ABSTRACT Objective: Existing evidence suggests a potential association between coffee consumption and Non-alcoholic fatty liver disease (NAFLD，now known as MASLD), yet the nature of this relationship remains ambiguous. The primary objective of this study was to comprehensively investigate and clarify the association between coffee intake and the occurrence of NAFLD. Design: A cross-sectional study design was employed, analyzing data from NHANES(National Health and Nutrition Examination Survey,NHANES) spanning from 2013 to 2018. Weighted univariate and multivariate logistic regression models were utilized to assess the relationship between coffee consumption and NAFLD. RCS analysis was conducted to explore any potential nonlinear associations. Forest plots were generated to visualize the impact of coffee consumption on NAFLD across different subgroups, and threshold effect analysis was performed to evaluate the nonlinear relationship between coffee consumption and NAFLD prevalence specifically in women. Setting: Data were from the US - representative NHANES. Participants: 8062 subjects aged ≥20 years were included. Results: The weighted prevalence of NAFLD among the participants was 44.18%. After controlling for confounding variables, coffee consumption was found to be negatively associated with the risk of NAFLD (OR = 0.96, 95%CI: 0.94, 0.99). The association between coffee consumption and NAFLD was observed to vary by gender and education level. For the prevention of NAFLD in women, the optimal coffee intake was determined to be 2 cups. Conclusions: Increasing coffee intake emerges as a potentially effective non-pharmacological strategy for the prevention and management of NAFLD. Notably, for women, consuming 2 cups of coffee appears to represent the optimal threshold for maximizing this beneficial effect.
Chen et al. (2026) studied this question.