Assessment of dietary intake in patients with metabolic dysfunction-associated steatotic liver disease using the Ukrainian version of the EPIC-Norfolk Food Frequency Questionnaire: A cross-sectional study

Metabolic dysfunction‑associated steatotic liver disease (MASLD) is prevalent worldwide. Studies demonstrate a possible association between diet and MASLD. However, data regarding patients in Ukraine are lacking. Objective — to study dietary habits and meeting recommended dietary intake in patients with MASLD. Materials and methods. Adults with MASLD aged 18 years and older (n=29) receiving care in outpatient settings who fully completed the adapted and validated Ukrainian version of the EPIC‑Norfolk Food Frequency Questionnaire (FFQ) were included in the analysis. Liver steatosis was confirmed by ultrasound examination, and diagnosis of MASLD was based on the criteria defined by the American Association for the Study of Liver Diseases. As a reference for recommended dietary intake, data from the Dietary Guidelines for Americans, 2020—2025 years were used. FETA software was used to calculate nutrient data from the FFQ. The one‑sample t‑test, t‑test, the one‑sample signed rank sum test, and Mann‑Whitney test were used to assess the differences between the sample and the reference data. The chi‑squared test was used to analyse categorical data. Results. The mean age of participants was 41.4±12 years, 69% of participants being female. The mean body mass index was 35.4±7.9 kg/m2. Participants consumed more protein, than recommended by current dietary recommendations. Women also tended to have higher energy intake and consume more fat, saturated fatty acids, and carbohydrates than recommended. The median fibre intake was 19.36 g (Q1; Q3 : 13.29; 26.45), which is lower than the recommended 14 g per 1000 kcal (p=0.0015). Dietary intake of most vitamins and micronutrients was met. However, women and men consumed less than 600 IU of vitamin D daily. Among all patients with MASLD, sodium intake (3829.5±1559.3 mg) was significantly higher than recommended (2300 mg, p<0.0001). Approximately 62% of participants take dietary supplements, with vitamin D being the most popular choice. Conclusions. Our study showed that patients with MASLD in Ukraine tend to exceed recommended protein and sodium intake and, at the same time, have low fibre and Vitamin D consumption. High energy intake and saturated fatty acids consumption are also of concern.