Dietary characteristics associated with the risk of non‐alcoholic fatty liver disease and metabolic dysfunction‐associated steatotic liver disease in non‐obese Japanese participants: A cross‐sectional study

Abstract Background and Aim Dietary characteristics associated with non‐alcoholic fatty liver disease (NAFLD) and metabolic dysfunction‐associated steatotic liver disease (MASLD) in non‐obese patients remain to be elucidated. This study examined the association of NAFLD and MASLD with dietary characteristics according to obesity status. Methods We performed a cross‐sectional study of 15 135 participants (n = 7568 men and 7567 women) aged 35–74 years using data of annual health checks between 2008 and 2020. Obesity was defined as BMI ≥ 25 kg/m2. Diagnosis of fatty liver was based on abdominal ultrasonography. Fatty‐liver‐related dietary characteristics were assessed using a self‐administered questionnaire. Results For non‐obese participants, NAFLD was found in 31.0% of men and 19.4% of women. Non‐obese MASLD was found in 27.6% of men and 18.1% of women. Multivariable‐adjusted stepwise logistic regression analysis indicated that, in males, both non‐obese NAFLD and non‐obese MASLD were significantly and negatively associated with “often eat sesame/nuts”, and positively associated with “often eat noodles/rice bowl” and “often eat evening meal” (P