors of early atherosclerosis and metabolic risk. Computed tomography (CT) has been proposed as a diagnostic method. Currently, the factors associated with NAFPD have not been fully described. The aim of this study is to describe the prevalence and association of NAFPD and liver steatosis in patients with very high cardiovascular risk. Methods: A retrospective evaluation was conducted on the medical records of patients classified as very high cardiovascular risk who had undergone a CT scan. NAFPD was determined by the difference in pancreatic and splenic attenuation (−1.9), while liver steatosis was identified by hepatic attenuation <40. Bivariate and multivariate analyses were performed to determine the independent factors associated with NAFPD. Results: 169 medical records were collected; 68.6% (n = 116) were men, with a median age of 70 [IQR 61–78] years and 25.8 [IQR 23.7–28.7] kg/m² of body mass index. According to the CT scans, 80.5% (n = 136) presented NAFPD, 24.3% (n = 41) had liver steatosis, and 21.3% (n = 36) had both. In the multivariate analysis, liver steatosis, abnormal levels of aspartate aminotransferase, and being overweight were independent factors associated with NAFPD. Conclusions: In a very high cardiovascular-risk population, the prevalence of NAFPD is high, and it is independently associated with the presence of liver steatosis.