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Association between chrononutrition patterns and metabolic dysfunction-associated steatotic liver disease in adolescents: a population-based study

Eat Weight Disord. 2026 May 26. doi: 10.1007/s40519-026-01874-0. Online ahead of print.

ABSTRACT

BACKGROUND: Previous studies have primarily examined the benefits of calorie restriction and fasting for metabolic dysfunction-associated steatotic liver disease (MASLD). However, the impacts of eating timing and frequency on MASLD remain uncertain.

METHODS: This study comprised 2128 participants aged 12 to 19 years, drawn from the National Health and Nutrition Examination Survey (NHANES) data collected during the period 2017 to 2023. Chrononutrition patterns were determined with two 24-h dietary recalls. Logistic regression, accounting for potential confounders, was used to examine the relationship between chrononutrition patterns and MASLD. Subgroup analyses stratified by demographic and clinical variables were used to evaluate their potential impact on the associations observed. Mediation analysis was conducted to assess the indirect effects of metabolic indicators on MASLD risk.

RESULTS: Logistic regression demonstrated that the timing of the first (continuous: OR: 1.07; 95% CI 1.02-1.14) and midpoint (continuous: OR: 1.11; 95% CI 1.00-1.22) food/beverage intake, as well as energy intake at dinner (OR: 1.01; 95% CI 1.00-1.01), were significantly associated with an increased risk of MASLD. Furthermore, the eating window (continuous: OR: 0.95; 95% CI 0.91-0.99) was significantly negatively correlated with the risk of MASLD. Subgroup analyses revealed that the chrononutrition pattern was particularly linked to an elevated risk of MASLD among males and Mexican Americans (P < 0.05). Additionally, HDL-C and NHHR (58.69% and 61.90%, respectively) partially mediated the association between the timing of the first food/beverage intake and MASLD risk.

CONCLUSION: Later timing of the first and midpoint food and beverage intake, as well as greater energy consumption at dinner, are linked to an elevated risk of MASLD. HDL-C and NHHR serve as mediators in these associations, particularly with respect to the timing of the first food or beverage intake.

PMID:42189361 | DOI:10.1007/s40519-026-01874-0

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