P3163 - Diet Quality and Its Association With Lean Metabolic Dysfunction-Associated Steatotic Liver Disease: An Analysis of NHANES 2017-2020

Sarpong Boateng, MD, MPH¹, Amita Kasar, MD², Prince A. Ameyaw, MD¹, Rohit Balasundaram, MPH³, Basile Njei, MD^4
1Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT; ²Poplar Bluff Regional Medical Center, Poplar Bluff, MO; ³University of North Texas Health Science Center, Fort Worth, TX; ⁴Yale University School of Medicine, New Haven, CT

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is influenced by dietary quality. While prior studies have highlighted the relationship between poor diet and MASLD, there is limited understanding of how diet quality, as measured by the Healthy Eating Index (HEI), impacts MASLD among lean individuals. This study aims to investigate the association between HEI and MASLD status in lean individuals.

Methods: A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020. Lean individuals were defined based on BMI thresholds: BMI < 23kg/m² for Non-Hispanic Asians and BMI < 25 kg/m² for other ethnicities. Participants were categorized into sex specific quartiles based on HEI scores. HEI is a measure to assess the quality of an individual's diet. The HEI includes 13 different food components. The total HEI score ranges from 0 to 100, with higher scores representing healthier eating patterns. Survey-weighted logistic regression models were used to evaluate the association between HEI quartiles as well as its individual food components and MASLD status among lean individuals, adjusting for sociodemographic factors, lifestyle characteristics, and comorbidities.

Results: Among 1,707 participants, the mean age was 44.4±19.95 years, with 47.9% being male. Participants in the top HEI quartile had 66% lower odds of lean MASLD compared to the bottom HEI quartile (OR=0.34,95%CI=0.12-0.96,p=0.043) in the adjusted model. Higher total protein foods (OR=1.08,95%CI=1.01-1.16,p=0.035) and refined grains intake (OR=1.10, 95%CI=1.002-1.208, p=0.048) were significantly associated with higher odds of MASLD. Conversely, higher intake of oils was associated with lower odds of MASLD (OR=0.99,95%CI=0.980-0.995,p=0.013). Significant associations were found between lean MASLD, age (OR=1.04 per year increase,95%CI=1.02-1.06,p=0.001) and sex (females had lower odds compared to males, OR =0.50,95%CI=0.28-0.8,p=0.019)

Discussion: Higher HEI scores were associated with reduced odds of MASLD among lean individuals in the adjusted model. Higher intake of total protein foods and refined grains increases the risk, while higher intake of oils decreases the risk. These findings suggest that even among lean individuals, diet quality, as measured by HEI, plays a significant role in the risk of MASLD. Public health strategies focusing on improving dietary quality and balanced diet should include lean individuals as it may help mitigate the risk of MASLD


Disclosures:


Sarpong Boateng, MD, MPH¹, Amita Kasar, MD², Prince A. Ameyaw, MD¹, Rohit Balasundaram, MPH³, Basile Njei, MD⁴. P3163 - Diet Quality and Its Association With Lean Metabolic Dysfunction-Associated Steatotic Liver Disease: An Analysis of NHANES 2017-2020, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.