Previously known as non-alcoholic fatty liver disease, MASLD is a rising public health concern that presently affects around 30% of the world's population. This percentage is expected to increase to 55.7% by 2040, which is concerning. In addition to developing cirrhosis and hepatocellular carcinoma, people with MASLD are especially vulnerable to extrahepatic consequences such type 2 diabetes, cardiovascular disease (CVD), chronic renal disease, and extrahepatic malignancies. However, there is now just one medication licensed for MASLD, resmetirom. Thus, prevention and early identification of cirrhosis, HCC, and modifiable risk factors for MASLD remain top public health priorities.
Adding salt to meals has been positively linked to a number of diseases and death, making it a unique indication for researching habitual sodium consumption. On the other hand, not much is known regarding its connection to liver-related conditions. This study looked at the relationships between the risks of cirrhosis, hepatocellular carcinoma (HCC), and MASLD and the addition of salt to meals.
A total of 4,92,265 people from the UK Biobank who did not have any common liver disorders at baseline were included in this prospective cohort research. Electronic health records were used to identify incident liver-related diseases, and a self-reported query was used to gather the frequency of adding salt to diets. Hazard ratios (HRs) and 95% CIs for the results were estimated using multivariable Cox proportional hazard models.
There were 413 HCC cases, 5,546 cirrhosis cases, and 7,005 incident MASLD patients with a median follow-up of 13 years. The HRs (95% CIs) of MASLD throughout the increasing frequency of incorporating salt into 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, after controlling for sociodemographic characteristics, lifestyle factors, personal history of diseases, and dietary factors.
Adiposity was a contributing factor in this connection. Additionally, the same favorable correlations between HCC and cirrhosis were identified. Overall, higher incidences of cirrhosis, HCC, and MASLD were linked to more frequent salt additions to meals. According to these results, cutting back on salt and sodium consumption may be a good way to avoid liver-related illnesses.
Source:
Zhang, S., Huo, Z., Borné, Y., Sonestedt, E., & Qi, L. (2025). Adding salt to foods and risk of metabolic dysfunction-associated steatotic liver disease and other chronic liver diseases. European Journal of Nutrition, 64(5), 224. https://doi.org/10.1007/s00394-025-03745-3
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