The associations between irregular breakfast and late-night snacking with metabolic dysfunction-associated steatotic liver disease.

Background: The newly coined term Metabolic dysfunction-associated steatotic liver disease (MASLD) emphasizes the critical role of metabolic risk factors in the pathogenesis of fatty liver disease. The consumption of irregular breakfasts or late-night snacks has been identified as a factor closely associated with disruptions in the body's energy homeostasis and metabolic balance. However, the relationship between these behaviors and MASLD has not been previously examined.

Methods: Participants in this study were recruited from the Kailuan cohort, a prospective cohort. All participants completed questionnaires regarding breakfast and late-night snack frequencies. The primary outcomes were MASLD and MASLD with increased alcohol intake (MetALD). Cox regression analysis was utilized to calculate the hazard ratios (HR) and 95 % confidence intervals (CI) for MASLD and MetALD in different groups. Mediation analysis was used to assess the mediating effect of BMI on this relationship.

Results: A total of 32,030 participants were included in the study. Both irregular breakfast consumption and late-night snacking were associated with an increased risk of MASLD. Compared to participants who consumed regular breakfast and no late-night snacks, the risk of MASLD was elevated in participants who consumed regular breakfast but late-night snacks (HR = 1.12, 95 % CI: 1.05-1.20), irregular breakfast but no late-night snacking (HR = 1.16, 95 % CI: 1.05-1.27), irregular breakfast and late-night snacking (HR = 1.26, 95 % CI: 1.13-1.42), never ate breakfast and no late-night snacking (HR = 1.33, 95 % CI: 1.23-1.44), and never ate breakfast and late-night snacking (HR = 1.52, 95 % CI: 1.30-1.77).

Conclusion: Irregular or skipped breakfast and late-night snacking were associated with an increased risk of MASLD and MetALD.