ArticleThe American journal of clinical nutrition2021
Food insecurity is associated with magnetic resonance-determined nonalcoholic fatty liver and liver fibrosis in low-income, middle-aged adults with and without HIV.
Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pediatric MASLD and Food Insecurity
Food Insecurity and MASLD: A Fruit and Vegetable Intervention Study
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- The impact of food insecurity on chronic liver disease: A systematic review of the literature.Hepatology communications · 2025Pooled it
- Metabolic dysfunction-associated steatotic liver disease assessment and management: Clinical practice guidance from the Canadian Association for the Study of the Liver.Canadian liver journal · 2026Article
- Joint effects of social determinants of health on NAFLD mortality: the mediating role of phenotypic age acceleration.GeroScience · 2026Article
- Association of food insecurity with metabolic dysfunction-associated steatotic liver disease by sex and race/ethnicity.European journal of nutrition · 2026Article
- A narrative review of lifestyle management guidelines for metabolic dysfunction-associated steatotic liver disease.Hepatology (Baltimore, Md.) · 2026Review
- Modern Diets, Metabolic Inequity, and Race-Ethnic Disparities: Unraveling the Associations With MASLD and Cancer Risk.Journal of gastroenterology and hepatology · 2026Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease Is Associated With Adverse Social Factors: An Analysis UsingGastro hep advances · 2026Article
- Food Insecurity and Mortality From Digestive Tract Diseases in the United States.Gastro hep advances · 2026Article
- The association of food insecurity with hepatic steatosis in women with and without HIV.AIDS (London, England) · 2025Article
- Food Insecurity Is Highly Prevalent Amongst Patients With Chronic Liver Disease in Northern England: A Cross-Sectional Analysis.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025Article
- Multifaceted environmental factors linked to metabolic dysfunction-associated fatty liver disease: an environment-wide association study.BMC public health · 2025Article
- Food inequity and insecurity and MASLD: burden, challenges, and interventions.Nature reviews. Gastroenterology & hepatology · 2024Review
- Effects of Food Insecurity on Hepatic Steatosis and Fibrosis in People With HIV.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Food insecurity is a risk factor for metabolic dysfunction-associated steatotic liver disease in Latinx children.Pediatric obesity · 2024Article
- Clinical Overview of Sarcopenia, Frailty, and Malnutrition in Patients With Liver Cirrhosis.Gastroenterology research · 2024Review
- Association between food insecurity and metabolic dysfunction-associated steatotic liver disease/significant fibrosis measured by fibroscan.European journal of nutrition · 2024Article
- Community-Engaged Research: COVID-19 Testing, Infection, and Vaccination among Underserved Minority Communities in Miami, Florida.Vaccines · 2024Article
- The Impact of Climate Change, Pollution, and Biodiversity Loss on Digestive Health and Disease.Gastro hep advances · 2024Review
- Screening for social determinants of health among populations at risk for MASLD: a scoping review.Frontiers in public health · 2024Article
- Fatty Liver Disease: Enter the Metabolic Era.Current HIV/AIDS reports · 2023Review
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundNonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in the United States. Food-insecure individuals often depend on low-cost, energy-dense but nutritionally poor foods, resulting in obesity and chronic diseases related to NAFLD.
objectivesTo determine whether food insecurity is associated with NAFLD in a cohort of HIV and hepatitis C virus (HCV) infected and uninfected adults.
methodsWe conducted a cross-sectional analysis of low-income, middle-aged adults from the Miami Adult Studies on HIV (MASH) cohort without a history of excessive alcohol consumption. Food security was assessed with the USDA's Household Food Security Survey. MRIs were used to assess liver steatosis and fibrosis. Metabolic parameters were assessed from fasting blood, anthropometrics, and vitals.
resultsOf the total 603 participants, 32.0% reported food insecurity. The prevalences of NAFLD, fibrosis, and advanced fibrosis were 16.1%, 15.1%, and 4.6%, respectively. For every 5 kg/m2 increase in BMI, the odds of NAFLD increased by a factor of 3.83 (95% CI, 2.37-6.19) in food-insecure participants compared to 1.32 (95% CI, 1.04-1.67) in food-secure participants. Food insecurity was associated with increased odds for any liver fibrosis (OR, 1.65; 95% CI, 1.01-2.72) and advanced liver fibrosis (OR, 2.82; 95% CI, 1.22-6.54), adjusted for confounders. HIV and HCV infections were associated with increased risks for fibrosis, but the relationship between food insecurity and liver fibrosis did not differ between infected and uninfected participants.
conclusionsAmong low-income, middle-aged adults, food insecurity exacerbated the risk for NAFLD associated with a higher BMI and independently increased the risk for advanced liver fibrosis. People who experience food insecurity, particularly those vulnerable to chronic diseases and viral infections, may be at increased risk for liver-related morbidity and mortality. Improving access to adequate nutrition and preventing obesity among low-income groups may lessen the growing burden of NAFLD and other chronic diseases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.