Role of dietary quality in lean metabolic dysfunction–associated steatotic liver disease: analysis of NHANES 2017–2020
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background Metabolic dysfunction–associated steatotic liver disease (MASLD) affects a significant proportion of the global population. Lean MASLD, characterized by normal body mass index but the presence of metabolic dysfunction, presents a unique clinical challenge. This study explored the role of diet quality, measured by the Healthy Eating Index (HEI), in the development of lean MASLD.Methods We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES, 2017–2020). Participants were adults classified as lean (body mass index <23 kg/m2 for non-Hispanic and Asian, <25 kg/m2 for others) with metabolic dysfunction. MASLD was diagnosed based on hepatic steatosis and at least one cardiometabolic risk factor. We assessed diet quality using HEI-2015 and employed survey-weighted logistic regression to evaluate the association between HEI scores and lean MASLD, adjusting for potential confounders.Results Among 1707 participants, higher HEI scores were associated with a reduced likelihood of lean MASLD. Specifically, individuals in HEI quartile 4 had 66% lower odds of developing MASLD compared to those in quartile 1 (odds ratio = 0.34, 95% confidence interval = 0.12–0.96, P = 0.04). Higher protein intake and refined grain consumption were positively associated with MASLD, while oil intake showed a protective effect.Conclusions A higher-quality diet, as indicated by a better HEI score, is associated with a lower risk of lean MASLD. This study underscores the importance of diet quality in MASLD prevention and highlights the need for further research into specific dietary components that impact liver health in lean individuals.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4415245198