Association Between Food Insecurity and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Cross-Sectional Study in South Korea

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become an important public health burden. However, the association of food insecurity with MASLD remains understudied. Accordingly, this study analyzed the association between food insecurity and MASLD in Korean adults. Methods: We used data from 12,697 adults drawn from a nationally representative survey. Food insecurity was determined using the Household Food Security Survey Module. Food insecurity was categorized into no, mild, and moderate-to-severe. MASLD was determined by a hepatic steatosis index >36 in conjunction with at least one metabolic abnormality. The association was analyzed using logistic regression. Results: Among the participants, 95.5%, 3.7%, and 0.8% were classified as having no, mild, and moderate-to-severe food insecurity, respectively. Compared to no food insecurity, the odds ratios (ORs) (95% CIs [confidence intervals]) for MASLD were 1.40 (1.09–1.81) for mild food insecurity and 1.76 (1.06–2.90) for moderate-to-severe food insecurity. Additionally, the continuous HFSSM score was directly associated with MASLD (OR: 1.07; 95% CI: 1.02–1.12). Conclusions: This nationally representative study showed that, compared with no food insecurity, mild and moderate-to-severe food insecurity were associated with MASLD.