Gdue Plus a Hypocaloric Mediterranean Diet in Adults With MASLD

Metabolic Dysfunction-Associated Steatotic Liver Disease, Metabolic Syndrome

MASLD, Metabolic Dysfunction-Associated Steatotic Liver Disease, Hepatic Steatosis, Metabolic Syndrome, Hypocaloric Mediterranean Diet, Ascophyllum nodosum, Fucus vesiculosus, Nutraceutical, Controlled Attenuation Parameter, Insulin Resistance, Body Composition

This randomized, double-blind, placebo-controlled study evaluated whether Gdue®, a nutraceutical containing extracts of the brown algae Ascophyllum nodosum and Fucus vesiculosus together with chromium picolinate, could improve metabolic health and liver fat when added to a hypocaloric Mediterranean diet. Adults with metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic syndrome, and moderate-to-severe hepatic steatosis were randomly assigned to receive either Gdue® or a matching placebo for 6 months. All participants received an individualized hypocaloric Mediterranean diet and lifestyle counseling. Body weight, body mass index, waist circumference, blood pressure, blood glucose, insulin resistance, lipid levels, liver enzymes, body composition, and liver steatosis were assessed during the study. Liver steatosis was measured using the controlled attenuation parameter obtained by transient elastography. Safety, tolerability, treatment adherence, and adherence to the Mediterranean diet were also evaluated.

This was a single-center, randomized, double-blind, placebo-controlled, parallel-group clinical trial conducted in adults with metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic syndrome, and moderate-to-severe hepatic steatosis. Eligible participants were aged 18 years or older and had hepatic steatosis classified as grade S2 or S3 according to the controlled attenuation parameter (CAP), together with metabolic syndrome defined according to International Diabetes Federation criteria. Participants were randomly assigned in a 1:1 ratio to one of two study groups: Gdue® plus an individualized hypocaloric Mediterranean diet; or Matching placebo plus the same individualized hypocaloric Mediterranean diet. Gdue® contained 237.5 mg of Ascophyllum nodosum, 12.5 mg of Fucus vesiculosus, and 7.5 µg of chromium picolinate per capsule. Participants took one capsule three times daily, approximately 30 minutes before the main meals, for 6 months. The placebo was provided in an indistinguishable dosage form and identical packaging to maintain masking. All participants received individualized dietary counseling from a qualified dietitian. The dietary intervention consisted of a hypocaloric Mediterranean diet with an estimated energy deficit of approximately 600 to 1,000 kcal per day relative to individual energy requirements. The diet emphasized minimally processed foods, vegetables, fruit, whole grains, legumes, fish, nuts, and extra-virgin olive oil, while limiting refined sugars, sweetened beverages, processed foods, and excess saturated fat. Participants also received counseling on physical activity and were advised to avoid alcohol during the study. Clinical and biochemical assessments were performed at baseline, approximately 3 months, and approximately 6 months. Evaluations included body weight, body mass index, waist circumference, blood pressure, fasting glucose, glycated hemoglobin, fasting insulin, HOMA-IR, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, liver enzymes, homocysteine, and serum creatinine. Body composition was assessed at baseline and 6 months using bioelectrical impedance analysis. Liver steatosis was assessed using CAP, and liver fibrosis was evaluated using vibration-controlled transient elastography at baseline and 6 months. Adherence to the study product was assessed by pill count and collection of unused capsules. Adherence to the Mediterranean diet was evaluated using the 14-item Mediterranean Diet Adherence Screener. Adverse events and treatment tolerability were recorded throughout the study.

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