Dietary Anthocyanin Intake and Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease: Results from the NUTRIHEP Study

Background: MASLD is characterised by chronic inflammation and oxidative stress, which contribute to disease progression. Currently, no effective pharmacological treatment is available, and the first-line treatment remains lifestyle modification, including dietary changes and physical activity. This study aimed to assess the effect of dietary antioxidants, anthocyanins, on the risk of MASLD in a cohort from Southern Italy. Methods: The sample of this study comprised 1, 297 individuals aged between 54 and 64 years from a larger cohort, the NUTRIHEP study cohort. Data on anthocyanin intake were collected using a food-frequency questionnaire. MASLD is diagnosed when fatty liver disease is present in conjunction with at least one cardiometabolic risk factor. Results: Anthocyanin intake was inversely associated with MASLD risk. In Model b, adjusted for adjusted for age, sex, Fasting Glucose, Triglycerides, Diastolic Blood Pressure, Job, Alcohol consumption (g/day), daily energy intake, adherence to the Relative Mediterranean Diet (rMED), Available Carbohydrates, fibre intake, the third quartile (Q3) and the highest intake group (Q4) of anthocyanins showed a negative correlation with MASLD. Analysis of Anthocyanin intake as a continuous variable showed a modest negative association with MASLD risk (OR = 0.990, 95% CI 0.989–0.999), suggesting that higher anthocyanin intake may slightly lower the risk of MASLD. Conclusions: Our study highlights the protective effects of dietary anthocyanins against MASLD. These findings confirm the potential preventive role of dietary polyphenols in MASLD and identify anthocyanins as novel targets for intervention.