Suenghataiphorn Thanathip, Tribuddharat Narisara, Danpanichkul Pojsakorn, Kulthamrongsri Narathorn
Department of Internal Medicine, Griffin Hospital, Derby, CT, United States.
St. Elizabeth, Boston, MA, United States.
Clin Nutr ESPEN. 2025 Aug;68:583-590. doi: 10.1016/j.clnesp.2025.06.005. Epub 2025 Jun 7.
Hepatic Steatosis is an intrahepatic fat accumulation and can lead to liver dysfunction, inflammation, and advanced forms of nonalcoholic fatty liver disease (NAFLD). Fruits have been explored as a possible beneficial factor for some individuals with metabolic-associated liver diseases, but the evidence regarding the specific relationship between fruit types and hepatic steatosis remains limited.
We examined the data from a nationwide cross-sectional study using the 2017-March 2020 National Health and Nutrition Examination Survey (NHANES) database and the Food Patterns Equivalents Database (FPED) database. Using controlled attenuation parameter scores to differentiate between S0 to S3, for participants aged 18 years and older, we employed multivariable logistic regression to determine the association between specific types of fruit intake (citrus fruits, non-citrus fruits, and fruit juice) and the presence of hepatic steatosis.
A total of 7568 participants were included in our study. Hepatic steatosis was present in 63 % of our participants. The average age was 48.8 years, with 50 % being females. Patients who consumed at least 0.86 cup-equivalents of citrus fruits daily (adjusted odds ratio [aOR] 0.82, 95 % confidence interval [CI] (0.71, 0.94), p = 0.004) had lower odds of having hepatic steatosis, whereas intake of fruit juice and non-citrus fruits was not statistically significantly associated with hepatic steatosis.
Citrus fruit consumption was associated with reduced odds of having hepatic steatosis in this U.S. adult population. Additional investigations into the pathophysiology, as well as longitudinal studies, are required to understand this relationship further and establish causality.