Eating tomatoes every day significantly reduced liver fat in people with fatty liver disease, a six-week trial by the Italian National Institute of Gastroenterology found.
The clinical trial, published in the journal Nutrients, tracked 79 participants diagnosed with fatty liver disease and revealed a 35-point reduction in liver-fat readings among those who ate tomatoes, compared with an 18-point drop in those who avoided them.
Researchers split the 79 subjects into two distinct test groups for six weeks. One group consumed 200 grams of raw tomatoes alongside 50 grams of tomato sauce daily, while the control group eliminated tomatoes from their diet entirely.
Fatty liver disease is an increasingly common health condition closely linked to excess weight, insulin resistance and type 2 diabetes. The condition often progresses without immediate symptoms, allowing fat to accumulate inside the liver while patients feel fine. In some individuals, untreated fat buildup progresses to inflammation, tissue scarring, cirrhosis and liver cancer.
To measure liver fat, investigators used a diagnostic FibroScan device to record the Controlled Attenuation Parameter, or CAP, where higher numbers signal greater fat accumulation. While the control group recorded an 18-point drop in liver fat, potentially because taking part in a health study prompted broader dietary or lifestyle changes, the tomato-eating group achieved nearly double that reduction.
The trial showed that the reduction in liver fat occurred independently of overall weight loss. Participants in the tomato group recorded virtually no change in total body weight over the six-week period.
Measurements revealed no significant differences between the two groups in body mass index, waist circumference, total body fat or visceral fat, which is the toxic fat surrounding internal organs. Blood tests also showed no major changes in cholesterol, blood sugar or standard liver enzyme levels, pointing to a specific mechanism within the liver.
Researchers believe compounds in tomatoes, particularly lycopene and beta-carotene, alter how the liver handles fat by reducing new fat creation, limiting fat uptake and increasing fat burning.
Writing about the findings, emergency medicine consultant Professor Rob Galloway noted that while most nutritional studies rely on observational questionnaires, this trial directly tested the physical effect of eating tomatoes. Galloway acknowledged that a small six-week study of 79 people does not prove tomatoes are a treatment for fatty liver disease, but argued common sense favours acting on the evidence because tomatoes are cheap, nutritious and carry virtually no downside.
The trial adds to broader observational research linking tomato consumption to improved health outcomes. A 2021 study of more than 100,000 adults in the United States, followed for an average of 17 years, associated moderate tomato consumption with a lower risk of overall mortality and cardiovascular death. Additionally, a 2025 analysis of 119 studies linked higher tomato intake to an 11 per cent reduction in cancer mortality, with evidence suggesting specific protection against prostate cancer.
Cellular protection and optimal cooking methods
Beyond fat regulation, tomatoes contain polyphenols and vitamin C alongside lycopene and beta-carotene. These compounds help dampen inflammation and protect cells against oxidative stress, which occurs when unstable molecules called free radicals accumulate. Free radical damage is involved in conditions ranging from heart disease and cancer to skin ageing.
Although lycopene supplements are widely sold, evidence supporting health benefits comes primarily from eating whole tomatoes rather than taking pills. Researchers do not yet know whether lycopene is the main active ingredient or whether the benefits stem from multiple compounds working together.
The Italian researchers intentionally used both raw tomatoes and cooked sauce because each offers distinct advantages. Raw tomatoes preserve heat-sensitive vitamin C, whereas cooking makes lycopene easier to absorb. Because lycopene is fat-soluble, eating cooked tomatoes with olive oil can boost absorption even further.
Galloway advised eating both raw and cooked tomatoes daily, particularly for people who are overweight or have prediabetes or diabetes, who face a higher risk of developing fatty liver disease. He recommended incorporating raw tomatoes into salads or snacks and adding cooked tomatoes with olive oil to pasta sauces, soups and stews.
While clarifying that he would not prescribe tomatoes in emergency departments, Galloway called for hospital vending machines to stock tomatoes instead of crisps and chocolate. He added that he will advise his patients, family and himself to eat more tomatoes.
Muscle loss concerns and new weight loss drugs
The discussion around liver health coincides with ongoing research into metabolic treatments, including GLP-1 weight-loss medications. Although GLP-1 drugs have proven revolutionary, significant weight loss can cause muscle depletion. Preserving lean muscle is fundamental to metabolic health and physical mobility.
Researchers are monitoring a new oral drug candidate called ENV-308, developed by pharmaceutical company Enveda. The drug is based on a 2022 discovery that strenuous exercise increases levels of Lac-Phe, a substance that suppresses appetite and reduces obesity in animals.
Designed as a once-daily tablet, ENV-308 mimics this natural exercise signal. Enveda reported that animal trials showed the drug preserved lean muscle during weight loss and prevented weight regain when treatment stopped. Latest trial results indicate ENV-308 is safe in humans, though the trial was not designed to evaluate weight loss or muscle changes. Currently, weightlifting and high-intensity exercise remain the established methods for preserving muscle mass.
