The Impact of Ultra-Processed Foods on Dietary Patterns in Patients with Metabolic Dysfunction–Associated Steatotic Liver Disease

Abstract Background : Ultra-processed foods (UPFs) are industrial formulations characterized by a high processing with the addition of food additives. Consumption of UPFs has been associated with adverse metabolic outcomes, including metabolic dysfunction-associated steatotic liver disease (MASLD). Lifestyle changes, including weight loss combined with caloric restrictions are central therapeutic strategies for metabolic control, qualitative dietary modifications may be crucial for the management of MASLD. Objectives : to determine the prevalence of UPFs consumption among patients with MASLD in outpatient follow-up and to assess its contribution to energy intake. Patients and Methods : This cross-sectional study included patients diagnosed with MASLD, who were followed at a hepatology outpatient clinic. Sociodemographic, clinical, and anthropometric data were collected. Dietary intake was assessed using three 24-hour dietary recalls and classified according to NOVA system to quantify the contribution of UPFs to total caloric and nutrient intake. Results : Ninety-seven patients with MASLD were evaluated, women (78.4%), with a high frequency of obesity (60.8%), type 2 diabetes (52.6%), and systemic arterial hypertension (SAH) (56.7%). UPFs consumption ranged from 0.0% to 41.0% of total caloric intake. Higher UPF consumption was associated with lack of paid employment, whereas lower UPFs consumption was associated with the presence of type 2 diabetes (p < 0.05). Carbohydrates, total fats, and proteins derived from UPFs showed a strong positive correlation with caloric intake, with carbohydrates representing the main energy source. Conclusions : Consumption of UPFs was relevant in this sample of patients with MASLD, with energy intake derived from carbohydrates and total fats.