Food insecurity is an emerging risk factor for liver disease: a scoping review

Food insecurity, the household-level socio-economic condition of having limited or uncertain ability to acquire adequate and safe food, has affected 13.8 million households in the United States in 2020 and is a cofactor in the onset and worsening of metabolic dysfunction-associated steatotic liver disease (MASLD).

To illustrate the epidemiological evidence linking MASLD with food insecurity, and the potential pathobiological mechanisms underlying their association we searched the PubMed, Web of Science, and Scopus database from inception to April 2025 for relevant keywords pertaining to the topic. Finally, we discuss promising areas of future research in this field.

Research on food insecurity contributes to the establishment of the biopsychosocial disease model in the MASLD field. Understanding the broader sociocultural factors influencing food choices, which may disproportionately affect certain vulnerable populations, can help shift the focus from individual responsibility to a more comprehensive approach to addressing obesity-related metabolic dysfunction. Future studies should focus on quantifying descriptors of food insecurity more effectively. Additionally, further research is necessary to determine whether and to what extent global cultural advancements and specific education in food security can prevent and reverse the negative outcomes of food insecurity-associated MASLD.