Takeaway food consumption and the risk of metabolic dysfunction-associated steatotic liver disease in adult populations: an international multicohort study with biopsy-verified evidence

There is limited research into the impact of takeaway food on metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to evaluate the association between takeaway food consumption and MASLD in Chinese TCLSIH cohort (n = 3186) and UK Biobank (n = 99 781), plus 334 Chinese adults with biopsy-proven MASLD in the PERSONS cohort. Takeaway food consumption was assessed via questionnaires. MASLD was identified through liver ultrasonography and cardiometabolic factors (TCLSIH) and hospital records/death registries (UK Biobank). Cox proportional hazards regression models were used to evaluate hazard ratio (HR) and 95% confidence interval (CI). In the TCLSIH cohort, 724 participants developed MASLD within 12 941 person-years; the fully adjusted HRs (95% CIs) for MASLD across takeaway food consumption frequency were 1.00 (reference) for < 1 time/week, 0.92 (0.67, 1.27) for 1-3 times/week, 1.30 (1.07, 1.61) for ≥ 4 times/week in males. In the UK Biobank, 724 participants developed MASLD during 1 033 546 person-years; males eating takeaway food had a fully adjusted HR (95% CI) of 1.66 (1.08, 2.55) compared with non-consumers. In the PERSONS cohort, takeaway food consumption showed positive association with MASLD severity in males. These findings indicated that takeaway food consumption was positively associated with risk and severity of MASLD in adults, particularly among males.