Food insecurity associated with liver disease in teens

Teens from low-income families experiencing food insecurity are developing the most common form of liver disease twice as often as those who have easier access to food, likely because they rely on low-cost, ultra-processed foods, according to a study scheduled for presentation at The Liver Meeting, held by the American Association for the Study of Liver Diseases.

Participation in the food assistance program Supplemental Nutrition Assistance Program, known as SNAP, seems to protect young people against liver disease.

"The association between food insecurity and MASLD is most likely the result of not being able to eat a balanced meal and more likely having to purchase low-cost food," said Zobair Younossi, MD, professor and chairman of the Beatty Liver and Obesity Research Program, Inova Health, and lead author of the study. "Together, these factors may lead to a cycle of overeating along with the overconsumption of ultra-processed foods and sugar-sweetened food and beverages."

Researchers analyzed demographic, nutrition, physical activity and food insecurity data for 771 teens in the National Health and Nutrition Examination Survey from 2017 to 2018. Nearly 19% of the adolescents who were identified as food insecure had a condition known as metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), almost double the rate for those not experiencing food insecurity.

Food-insecure teens also had higher rates of advanced liver disease at 2.8% compared to 0.3% adolescents with fewer concerns about access to food.

Almost all adolescents identified as food insecure (98.9%) said they relied on low-cost food or couldn't get a balanced meal, while over half said they did not eat enough food.

The analysis found there were no differences in metabolic disease such as obesity and type 2 diabetes according to food insecurity, though these factors were independently associated with MASLD, the most common form of liver disease in the United States. MASLD is the buildup of fat in the liver.

"Our findings suggest that more needs to be done to make sure all those who qualify and are eligible for SNAP are obtaining their benefits," Younossi said. "SNAP may be an interventional tool to help improve the diets of adolescents. However, work must continue to remove the systemic and structural barriers to allow better accessibility to the SNAP program as well as to provide more physical activity in school and in after-school programs."

James Paik, Ph.D., will present the study, "Food Insecurity and Household Income Substantially Increase the Risk of NAFLD Among Adolescent Children in the United States," abstract 176, on Sunday, November 12, at 11:00 a.m. EDT.