Gender Differences in Healthy Eating Index as Informed by the Awareness of Diagnosis of Metabolic Dysfunction-Associated Steatotic Liver Disease

Authors

Wei Ting Lin, Tulane University, New Orleans, LA
Madeline Novack, Tulane University, New Orleans, LA
Suthat Liangpunsakul, Indiana University, Indianapolis, IN
Chiung Kuei Huang, Tulane University, New Orleans, LA
Hui Yi Lin, LSU Health Sciences Center - New OrleansFollow
Po Hung Chen, Johns Hopkins University, Baltimore, MD
Tung Sung Tseng, LSU Health Sciences Center - New OrleansFollow
Peng Sheng Ting, Tulane University, New Orleans, LA

Document Type

Article

Publication Date

11-28-2025

Publication Title

Livers

Abstract

Background/Objectives: Dietary quality is a driver of metabolic dysfunction-associated steatotic liver disease (MASLD). Men and women often have different levels of adherence to medical advice, but the effect of gender on adherence to dietary advice as a function of awareness of MASLD is understudied. We aim to investigate the differences in diet quality between men and women who are aware of their diagnosis of MASLD compared to their undiagnosed counterparts. Methods: We utilized the National Health and Nutrition Examination Survey 2017–2020 to identify a nationally representative sample of subjects with MASLD, 127 of whom reported a diagnosis of MASLD (diagnosed MASLD), and 1703 of whom did not report an existing diagnosis of MASLD but met criteria of the disease based on vibration-controlled transient elastography results and cardiometabolic criteria (undiagnosed MASLD). Results: In a gender-stratified analysis of diet quality as a function of reported MASLD diagnosis, women with diagnosed MASLD were more likely than women with undiagnosed MASLD to consume less added sugar and more total and whole fruits. Women with diagnosed MASLD had a 3.06 higher healthy eating index score than undiagnosed women, after adjusting for confounders such as demographics, comorbidities, lifestyle behaviors, and metabolic risk factors. In men, total diet quality did not differ based on awareness of MASLD diagnosis. Conclusions: Women with diagnosed MASLD have superior diets compared to their undiagnosed counterparts. Gender-specific approaches to counseling and prospective studies that investigate causes of gender-driven differences in dietary behavior in the context of MASLD are needed.

Volume

5

Issue

4

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Lin, Wei Ting; Novack, Madeline; Liangpunsakul, Suthat; Huang, Chiung Kuei; Lin, Hui Yi; Chen, Po Hung; Tseng, Tung Sung; and Ting, Peng Sheng, "Gender Differences in Healthy Eating Index as Informed by the Awareness of Diagnosis of Metabolic Dysfunction-Associated Steatotic Liver Disease" (2025). School of Public Health Faculty Publications. 543.
https://digitalscholar.lsuhsc.edu/soph_facpubs/543
10.3390/livers5040061