Food inequity and insecurity and MASLD: burden, challenges, and interventions

Area of Science:

• Hepatology
• Public Health
• Social Determinants of Health

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease globally.
• Socioeconomic status and food insecurity significantly impact liver disease prevalence, severity, and outcomes.
• Dietary changes can reverse MASLD, but individual efforts are often insufficient due to broader societal factors.

Purpose of the Study:

• To review current research on the link between food insecurity and liver disease.
• To highlight the need for interventions addressing sociocultural determinants of food choices.
• To explore the role of liver specialists in mitigating these issues.

Main Methods:

• Review of existing literature on food insecurity, social nutrition, and liver disease.
• Analysis of the impact of socioeconomic factors on dietary choices and health outcomes.
• Identification of intervention levels: environment, policy, community, and healthcare.

Main Results:

• Food insecurity acts as an upstream risk factor for MASLD, advanced fibrosis, and increased mortality in liver disease patients.
• Low-quality diets are often more affordable, creating a barrier to healthy eating for food-insecure individuals.
• Commercial pressures disproportionately affect vulnerable populations, exacerbating health disparities.

Conclusions:

• Interventions targeting food insecurity at multiple levels are crucial for reducing the burden of liver disease.
• Addressing social and environmental factors is essential for improving MASLD outcomes and reducing health inequities.
• Liver specialists have a role in advocating for and implementing interventions to combat food insecurity's impact on liver health.