Navy beans take on fatty liver: a diet swap put to the test

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Adults 18-75 years of age with capacity to provide informed consent * Clinical diagnosis of MASLD, confirmed by imaging (MRI-PDFF or VCTE) or prior liver biopsy. * Intermediate-stage fibrosis (F2-F3) confirmed by one of the following (most recent qualifying result): VCTE (FibroScan) 8.0-14 kPa, MRE 3.0-4.6 kPa (2D EPI @ 60 Hz), or liver biopsy read as F2-F3 * Body mass index 25-45 kg/m² * Stable medications for ≥12 weeks for diabetes, hypertension, dyslipidemia, or weight management * Alcohol intake below MASLD thresholds (≤15 drinks/week for men, ≤10 drinks/week for women) * Willing and able to consume study navy beans and complete dietary recalls (ASA-24/DSQ) * Able to undergo MRI and MRE (no contraindications) and attend study visits * Agrees to biospecimen collection (blood, stool, saliva) and patient-reported outcomes Exclusion Criteria: * Other chronic liver disease (hepatitis B, hepatitis C, autoimmune hepatitis, hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, primary biliary cholangitis, primary sclerosing cholangitis) * Decompensated liver disease (ascites, variceal bleeding, encephalopathy) or Child-Pugh B/C cirrhosis, or clinical portal hypertension/decompensation * Heavy alcohol use above MASLD thresholds, or alcohol use disorder within 12 months * Legume/bean allergy or intolerance * Initiation or dose change of antidiabetic, lipid-lowering, antihypertensive, or weight-loss medications within the past 12 weeks, or anticipated changes during the trial * Recent initiation of agents known to affect hepatic fat or fibrosis (e.g., GLP-1 receptor agonist, SGLT2 inhibitor, pioglitazone, resmetirom) within 12 weeks * Use of hepatotoxic drugs likely to confound liver enzymes in the prior 12 weeks (per investigator judgment) * New supplements targeting weight loss, liver health, or the microbiome within 8-12 weeks (e.g., berberine, high-dose omega-3, pre/probiotics) * Antibiotics, probiotics, or colonoscopy preparation within 8 weeks * Planned bariatric surgery or other major weight-loss intervention during the study * Recent weight change \>5% within 8-12 weeks prior to baseline * Severe gastrointestinal disease (inflammatory bowel disease, celiac disease, short bowel syndrome) that may impair tolerance * Uncontrolled diabetes (HbA1c \>10%), severe renal dysfunction (eGFR \<45), or unstable cardiovascular, thyroid, or psychiatric illness * Pregnant or breastfeeding * Contraindications to MRI (e.g., non-compatible implants, severe claustrophobia) * Participation in another interventional study within the last 30 days