Evidence mapPaperPMID 41992009Full record

ArticleEuropean journal of clinical nutrition2026

Association between plant-based diet quality and metabolic dysfunction-associated steatotic liver disease (MASLD) among multiethnic adults.

Darya Moosavi, Unhee Lim, Meredith A Hullar, Christoph Rettenmeier, Sandi A Kwee, Kristine R Monroe, Thomas Ernst, Tim Randolph, Lynne R Wilkens, Loïc Le Marchand and 2 more

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Article in European journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Darya MoosaviPublic Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA. daryaamoosavi@gmail.com.ORCID http://orcid.org/0000-0002-2575-9510
Unhee LimUniversity of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA.ORCID http://orcid.org/0000-0001-6221-7190
Meredith A HullarPublic Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Christoph RettenmeierUniversity of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA.
Sandi A KweeUniversity of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA.
Kristine R MonroeKeck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
Thomas ErnstUniversity of Maryland School of Medicine, Baltimore, MD, USA.
Tim RandolphPublic Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Lynne R WilkensUniversity of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA.
Loïc Le MarchandUniversity of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA.
Johanna W LampePublic Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Song-Yi ParkUniversity of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA.ORCID http://orcid.org/0000-0001-7734-5320

Funding

Understanding Population Differences in Cancer: The MEC StudyU01CA164973 · UNIVERSITY OF HAWAII AT MANOA · 2025 to 2025
$4.9M
Longitudinal Study of Early NAFLD Progression and the Gut Microbiome in Asian Americans, Native Hawaiians and WhitesR01MD018265 · UNIVERSITY OF HAWAII AT MANOA · 2025 to 2025
$750k
NCI NIH HHS P01 CA168530NCI NIH HHS U01 CA164973NIMHD NIH HHS R01 MD018265U.S. Department of Health & Human Services | NIH | National Cancer Institute (NCI) (U01 CA164973U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging) R01 MD018265-03S2
6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-alcoholic fatty liver disease (NAFLD), is a growing public health concern with limited effective treatments. Diet quality may influence MASLD risk, yet the role of plant-based dietary patterns in diverse populations remains unclear.

objectiveTo evaluate the associations of plant-based dietary patterns with liver fat content or MASLD prevalence in multiethnic older adults.

methodsWe analyzed cross-sectional data on 1598 participants of five racial and ethnic groups in the Adiposity Phenotype Study, nested within the Multiethnic Cohort Study. Participants' adherence to three established plant-based diet indices was estimated from their food frequency questionnaire responses: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Magnetic resonance imaging was used to quantify liver fat and identify MASLD cases. Multivariable-adjusted linear regression of liver fat and logistic models of MASLD were performed to determine their associations with the plant-based diet indices, adjusting for demographic, lifestyle, and anthropometric covariates.

resultsHigher hPDI scores were associated with lower liver fat content (adjusted mean liver fat for 4th (5.39%) vs. 1st quartile (6.52%) of hPDI) and reduced likelihood of MASLD (OR for 4th vs. 1st quartile = 0.58 (95% CI: 0.41-0.81)). The hPDI-MASLD association varied by race and ethnicity (p-heterogeneity = 0.001), with stronger inverse associations observed among Latino and White participants than among African American, Japanese American, or Native Hawaiian participants. No consistent associations were observed for PDI or uPDI. Among hPDI components, higher nut and lower animal fat intakes were associated with lower hepatic adiposity.

conclusionsGreater adherence to a healthful plant-based diet is associated with lower liver fat and MASLD prevalence, with some racial and ethnic variation. These findings underscore the importance of plant-food quality and may inform dietary strategies for MASLD prevention in heterogeneous populations.

Indexed as

Diet, Plant-BasedDiet, VegetarianEthnicityNon-alcoholic Fatty Liver DiseaseRacial GroupsAgedCohort StudiesCross-Sectional StudiesFemaleHumansLiverMaleMiddle AgedPrevalenceRisk Factors

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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 Socratic graph.