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Adding salt to foods and risk of metabolic dysfunction-associated steatotic liver disease and other chronic liver diseases

Zhang, Shunming LU ; Huo, Zhenyu ; Borné, Yan LU ; Sonestedt, Emily LU orcid and Qi, Lu (2025) In European Journal of Nutrition 64(5). p.1-14
Abstract

PURPOSE: Adding salt to foods, a novel indicator for studying habitual sodium intake, has been positively associated with multiple diseases and mortality. However, little is known about its association with liver-related disorders. This study aimed to investigate the associations of adding salt to foods with risks of metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, and hepatocellular carcinoma (HCC).

METHODS: This prospective cohort study included 492,265 participants from the UK Biobank without prevalent liver diseases at baseline. The frequency of adding salt to foods was collected using a self-reported question, and incident liver-related disorders were identified through electronic health records.... (More)

PURPOSE: Adding salt to foods, a novel indicator for studying habitual sodium intake, has been positively associated with multiple diseases and mortality. However, little is known about its association with liver-related disorders. This study aimed to investigate the associations of adding salt to foods with risks of metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, and hepatocellular carcinoma (HCC).

METHODS: This prospective cohort study included 492,265 participants from the UK Biobank without prevalent liver diseases at baseline. The frequency of adding salt to foods was collected using a self-reported question, and incident liver-related disorders were identified through electronic health records. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the outcomes.

RESULTS: Over a median follow-up of 13 years, 7,005 incident MASLD cases, 5,546 cirrhosis cases, and 413 HCC cases occurred. After adjusting for sociodemographic characteristics, lifestyle factors, personal history of diseases, and diet factors, the HRs (95% CIs) of MASLD across the increasing frequency of adding salt to foods were 1.00 (reference) for never/rarely, 1.08 (1.02, 1.14) for sometimes, 1.22 (1.13, 1.31) for usually, and 1.40 (1.27, 1.53) for always, with a P for trend < 0.0001. Such association was partly driven by adiposity. Also, similar positive associations were observed for cirrhosis and HCC.

CONCLUSIONS: A higher frequency of adding salt to foods was associated with increased risks of MASLD, cirrhosis, and HCC. Reducing adding salt to foods at the table could be included in public health initiatives to promote liver health.

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Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Nutrition
volume
64
issue
5
article number
224
pages
1 - 14
publisher
Springer
external identifiers
  • pmid:40542866
ISSN
1436-6215
DOI
10.1007/s00394-025-03745-3
language
English
LU publication?
yes
additional info
© 2025. The Author(s).
id
e76f38b2-a218-4971-9513-a1600e77ce3f
date added to LUP
2025-06-23 17:08:23
date last changed
2025-06-24 07:56:16
@article{e76f38b2-a218-4971-9513-a1600e77ce3f,
  abstract     = {{<p>PURPOSE: Adding salt to foods, a novel indicator for studying habitual sodium intake, has been positively associated with multiple diseases and mortality. However, little is known about its association with liver-related disorders. This study aimed to investigate the associations of adding salt to foods with risks of metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, and hepatocellular carcinoma (HCC).</p><p>METHODS: This prospective cohort study included 492,265 participants from the UK Biobank without prevalent liver diseases at baseline. The frequency of adding salt to foods was collected using a self-reported question, and incident liver-related disorders were identified through electronic health records. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the outcomes.</p><p>RESULTS: Over a median follow-up of 13 years, 7,005 incident MASLD cases, 5,546 cirrhosis cases, and 413 HCC cases occurred. After adjusting for sociodemographic characteristics, lifestyle factors, personal history of diseases, and diet factors, the HRs (95% CIs) of MASLD across the increasing frequency of adding salt to foods were 1.00 (reference) for never/rarely, 1.08 (1.02, 1.14) for sometimes, 1.22 (1.13, 1.31) for usually, and 1.40 (1.27, 1.53) for always, with a P for trend &lt; 0.0001. Such association was partly driven by adiposity. Also, similar positive associations were observed for cirrhosis and HCC.</p><p>CONCLUSIONS: A higher frequency of adding salt to foods was associated with increased risks of MASLD, cirrhosis, and HCC. Reducing adding salt to foods at the table could be included in public health initiatives to promote liver health.</p>}},
  author       = {{Zhang, Shunming and Huo, Zhenyu and Borné, Yan and Sonestedt, Emily and Qi, Lu}},
  issn         = {{1436-6215}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{5}},
  pages        = {{1--14}},
  publisher    = {{Springer}},
  series       = {{European Journal of Nutrition}},
  title        = {{Adding salt to foods and risk of metabolic dysfunction-associated steatotic liver disease and other chronic liver diseases}},
  url          = {{http://dx.doi.org/10.1007/s00394-025-03745-3}},
  doi          = {{10.1007/s00394-025-03745-3}},
  volume       = {{64}},
  year         = {{2025}},
}