Association of food insecurity with metabolic dysfunction-associated steatotic liver disease by sex and race/ethnicity

Document Type

Article

Publication Date

6-19-2026

Publication Title

European journal of nutrition

Keywords

Humans, Male, Female, Food Insecurity, Nutrition Surveys, Adult, Middle Aged, Fatty Liver, Ethnicity, Sex Factors, United States, Racial Groups, Metabolic Diseases, Cross-Sectional Studies, Odds Ratio

Abstract

PURPOSE: We examined whether the association between food insecurity and metabolic dysfunction-associated steatotic liver disease (MASLD) differs across different racial/ethnic groups and sex using data from the 2017-March 2020 National Health and Nutrition Examination Survey (NHANES).

METHODS: A total of 5076 participants aged ≥ 20 years who completed transient elastography examination for evaluation of MASLD were included. Logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the association of food insecurity with MASLD.

RESULTS: Adult food insecurity was associated with increased odds of MASLD (low/very low vs. full security: OR = 1.41, 95% CI 1.12-1.77). Although there was no significant interaction between food insecurity and race/ethnicity (p interaction = 0.23), the positive association between food insecurity and MASLD was limited among non-Hispanic Whites. Food insecurity was associated with higher odds of MASLD in women but not men, with an interaction between food insecurity and sex (p interaction = 0.049). Furthermore, mediation analyses suggested that added sugar intake and intake of whole fruits and non-potato vegetables partially mediated the association of food insecurity with MASLD. The partial mediating effects of these foods were observed only among non-Hispanic Whites but not observed in other racial/ethnic groups or across sex.

CONCLUSION: Our results suggest that the positive association between food insecurity and MASLD may be dependent on race/ethnicity and sex. Increased consumption of whole fruits vegetables intake and reduced intake of added sugar may partially reduce the impact of food insecurity on MASLD development.

Medical Subject Headings

Humans; Male; Female; Food Insecurity; Nutrition Surveys; Adult; Middle Aged; Fatty Liver; Ethnicity; Sex Factors; United States; Racial Groups; Metabolic Diseases; Cross-Sectional Studies; Odds Ratio

PubMed ID

42319478

Volume

65

Issue

5

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