eHealth lifestyle interventions have emerged as promising management strategies for metabolic dysfunction-associated steatotic liver disease (MASLD). Our review aimed to synthesize the most recent evidence to evaluate the effectiveness of eHealth lifestyle interventions on clinical and behavioral outcomes in adults with MASLD. Twelve databases (Medline, Web of Science Core Collection, Embase, Cochrane Central Register of Controlled Trials, ProQuest Health & Medical Collection, CINAHL Complete, Academic Search Complete, Scopus, Emerald, China National Knowledge Infrastructure, Wanfang Data, and VIP Database) were searched from inception to April 2, 2025. Thirteen randomized controlled trials and fifteen quasi-experimental trials comprising 2579 adult patients with MASLD were included. Seven intervention components were identified: goal setting, health education, consultation, self- and device-monitoring, feedback, patient reminders, and social support. Meta-analysis of randomized controlled trials demonstrated that eHealth lifestyle interventions were significantly superior to standard care in reducing weight, body mass index, waist circumference, alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transferase levels, and improving MASLD status. Improvements in self-management, dietary adherence, physical activity, exercise, and quality of life were also observed. Our findings suggest that ehealth intervention is a better choice for the patients with MASLD to achieve precise and scalable management. PROSPERO CRD420251001470.

PROSPERO CRD420251001470; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251001470.