Late eating is associated with a higher risk of metabolically related fatty liver disease and cirrhosis, according to an analysis of data from 199,155 people. The results are published in the journal Clinical Gastroenterology and Hepatology.
The study included participants from three long-term US health studies - the Nurses' Health Study, the Nurses' Health Study II and the Health Professionals Follow-up Study. The average age of the people in the analysis was 59 years, and the follow-up lasted an average of 16 years.
Higher risk for eating after dinner
Late eating was defined as eating after dinner or after your usual bedtime. People who reported this habit had a 28% higher risk of cirrhosis compared to participants who did not eat late. The risk of metabolically related fatty liver disease was 36% higher.
Metabolically related fatty liver disease is characterized by the accumulation of fat in the liver. In some patients, it can be followed by inflammation, scarring, and the development of cirrhosis.
The analysis took into account a number of factors, including age, body weight, daily calorie intake, diabetes, lipid profile disorders, smoking, physical activity, alcohol use, and quality of nutrition. The relationship between late eating and liver disease remained even after their inclusion in the statistical model.
The study does not prove a cause-and-effect relationship
The authors emphasize that the study is observational. The dietary habits were self-reported, and the results suggest a link between the two phenomena, but do not prove that late eating per se causes fatty liver disease or cirrhosis.
According to lead author Robert Willechanski, MD, a hepatologist at Oregon Health & Science University, “restricting caloric intake to a few hours before bedtime may be beneficial.” He notes that a small proportion of people with fatty liver disease develop serious complications such as cirrhosis.
The researchers suggest that a possible explanation is disruption of the circadian rhythm – the internal biological clock that regulates sleep, wakefulness and some metabolic processes. The liver also follows a circadian rhythm, so eating at night may affect how the body processes food.
The team is preparing a clinical trial that will directly track eating behavior and test whether eating earlier leads to changes in medical indicators in people with fatty liver disease. This data will be needed to determine whether changing the time of eating can have an independent effect on liver health.