EAT-Lancet diet and risk of metabolic dysfunction-associated steatotic liver disease and other liver chronic diseases: a large prospective cohort study in the UK Biobank

Abstract

Background and aim: As a newly recommended healthy dietary blueprint, the EAT-Lancet diet emphasizes both environmental sustainability and human health. However, its impact on chronic liver diseases remains unclear. This study examined the influence of the EAT-Lancet diet on the risk of metabolic dysfunction-associated steatotic liver disease (MASLD) and other chronic liver diseases. Methods: Our study included 160,394 UK Biobank participants who completed 24-h dietary assessments between April 2009 and June 2012, from which EAT-Lancet diet scores were calculated. The Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the primary outcome (MASLD) and secondary endpoints, including cirrhosis, liver cancer, and other liver diseases. Results: A total of 1,727 cases of MASLD, 602 cases of liver cirrhosis, 103 cases of liver cancer, and 2,053 cases of other liver diseases were identified over a median follow-up period of 13.3 years. Using the lowest tertile as the reference, the highest EAT-Lancet diet index group demonstrated a 33% reduction in MASLD incidence (HR:0.67, multivariate 95%CI: 0.55, 0.80). In several secondary outcome measures, similar associations were also observed. Furthermore, the risk of MASLD was lowest among individuals with both higher EAT-Lancet dietary scores and lower genetic risk (HR = 0.52; 95%CI: 0.36–0.74), although no significant interaction was detected between the two groups. Conclusion: Adherence to the EAT-Lancet diet is associated with a reduced risk of chronic liver disease, independent of genetic factors.