The association between total, animal, and plant protein intake and metabolic dysfunction-associated fatty liver disease in overweight and obese children and adolescents.

Background: Dietary protein plays a crucial role in the growth and development of children and adolescents. However, recent evidence has shown inconsistent findings regarding the impact of dietary protein sources on health outcomes. This study aimed to investigate the association between total, animal, and plant protein intake and the odds of metabolic dysfunction-associated fatty liver disease (MAFLD) in overweight and obese children and adolescents.

Methods: This cross-sectional study included 505 participants (52.9% males) aged 6-18 years, with a body mass index (BMI)-for-age z-score ≥ 1 based on WHO standards. MAFLD diagnosis followed established consensus definitions. Dietary intake of total, animal, and plant protein was assessed using a validated 147-item food frequency questionnaire. Adjusted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for MAFLD across protein intake and subtype quartiles.

Results: The participants had a mean age of 10.0 ± 2.3 years and a mean BMI-for-age z-score of 2.70 ± 1.01. Higher animal protein intake was significantly associated with an increased likelihood of MAFLD (highest vs. lowest quartile OR: 2.31; 95% CI: 1.01-5.30). Conversely, higher plant protein intake was significantly associated with reduced odds of MAFLD (highest vs. lowest quartile OR:0.48;95% CI:0.23-0.96). No significant relationship was found between total protein intake and MAFLD odds.

Conclusions: Our findings highlight the significance of dietary protein source in the odds of MAFLD among overweight and obese children and adolescents. Further studies are warranted to confirm these findings and explore the underlying mechanisms.