Dietary intake and eating habits in relation to metabolic dysfunction-associated steatotic liver disease: a case–control study

Abstract Nutrition is an important modifiable factor in metabolic dysfunction-associated steatotic liver disease (MASLD); however, the role of dietary intake and eating habits in its pathogenesis remains unclear. This case–control study aimed to investigate the associations of dietary intake and eating habits with MASLD. A total of 111 individuals (fifty-six cases and fifty-five controls), aged 18–65 years, who attended a diet clinic between March and July 2021 were included. Food frequency data, 3-d dietary records, anthropometric measurements and body composition analyses were obtained. Compared with controls, cases had lower rates of regular breakfast consumption and olive oil use and more frequent use of frying and roasting cooking methods ( P < 0·05). The case group also had lower Ca intake, lower proportions of energy from fat, MUFA and PUFA, and higher total energy intake, carbohydrate intake and n -6/ n -3 ratio ( P < 0·05). After adjustment for age, sex and daily energy intake, lower intake of protein (<1 g/kg/d; OR: 5·70, 95 % CI: 1·46–22·17), fish (<1 serving/week; OR: 4·51, 95 % CI: 1·45–14·05), legumes (<2 servings/week; OR: 6·03, 95 % CI: 1·96–18·56) and fruit (<2 servings/d; OR: 6·20, 95 % CI: 2·02–18·98) was associated with higher odds of MASLD. In the model additionally adjusted for BMI, associations for fish, legumes and fruit remained significant, whereas the association with protein intake was attenuated. These findings suggest that specific dietary components are associated with MASLD. However, due to the cross-sectional design of the study, causal inferences cannot be made.