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: 1.23-1.4 4), 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. (c) 2025 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).