Late-night eating linked to higher risk of cirrhosis and fatty liver disease

A new analysis of data from 199,155 participants, with a median age of 59, indicates that eating after bedtime raises the risk of two serious liver conditions. The study, published in Clinical Gastroenterology and Hepatology, reported a 28% increase in cirrhosis risk and a 36% increase in metabolic dysfunction-associated steatotic liver disease (MASLD) among those who ate late at night compared with people who ate at more conventional times.

Researchers from Oregon Health and Science University and Massachusetts General Hospital tracked participants through health questionnaires completed every two to four years and followed them for a median of 16 years. Adjustments for age, body-mass index, physical activity and other factors did not eliminate the association.

"We know the liver is very much in tune with the body's circadian rhythms. So we're interested in changing the timing of eating in a way that could make a difference in health, without changing the composition of what people eat," said hepatologist Robert Wilechansky of OHSU.

The authors suggest that the body's internal clocks may make the liver less efficient at processing food late at night, potentially leading to increased fat accumulation and higher blood-sugar levels. While the study cannot prove causation and did not account for sleep timing or quality, the findings align with earlier research linking evening caloric intake to metabolic disturbances.

"The timing of behaviors, whether it's sleep, eating or exercise, really matters," added sleep and circadian physiologist Andrew McHill of OHSU.

The researchers call for further investigations, including clinical trials that examine the specific types of late-night snacks and incorporate liver imaging and disease-severity markers. Confirmation of these results could influence nutritional recommendations for chronic liver disease prevention and management.