Nutrition journalSep 30, 2025

How daily meal frequency and overnight fasting relate to the risk of non-alcoholic fatty liver disease

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Apr 4, 2026

Abstract

Participants with (DEF) of 3 times or fewer had a 21% higher risk of (NAFLD).

DEF, defined as the number of times individuals eat throughout the day, was associated with NAFLD risk.
Individuals with DEF ≤ 3 times had an odds ratio of 1.21 for developing NAFLD compared to those with DEF > 4.5 times.
(NFD) refers to the time between the last and first meal of the day.
NFD of 14 hours or more was linked to a 26% increased likelihood of NAFLD relative to NFD of 10 hours or less.
The association between DEF and NAFLD risk was more pronounced in participants without type 2 diabetes and with low fibrosis risk.
The negative impact of NFD on NAFLD risk was particularly significant in individuals younger than 60 years.

Simplified

BACKGROUND: The understanding of (DEF) and (NFD) is limited. The aim of this research is to investigate the links between DEF, NFD, and (NAFLD).

METHODS: The research involved 11,153 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018. The evaluation of DEF and NFD was conducted through interviews focusing on dietary recalls spanning 24 h. DEF refers to the overall number of times individuals eat throughout the day, whereas NFD indicates the duration between the last and first meal of the day. The diagnosis of NAFLD was established through the application of the US fatty liver index (USFLI). A weighted logistic regression model investigated the connection between DEF, NFD, and NAFLD.

RESULTS: After full adjustment, participants with DEF ≤ 3 times exhibited a 21% higher risk of NAFLD than those with DEF > 4.5 times (OR = 1.21, 95% CI: 1.01-1.45). Similarly, individuals with NFD ≥ 14 h were 26% more likely to develop NAFLD than those with NFD ≤ 10 h (OR = 1.26, 95% CI: 1.04-1.53). The effect of DEF on NAFLD risk was more evident in participants without T2D and with low fibrosis risk, whereas the adverse impact of NFD was particularly pronounced among those younger than 60 years.

CONCLUSION: DEF below 3 times and NFD exceeding 14 h were significantly linked to a heightened risk of developing NAFLD.

Key numbers

21%

Increase in Risk with Low Eating Frequency

Participants with ≤ 3 times vs. > 4.5 times.

26%

Increase in Risk with Long Nighttime Fasting

Participants with ≥ 14 h vs. ≤ 10 h.

11,153 participants

Study Population Size

Total participants analyzed from NHANES.

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Funding

Competing interests

Declarations. Ethics approval and consent to participate: This study was reviewed and approved by the NCHS Ethics Review Board. The participants provided written informed consent to participate in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

PubMed

How daily meal frequency and overnight fasting relate to the risk of non-alcoholic fatty liver disease

Abstract

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