New research led by Oregon Health & Science University suggests you should think twice about indulging in a late-night snack if you'd like to preserve liver health.
The study, published today in the journal Clinical Gastroenterology and Hepatology, documents an increase in the correlation between people who reported late-night eating - defined as eating after dinner or after bedtime - and a heightened risk of two types of liver disease, metabolic dysfunction-associated steatotic liver disease and cirrhosis.
Previous research has associated late-night snacking with heart disease and obesity, but in the new study researchers set out to find a signal of liver disease in late-night eating.
"A few studies have hinted at this idea but this is among the first long-term analyses to explicitly draw the connection to fatty liver disease," said lead author Robert Wilechansky, M.D., a hepatologist at OHSU who specializes in liver transplantation.
Wilechansky noted that night shift workers grapple with misalignment of the body's natural day-night cycle, with elevated rates of obesity and heart disease. With as much as 30% of the U.S. population affected by fatty liver disease, he wondered whether small changes in timing meals might make a difference.
We know the liver is very much in tune with the body's circadian rhythms. So we're interested in changing the timing of eating in a way that could make a difference in health without changing the composition of what people eat."
Robert Wilechansky, M.D., hepatologist, OHSU
Researchers analyzed three large, preexisting nationwide datasets: the Nurses' Health Study, the Nurses' Health Study II, and the Health Professionals Follow-up Study. They extracted diet and lifestyle habits self-reported by almost 200,000 participants in all three studies, grouped them by eating behaviors, and then looked for correlations to people who reported fatty liver disease or cirrhosis.
They found a 20% to 30% increase in all forms of liver disease among the group of people who reported late-night eating compared to those who did not.
"It's important to remember, of the people who developed fatty liver disease, only a small fraction develop serious forms of the condition like liver cirrhosis," Wilechansky said. "Even so, the big take-away here is that confining your calorie intake to several hours before bedtime might be beneficial."
New clinical study
A co-author who studies circadian rhythms said the new study builds upon previous research revealing the importance of the body clock to overall health.
"We are seeing over and over again that the timing of behaviors, whether it's sleep, eating, or exercise, really matters," said co-author Andrew McHill, Ph.D., associate professor and sleep and circadian physiologist at OHSU. "For example, we have shown that eating during the night, when the internal biological clock is promoting sleep, reduces the ability of your body to metabolize foods as efficiently and can eventually lead to obesity, diabetes and now poor liver health."
He noted that previous research in animal models reveals the liver to be one of the organs most susceptible to misalignment in timing between eating and sleep.
Wilechansky cautions that the study is observational and based on broadly defined self-reported data, but it does provide a starting point for more research.
To that end, he is part of a team at OHSU recruiting for a study that will monitor eating behaviors directly and see whether eating earlier improves clinical measures of underlying fatty liver disease. The new study provides a starting point to put the findings to the test.
"Our findings add to the growing body of literature linking late-evening eating patterns to adverse metabolic and liver outcomes," the authors write.
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