Lonardo Amedeo, Zheng Ming-Hua, Weiskirchen Ralf
Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Modena (-2023), Modena, Italy.
MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Expert Rev Gastroenterol Hepatol. 2025 Sep;19(9):1033-1049. doi: 10.1080/17474124.2025.2545812. Epub 2025 Aug 12.
Food insecurity, the household-level socio-economic condition of having limited or uncertain ability to acquire adequate and safe food, has affected 13.8 million households in the United States in 2020 and is a cofactor in the onset and worsening of metabolic dysfunction-associated steatotic liver disease (MASLD).
To illustrate the epidemiological evidence linking MASLD with food insecurity, and the potential pathobiological mechanisms underlying their association we searched the PubMed, Web of Science, and Scopus database from inception to April 2025 for relevant keywords pertaining to the topic. Finally, we discuss promising areas of future research in this field.
Research on food insecurity contributes to the establishment of the biopsychosocial disease model in the MASLD field. Understanding the broader sociocultural factors influencing food choices, which may disproportionately affect certain vulnerable populations, can help shift the focus from individual responsibility to a more comprehensive approach to addressing obesity-related metabolic dysfunction. Future studies should focus on quantifying descriptors of food insecurity more effectively. Additionally, further research is necessary to determine whether and to what extent global cultural advancements and specific education in food security can prevent and reverse the negative outcomes of food insecurity-associated MASLD.
粮食不安全是指家庭层面获取充足和安全食物的能力有限或不确定的社会经济状况，2020年在美国影响了1380万户家庭，是代谢功能障碍相关脂肪性肝病（MASLD）发病和恶化的一个辅助因素。
为了阐明将MASLD与粮食不安全联系起来的流行病学证据，以及它们之间关联的潜在病理生物学机制，我们在PubMed、科学网和Scopus数据库中从建库至2025年4月搜索了与该主题相关的关键词。最后，我们讨论了该领域未来有前景的研究方向。
对粮食不安全的研究有助于在MASLD领域建立生物心理社会疾病模型。了解影响食物选择的更广泛社会文化因素，这些因素可能对某些弱势群体产生不成比例的影响，有助于将关注点从个人责任转移到更全面地解决与肥胖相关的代谢功能障碍的方法上。未来的研究应更有效地关注粮食不安全描述指标的量化。此外，有必要进一步研究全球文化进步和粮食安全方面的特定教育是否以及在多大程度上能够预防和扭转与粮食不安全相关的MASLD的负面后果。
