November 11, 2023
2 minutes of reading
- Nearly 19% of adolescents classified as food insecure had steatotic liver disease associated with metabolic dysfunction.
- Food insecurity is more common among girls and adolescents aged 15 to 18 years.
BOSTON — Adolescent food insecurity is “very strongly associated” with metabolic dysfunction-related fatty liver disease, which may result from an inability to eat or purchase a balanced diet, according to a researcher.
“Food insecurity among children is about 10.2% in the United States and may be a risk factor for MASLD among adults,” Zobair M. Younossi, MD, chairman of the Global NASH Council in Washington, D.C., said during The Liver Meeting’s media briefing. “But the data for children and adolescents is really lacking at the moment.”
To determine the relationship between MASLD, formerly nonalcoholic fatty liver disease, and food insecurity in US adolescents, Yunosi and colleagues assessed demographics, dietary information, physical activity, and food insecurity from 711 children aged 12 to 18 years. in the 2017 to 2018 National Health and Nutrition Examination Survey.
The researchers also used the USDA’s Child Food Security Survey Module, which included eight questions about food insecurity, and found that adolescents were considered food insecure if they had at least two affirmative answers.
They also analyzed participation in the Supplemental Nutrition Assistance Program (SNAP) as well as household income level, defining low income as less than 138% of the federal poverty level.
According to Younossi, nearly 19% of adolescents classified as food insecure had MASLD.
“Adolescents with MASLD are more likely to live in a food insecure household that has a low income and that the head of the household has a lower level of education, less than a high school education,” he said. “Apparently, patients with MASLD have more metabolic disease, are more obese, and have more type 2 diabetes.”
Of the adolescents who were food insecure, 98.7% relied on cheap food, 93.2% could not get a balanced diet and 51.5% did not eat enough food, the data showed. In addition, adolescents with food insecurity had higher rates of advanced liver disease than those less concerned about food access (2.8% vs. 0.3%). However, Yunosi noted that there were no differences in metabolic diseases based on food insecurity.
“Food insecurity is more common among girls and also among those between the ages of 15 and 18,” he added. “That’s important because that’s when maturity begins.”
After adjusting for age, sex, and race, food insecurity and low household income were associated with a greater risk of MASLD, and when demographics or metabolic syndrome were included as confounders, “food insecurity remained very strongly associated with MASLD,” Yunosi said.
“The association of food insecurity with MASLD is probably more likely a result of not being able to eat well or have a balanced diet [or] buying good food, which leads to buying food at a low price,” he concluded. “Together, these factors can lead to a cycle of overeating, along with overconsumption of ultra-processed foods and sugar-sweetened foods and beverages, that really promote this important liver disease.”
Paik J, et al. Food insecurity and household income significantly increase the risk of MASLD/NAFLD among adolescent children in the United States. Presented at: The Liver Meeting; November 10-14, 2023; Boston (hybrid meeting).
Disclosures: Younossi reports consulting and/or receiving research funding from Abbott, AstraZeneca, BMS, Boehringer Ingelheim, CymaBay, GSK, Intercept, Madrigal, Merck, Novo Nordisk, and Siemens.