Processing Status, Rather Than Meat Source, Is Associated with Metabolic Dysfunction-Associated Steatotic Liver Disease Among US Adults.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the most common chronic liver diseases worldwide and is closely related to modifiable dietary factors. The authors aimed to examine whether the association between meat intake and MASLD is more closely related to meat source or processing status. Materials and Methods: The current study analyzed data from 1828 adults in the 2017 2018 National Health and Nutrition Examination Survey (NHANES). Meat intake was assessed using 24-hour dietary recalls and classified into processed red meat, processed poultry, unprocessed red meat, and unprocessed poultry. The presence of MASLD was determined using the controlled attenuation parameter measured by vibration-controlled transient elastography. Results: In fully adjusted models, each 1 oz-eq/day increase in processed meat was associated with 27% higher odds of MASLD (odds ratio (OR) 1.27, 95% CI 1.10-1.46, P = .003). Patients in the highest tertile had 2.46 times higher odds of MASLD than those in the lowest tertile (P = .002), with a robust linear trend (P for nonlinearity = .817). This association was observed for both processed red meat and processed poultry. In contrast, neither total unprocessed meat nor its specific subtypes (unprocessed red meat and unprocessed poultry) was significantly associated with MASLD. Iso-serving substitution analysis indicated that replacing 1 oz-eq/day of processed meat with unprocessed meat was associated with a 24% reduction in the odds of MASLD (OR 0.76, 95% CI 0.66-0.88; P = .001). Conclusion: The observed association with MASLD appeared to be more closely related to processing status than to meat source.