Non-Skimmed Milk Consumption Linked to Increased MAFLD Risk

Frequent consumption of non-skimmed milk is associated with an increased risk of metabolic dysfunction-associated fatty liver disease (MAFLD), according to findings from a recent study.1

Leveraging National Health and Nutrition Examination Survey (NHANES) data, the study found those who reported drinking non-skimmed milk ≥ 1 time per week but < 1 time per day and ≥ 1 time per day had a greater risk of developing MAFLD, suggesting lower-fat alternatives may be helpful in preventing disease development.1

“Non-skimmed milk consumption is particularly relevant in the context of MAFLD due to its unique nutritional composition, including higher levels of saturated fats and bioactive compounds that may influence lipid metabolism, insulin resistance and liver fat accumulation,” Futao Wu, of the department of gastroenterology at Nanfang Hospital at Southern Medical University in China, and colleagues wrote.1 “These factors are central to MAFLD pathogenesis, necessitating investigation of its role in this condition.”

In the absence of pharmacologic treatment options for MAFLD, disease management has long relied on diet and exercise. Even with the FDA approval of resmetirom (Rezdiffra) as the first metabolic dysfunction-associated steatohepatitis treatment, diet continues to play a pivotal role in liver disease care.2 The Mediterranean diet is widely recommended for patients with MAFLD, underscoring the value of identifying modifiable dietary risk factors to prevent liver-related metabolic disorders and mitigate the growing burden of MAFLD.1

To assess the association between non-skimmed milk consumption and MAFLD, investigators conducted a cross-sectional study using NHANES data from the 2017-March 202 cycle. They identified participants ≥ 20 years of age with complete information on demographic characteristics, MAFLD diagnosis, milk consumption frequency and type, laboratory results, and Diet Behavior and Nutrition questionnaire responses.1

MAFLD was defined based on a controlled attenuation parameter (CAP) value ≥ 285 dB/m alongside the presence of ≥ 1 of the following metabolic criteria: type 2 diabetes, metabolic risk abnormalities, or overweight/obese status.1

In total, the study included 3758 participants, 1423 (37.87%) of whom had MAFLD. Among the cohort, the weighted mean age of the study population was 47.68 ± 0.72 years and the weighted percentage of male participants was 51.36% (95% CI, 48.87%–53.83%).1

In the NHANES Diet Behavior and Nutrition questionnaire, participants were asked to report their frequency of consuming milk products over the past 30 days, offering an estimate of their milk consumption habits. Consumption frequency was categorized as “Rarely,” defined as less than once per week, “Sometimes,” defined once or more per week but less than once per day, and “Often,” defined as once or more per day.1

Investigators noted the prevalence of MAFLD was significantly greater among participants with frequent non-skimmed milk consumption categorized as “Sometimes” (42.77%; 95% CI, 38.45%–47.09%) or “Often” (37.27%; 95% CI, 32.88%–41.66%) compared to those who consumed it “Rarely” (32.21%; 95% CI, 29.15%–35.26%).1

Further analysis revealed the frequency of non-skimmed milk consumption was significantly associated with the prevalence of MAFLD. Specifically, the “Sometimes” group exhibited a 67% greater risk of MAFLD than the “Rarely” group (odds ratio [OR], 1.67; 95% CI, 1.32–2.12; P = .004), an association that remained significant after Bonferroni correction for multiple testing (adjusted α = 0.025).1

In contrast, investigators pointed out the increased MAFLD risk observed in the “Often” group (OR, 1.36; 95% CI, 1.06–1.75; P = .046) did not retain significance after Bonferroni correction (P = .046 > .025).1

Subgroup analysis revealed education level significantly modified this relationship (P for interaction < 0.05), with a statistically significant association observed primarily among participants with an education level > high school. Among participants with an education level of > high school, those who sometimes consumed non-skimmed milk had a greater risk of MAFLD than those who rarely consumed it (OR, 1.89; 95% CI, 1.28–2.80), and those who often consumed non-skimmed milk had a similarly elevated risk (OR, 1.89; 95% CI, 1.24–2.88). In contrast, among participants with ≤ high school education, neither “Sometimes” nor “Often” consumption of non-skimmed milk was significantly associated with MAFLD risk.1

“These findings highlight the potential benefits of reducing non-skimmed milk consumption in MAFLD management, particularly in high-risk populations,” investigators concluded.1 “However, the slightly reduced risk observed in the high-intake group implies the involvement of complex physiological mechanisms, warranting further research to clarify the dose–response relationship and underlying pathways.”

References

1. Wu F, Zheng F, Li X, et al. Association between non-skimmed milk consumption and metabolic dysfunction-associated fatty liver disease in US adults: insights from NHANES data. BMC Gastroenterol. doi:10.1186/s12876-025-03834-x

2. Brooks A. Resmetirom (Rezdiffra) Receives Historic FDA Approval for Noncirrhotic NASH. HCPLive. March 14, 2024. Accessed April 24, 2025. https://www.hcplive.com/view/resmetirom-rezdiffra-receives-historic-fda-approval-for-noncirrhotic-nash