Adults with metabolic dysfunction-associated steatotic liver disease who ate tomatoes every day experienced a substantially greater reduction in liver fat than participants who avoided tomatoes, according to results from the randomized POMOSANO trial.
By yourNEWS Media Newsroom.
Eating roughly two medium tomatoes and a small serving of tomato sauce each day was associated with a significantly larger reduction in liver fat among adults with metabolic dysfunction-associated steatotic liver disease, or MASLD, according to findings from a six-week randomized clinical trial.
The POMOSANO trial included 79 adults with MASLD, the condition previously known as non-alcoholic fatty liver disease, or NAFLD. Participants were randomly assigned either to incorporate tomatoes into their diets every day or to avoid tomatoes completely during the study period.
Those in the tomato group consumed 200 grams of raw tomatoes — approximately two medium tomatoes — along with 50 grams of tomato sauce each day.
After six weeks, participants consuming tomatoes recorded a median decline in liver-fat measurements of 35 units, compared with an 18-unit reduction among those in the tomato-free group.
The findings, published in the journal Nutrients, suggest that a commonly consumed food may have measurable effects on fat accumulation in the liver even over a relatively short period.
Researchers cautioned, however, that the study was small and brief and does not establish tomatoes as a treatment for MASLD.
Liver Fat Fell Without Meaningful Weight Loss
One of the more notable findings was that the difference in liver fat did not appear to result from weight loss.
Body weight, body mass index and total body fat did not change meaningfully between the two groups. Researchers also found no significant difference in abdominal fat.
That distinction matters because weight reduction is commonly recommended for people with MASLD and is known to influence liver fat.
Because participants eating tomatoes experienced a greater reduction without losing significantly more weight than those avoiding tomatoes, the researchers said the food itself may have contributed to the change.
Participants were instructed to continue their normal diets and lifestyles throughout the intervention aside from the prescribed tomato consumption or avoidance.
Researchers measured liver fat before and after the experiment using FibroScan, a noninvasive technology used to evaluate fat accumulation and stiffness in the liver.
The benefits observed in liver-fat measurements did not extend to every health marker examined.
After six weeks, investigators found no significant differences between the two groups in liver stiffness, blood glucose, cholesterol, liver enzymes or markers of inflammation.
Researchers said the limited duration of the trial may partly explain why those measures remained unchanged. They called for longer and larger studies to determine whether the reduction in liver fat persists and whether continued tomato consumption could eventually affect other metabolic markers.
MASLD Has Become Increasingly Common Worldwide
MASLD develops when excessive fat accumulates in the liver in association with metabolic dysfunction.
The condition is frequently seen alongside obesity, Type 2 diabetes and high cholesterol. It represents one of the most common forms of chronic liver disease and has increased substantially worldwide.
A global analysis cited in the report estimated that approximately 1.3 billion people were living with MASLD in 2023, representing an increase of 143% since 1990.
The number of cases is projected to reach approximately 1.8 billion by 2050.
Because MASLD is so closely associated with metabolic health, much of the conventional guidance for reducing liver fat focuses on improving overall diet, increasing physical activity and achieving weight loss when appropriate.
The POMOSANO findings raise a narrower question: whether individual whole foods containing specific plant compounds can independently influence liver-fat metabolism.
Lycopene and Other Tomato Compounds May Play a Role
Researchers chose tomatoes in part because they are a prominent component of the Mediterranean diet and contain several biologically active compounds that have been studied for possible metabolic benefits.
Among the most prominent is lycopene, the red carotenoid pigment responsible for much of a tomato’s color.
Tomatoes also contain beta-carotene, polyphenols and other antioxidant compounds that may help protect cells against oxidative stress and influence inflammatory processes.
Earlier research has examined lycopene for potential benefits related to fatty liver disease.
Researchers have proposed several possible mechanisms through which compounds in tomatoes could affect liver fat. They may reduce the formation of new fat within the liver, support the breakdown of existing fat or influence oxidative and inflammatory processes involved in liver health.
Beta-carotene belongs to the carotenoid family of pigments and can be converted by the body into vitamin A, which contributes to immune function, cellular growth and other biological processes.
Other research has found that consuming foods including tomatoes, carrots and spinach may offer protection against certain forms of oxidative DNA damage.
The POMOSANO study does not establish which individual tomato compound, if any, was responsible for the observed reduction in liver fat.
Tomatoes contain numerous nutrients and plant chemicals that may act together, making it difficult to attribute the result exclusively to lycopene or another single component.
Preparation May Affect Lycopene Absorption
How tomatoes are prepared can influence the amount of lycopene the body absorbs.
Unlike some nutrients that decline with cooking, lycopene can become more bioavailable when tomatoes are heated and processed.
That means tomato sauce may provide lycopene in a form the body can absorb more readily than from raw tomatoes alone.
Lycopene is also fat-soluble, meaning its absorption may improve when tomatoes are consumed with dietary fat.
Pairing tomatoes with olive oil or another source of fat may therefore increase lycopene availability.
The trial’s intervention included both raw tomatoes and tomato sauce, giving participants exposure to tomatoes in more than one form.
Tomatoes Can Fit Easily Into Everyday Meals
The amounts used in the trial were relatively modest and could be incorporated into a normal diet without major changes to eating habits.
Approximately 200 grams of raw tomatoes can be added to salads, sandwiches, egg dishes, pasta or roasted vegetables.
Cherry tomatoes can provide another simple option as part of a meal or snack.
Tomato sauce can be incorporated into pasta dishes, vegetables or other meals, and using an olive-oil-based preparation may also improve the absorption of fat-soluble compounds such as lycopene.
Researchers stressed that tomatoes should not be treated as a standalone therapy for MASLD.
Instead, they can be viewed as one component of a broader eating pattern emphasizing vegetables, fruits and other minimally processed foods.
Evidence from broader dietary research supports that approach. A meta-analysis cited in the report found that people with higher Healthy Eating Index scores had a 32% lower risk of chronic liver disease.
That type of dietary pattern emphasizes overall food quality rather than reliance on a single ingredient.
Larger Studies Needed to Confirm the Effect
The POMOSANO trial provides randomized evidence that regular tomato consumption may influence liver-fat accumulation, but the researchers said the findings need confirmation.
The trial involved only 79 people and lasted six weeks, limiting conclusions about long-term effects.
It remains unclear whether the liver-fat reduction would continue, plateau or disappear with longer consumption.
Researchers also do not yet know whether the observed changes would ultimately translate into meaningful improvements in liver inflammation, fibrosis, blood sugar regulation, cholesterol or other measures associated with MASLD progression.
Additional clinical trials with larger groups and longer follow-up periods will be needed to answer those questions.
The findings nevertheless stand out because the improvement occurred without a significant difference in body weight or body fat between the groups.
Rather than demonstrating that tomatoes can cure fatty liver disease, the trial suggests that incorporating a familiar whole food into the daily diet may influence liver fat independently of weight loss.
For participants in the study, a routine consisting of roughly two medium tomatoes and 50 grams of tomato sauce per day was associated with nearly twice the median reduction in liver-fat measurements seen among those who avoided tomatoes over the same six-week period.
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