Antioxidant-rich and fibre-enhanced diets reduce liver fibrosis risk in metabolic dysfunction-associated steatotic liver disease: latent class analysis of a cohort study

Dietary patterns are increasingly recognised as crucial factors influencing the progression of metabolic-associated steatotic liver disease (MASLD). This study aimed to explore the association between dietary patterns and MASLD risk among adults, using latent class analysis (LCA), to our knowledge, for the first time in this context. This cross-sectional study included 8549 adults from the general population. Dietary intake data were collected using a validated FFQ and analysed with Nutritionist IV software. A 3-step LCA was applied to determine distinct dietary patterns among participants using micro- and macronutrients. Liver fibrosis severity was evaluated using a validated non-invasive marker, FIB-4 Score. Our analysis identified three distinct dietary patterns, each significantly associated with the severity of liver fibrosis. Class 1 (high-volume, high-fibre/mineral-rich pattern) was associated with the lowest risk of liver fibrosis. Compared with Class 1, participants in Class 2 (moderate volume, low-fibre/high-Na/mineral-poor pattern) (OR = 1·24; <i>P</i> = 0·002) and Class 3 (restricted volume, nutrient-depleted pattern) (OR = 1·13; <i>P</i> = 0·027) had significantly higher odds of moderate-to-high liver fibrosis risk. Class-specific regression analysis showed that age and smoking were the most consistent predictors of fibrosis risk across all patterns. Dietary patterns rich in antioxidants, fibre and essential micronutrients appear effective in reducing the risk of liver fibrosis. Further longitudinal studies are required to confirm these findings and determine practical clinical applications.