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. 2025 Apr 18;25(1):270.
doi: 10.1186/s12876-025-03834-x.

Association between non-skimmed milk consumption and metabolic dysfunction-associated fatty liver disease in US adults: insights from NHANES data

Futao Wu  1 , Fuying Zheng  1 , Xue Li  1 , Danzhu Wu  1 , Honghao Li  1   2 , Yingyi Zeng  1 , Yan Tang  1 , Side Liu  3   4 , Aimin Li  5
Affiliations

Association between non-skimmed milk consumption and metabolic dysfunction-associated fatty liver disease in US adults: insights from NHANES data

Futao Wu et al. BMC Gastroenterol. .

Abstract

Purpose: Previous studies on the association between non-skimmed milk consumption and non-alcoholic fatty liver disease (NAFLD) have reported inconsistent findings, with some suggesting an increased risk and others indicating a protective effect. Moreover, as the research focus has shifted globally from NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD), there remains limited evidence on the relationship between non-skimmed milk consumption and MAFLD. The objective of this cross-sectional study was to investigate this association using data from the National Health and Nutrition Examination Survey (NHANES).

Methods: In this U.S. population-based study, adults with complete information on non-skimmed milk consumption and MAFLD diagnosis from the 2017-March 2020 Pre-Pandemic NHANES were included. MAFLD was defined using the controlled attenuation parameter (CAP). The association between non-skimmed milk consumption and MAFLD was assessed using weighted multivariable logistic regression, adjusting for potential confounders. Subgroup and sensitivity analyses were conducted to evaluate effect modifications and robustness.

Results: The study involved 3,758 participants in total, 1,423 (37.87%) of whom had MAFLD according to the diagnosis. Frequent non-skimmed milk consumption was independently associated with higher MAFLD risk. Compared to the "Rarely" group (< 1 time/week), the "Sometimes" group (≥ 1 time/week but < 1 time/day) had an odds ratio (OR) of 1.67 (95% CI: 1.32-2.12, P = 0.004), and the "Often" group (≥ 1 time/day) had an OR of 1.36 (95% CI: 1.06-1.75, P = 0.046). Stratified analysis revealed that the association was significantly modified by education level (P for interaction = 0.010), with a stronger association observed among participants with higher education levels. Sensitivity analysis yielded consistent results, further supporting the robustness of the association.

Conclusion: Our findings suggest a significant association between frequent non-skimmed milk consumption and risk of MAFLD, particularly in highly educated individuals. These results highlight the importance of dietary modifications, specifically reducing non-skimmed milk intake, as a potential preventive strategy for MAFLD, especially in high-risk populations.

Keywords: Cross-sectional study; MAFLD (metabolic dysfunction-associated fatty liver disease); NHANES; Non-skimmed milk consumption.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The NHANES received institutional review board approval from the National Center for Health Statistics in accordance with the Declaration of Helsinki and all participants provided written informed consent before data collection. According to our institutional policy, research using legally obtained public databases for observational studies is exempt from ethical review. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of participant selection
Fig. 2
Fig. 2
Forest plots of subgroup analysis: association between non-skimmed milk consumption frequency and MAFLD in Model 3
See this image and copyright information in PMC

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