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Purpose <p>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).</p> Methods <p>A total of 5076 participants aged ≥ 20&#xa0;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.</p> Results <p>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 (<i>p</i> 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 (<i>p</i> 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.</p> Conclusion <p>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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Meng-Hua Tao,
  • Chun-Hui Lin,
  • Jialiang Liu,
  • Weiwen Chai,
  • Sheri Trudeau,
  • Humberto C. Gonzalez,
  • Mei Lu,
  • Stuart C. Gordon

摘要

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.