O018 - LOW PROTEIN INTAKE IS ASSOCIATED WITH HIGHER PREVALENCE OF METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE IN OLDER ADULTS – RESULTS FROM THE BERLIN AGING STUDY II

O018

LOW PROTEIN INTAKE IS ASSOCIATED WITH HIGHER PREVALENCE OF METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE IN OLDER ADULTS – RESULTS FROM THE BERLIN AGING STUDY II

S. Janiszewski^1,*, D. Spira¹, J. Nikolov², K. Norman^2,3,4, I. Demuth^1,5, K. Mai^1,4,6,7,8, D. Soll^1,6

¹Endocrinology and metabolism, ²Geriatric medicine, Charité Universitätsmedizin Berlin, Berlin, ³Nutrition and Gerontology, German Institute for Human Nutrition , Potsdam Rehbrücke, ⁴partner site Berlin, DZHK (German Centre for Cardiovascular Research), ⁵BCRT - Berlin Institute of Health Center for Regenerative Therapies, Charité Universitätsmedizin Berlin, Berlin, ⁶German Center for Diabetes Research, München-Neuherberg, ⁷Nutrition Research, NutriAct-Competence Cluster , ⁸Department of Human Nutrition, German Institute of Human Nutrition, Berlin-Potsdam, Germany

Rationale: Metabolic dysfunction-associated steatotic liver disease (MASLD) is gaining global relevance due to its increasing prevalence and far-reaching effects on metabolism, especially in older adults. While weight loss and dietary modification are current treatment recommendations, little is known about associations with macronutrient composition in advanced age. This study investigates whether dietary patterns are associated with the prevalence and development of MASLD in older adults.

Methods: 1037 participants (60-80 years; n=539 females) of the Berlin Aging Study II (BASE-II) without relevant alcohol intake were analyzed at baseline (T0) and follow-up after 7.4 ± 1.5 years (T1; n=555). MASLD was diagnosed by a Fatty Liver Index (FLI) of ≥ 60 if ≥1 cardiometabolic risk factor was present. Food intake and physical activity (PA) were assessed using frequency questionnaires and a prospective 5-day dietary protocol.

Results: At T0, individuals with MASLD (n=314 (30.3%)) had higher BMI and daily calorie intake (2286 ± 786 vs. 2113 ± 641 [kcal/d]; p<0.001), as well as lower carbohydrate (41 ± 6  vs. 42 ± 5 [%E/d]; p<0.001) and protein intake (0.95 ± 0.33 vs. 1.06 ± 0.34 [g/kg/d]; p<0.001). The FLI correlated with lower protein intake (r=-0.19; p<0.001). Participants with new-onset MASLD at T1 (n=59) consumed less protein at T0 than participants without new-onset MASLD (n=332) (0.97 ± 0.34 vs. 1.07 ± 0.33 [g/kg/d]; p=0.04). Longitudinally, a decrease in protein intake over time was associated with an increase in FLI. The effects were independent of age, sex, and PA.

Conclusion: Dietary patterns play a crucial role in the prevalence and development of MASLD in older adults, while adequate protein intake may be particularly relevant for preventing MASLD in advanced age.

Disclosure of Interest: None declared