Global structural determinants of MASLD: Development-stratified pathways linking food systems, metabolic risk, and liver outcomes

JHEP Reports 2026 Open access

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Authors: James M. Paik, Markos Kalligeros, Shira Zelber-Sagi, Annette Paik, Saleh A. Alqahtani, Zobair M. Younossi
DOI: 10.1016/j.jhepr.2026.101888
Cited by: 3
References: 22

Abstract

BACKGROUND & AIMS: Structural features of national food systems shape metabolic risk, yet their pathways to metabolic dysfunction-associated steatotic liver disease (MASLD) across development levels remain poorly characterized. We examined food-system pathways to MASLD prevalence and liver-related mortality across 204 countries. METHODS: A cross-national ecological study harmonized data from the Global Burden of Disease study, NCD Risk Factor Collaboration, and FAOSTAT. Exposures were anchored to 2005-2011, metabolic mediators to 2013-2015, MASLD prevalence to 2019-2021, and liver mortality to 2023. Countries were stratified by Socio-Demographic Index (SDI; low

Fields of Study & Subjects

Liver Disease Diagnosis and Treatment Nutritional Studies and Diet Food Security and Health in Diverse Populations

Publication details

Journal / source
JHEP Reports
Publisher
Elsevier BV
Volume
8
Issue
8
Pages
101888–101888
Publication date
5 May 2026
Language
EN