The following is a summary of “Food Insecurity Is Associated With Chronic Liver Disease Among US Adults,” published in the August 2023 issue of the Clinical Gastroenterology by Tapper et al.

Food insecurity is correlated with numerous adverse health outcomes. Most modern liver disease is metabolic and influenced by the individual’s nutritional condition. More data should be on the correlation between food insecurity and chronic liver disease. Researchers assessed the association between food insecurity and liver stiffness measurements (LSMs), a crucial indicator of hepatic well-being. A cross-sectional analysis was conducted on a cohort of 3,502 individuals aged 20 years and above, using data from the 2017 to 2018 National Health and Nutrition Examination Survey. Food security was assessed utilizing the Core Food Security Module developed by the US Department of Agriculture. The models were adjusted using age, gender, race/ethnicity, education level, poverty-income ratio, smoking status, level of physical activity, alcohol consumption, intake of sugary beverages, and the Healthy Eating Index-2015 score.

All participants underwent vibration-controlled transient elastography, a medical procedure that yields liver stiffness measurements (expressed in kilopascals) and quantification of hepatic steatosis (measured in controlled attenuation parameter, decibels per meter). Liver stiffness measurement (LSM) was categorized into different groups based on severity: <7, 7 to 9.49, 9.5 to 12.49 (indicating advanced fibrosis), and ≥12.5 (indicating cirrhosis) in the entire study population. Furthermore, the LSM categories were also analyzed separately for two age groups: 20 to 49 years and 50 years and older. Based on the individual’s food security status, there are no significant differences in the average controlled attenuation parameter, alanine aminotransferase, or aspartate aminotransferase values. Nevertheless, food insecurity correlated with an elevated average liver stiffness measurement (6.89±0.40 kPa vs. 5.77±0.14 kPa, P=0.02) among individuals aged 50 and above. 

Following multivariate adjustment, it was observed that food insecurity correlated with elevated LSMs (Life Stress Measures) in all risk stratifications for individuals aged 50 years and above. Liver stiffness measurement (LSM) of at least 7 kilopascals (kPa) was associated with an odds ratio (OR) of 2.06, with a 95% CI ranging from 1.06 to 4.02. Similarly, an LSM of at least 9.5 kPa had an OR of 2.50, with a 95% CI ranging from 1.11 to 5.64. Lastly, an LSM of at least 12.5 kPa had an OR of 3.07, with a 95% CI ranging from 1.21 to 7.80. Nutritional insufficiency is correlated with hepatic fibrosis and elevated susceptibility to progressive fibrosis and cirrhosis in elderly individuals.

Source: journals.lww.com/jcge/Abstract/2023/08000/Food_Insecurity_Is_Associated_With_Chronic_Liver.13.aspx