Study Links Late-Night Snacking to Liver Disease Risks

Rethinking those midnight fridge raids might be necessary: a recent study has revealed a connection between late-night snacking and two liver diseases, cirrhosis and metabolic dysfunction-associated steatotic liver disease (MASLD).

Published in Clinical Gastroenterology and Hepatology, this extensive research involved data from 199,155 participants with a median age of 59. These individuals are part of ongoing health studies and provide food and lifestyle information every few years.

The research team, from Oregon Health and Science University and Massachusetts General Hospital, discovered that those who eat late at night have a 28 percent higher risk of developing cirrhosis and a 36 percent greater risk of MASLD compared to those who maintain regular eating hours.

Late-night eating was classified as consuming food “after bedtime” or “between dinner and bedtime.”

To put this risk in context, though, cirrhosis is still relatively rare, with only 315 cases identified among almost 200,000 participants during the study period.

The researchers suggest our circadian rhythms—the internal cycles that synchronize our bodies with day and night—might help explain this association.

“Some earlier studies have pointed to this idea, but this one takes a long-term look and clearly connects it to fatty liver disease,” explains hepatologist Robert Wilechansky from OHSU.

“We understand that the liver is closely aligned with circadian rhythms. So, we’re interested in how adjusting meal times could positively influence health without altering what people consume.”

The median follow-up for the study was about 16 years, and even after accounting for factors like age, body mass index (BMI), and physical activity, the late-night eating connection remained significant.

While this study doesn’t establish direct causation—and other factors like sleep patterns weren’t considered—it suggests that the body’s digestive processes at night might contribute to these problems.

Our bodies have multiple circadian clocks, and the liver keeps its own time while linking to the overall circadian rhythms. It’s possible that late-night food intake doesn’t allow the liver to function at its best, potentially leading to fat accumulation and elevated blood sugar levels, though more investigation is necessary.

The findings add to existing literature connecting late-night eating patterns with negative metabolic and liver health outcomes. “This relationship is biologically plausible; higher calorie intake in the evening might contribute to obesity and metabolic issues due to decreased insulin sensitivity,” the researchers note in their published paper.

Future studies could delve deeper into what types of late-night snacks are consumed, as this analysis tracked the timing but not the actual snacks. They might also measure blood sugar levels and liver fat more directly.

A team from OHSU, including Wilechansky, is already working on a more extensive clinical trial.

The effects of eating late in the evening on liver health deserve to be explored further in varied populations, considering liver imaging and disease severity indicators. “If these results are confirmed, they could significantly influence dietary recommendations for managing chronic liver disease,” the researchers conclude.

MASLD, known as fatty liver disease, occurs when metabolic conditions lead to fat accumulation in the liver. If severe enough, it can cause scarring, resulting in cirrhosis, which can severely damage the liver and cause it to fail.

Understanding how these conditions develop could enhance prevention and treatment strategies. Perhaps a simple change in eating times might lower liver disease risks—much easier to manage than a strict diet or exercise plan.

“Time management in behaviors such as sleep, eating, and exercise is crucial,” notes sleep and circadian physiologist Andrew McHill from OHSU.

The research has been published in Clinical Gastroenterology and Hepatology.