Association between dairy-rich dietary pattern and metabolic dysfunction-associated steatotic liver disease: Findings from the Korean Genome and Epidemiology Study

Dietary components and the development of metabolic dysfunction-associated liver disease (MASLD) are closely linked, but large-scale studies on dietary patterns and MASLD are scarce, most previous studies having focused on individual nutrients or foods rather than overall dietary patterns. Therefore, we aimed to investigate the association between dietary patterns and MASLD in Koreans. A total of 6,052 participants from the Korean Genome and Epidemiology Study. Dietary intake was assessed using a validated Korean semiquantitative food frequency questionnaire comprising 106 food items. Principal component analysis was used to determine the major dietary patterns. Cox proportional hazard regression analysis was performed to assess the association between the incidence of MASLD and dietary patterns. Four major dietary patterns, namely carnivore, plant-based, dairy-rich, and starch-rich diet patterns, were identified. The carnivore, plant-based, and starch-rich diet patterns showed no significant association with incident MASLD, while the dairy-rich diet pattern was associated with a lower risk of MASLD, also showing significantly lower cumulative incidence of MASLD in the higher adherence to dairy-rich diet pattern. The dairy-rich diet pattern was significantly associated with a lower risk of MASLD in Koreans. Appropriate dietary guidance based on dietary patterns is crucial for preventing MASLD.