Consuming meals or snacks late into the evening may increase a person’s risk of developing serious liver conditions, according to a long-term observational study published in the journal Clinical Gastroenterology and Hepatology.
Researchers from Oregon Health & Science University and Massachusetts General Hospital evaluated data from 199,155 adults enrolled across three major U.S. health investigations: the Nurses’ Health Study, the Nurses’ Health Study II, and the Health Professionals Follow-up Study. The participants, who had a median age of 59, tracked their dietary patterns and lifestyle routines on questionnaires submitted every two to four years.
Disrupting the Liver’s Internal Clock
Over a median follow-up period of 16 years, individuals who regularly ate between dinner and bedtime or after going to bed showed a 20 percent to 30 percent higher overall risk of liver disease compared to those who avoided eating late. When looking at specific diagnoses, late-night eaters experienced a 36 percent higher risk of metabolic dysfunction-associated steatotic liver disease, commonly called fatty liver disease, and a 28 percent higher risk of cirrhosis, ScienceAlert reported.
Fatty liver disease occurs when surplus fat accumulates in liver tissue and currently affects up to 30 percent of the U.S. population, according to Science Daily. Although severe progression remains infrequent—cirrhosis was identified in 315 of the nearly 200,000 individuals evaluated—extensive scarring can eventually trigger organ failure.
Investigators pointed to circadian rhythms, the 24-hour biological cycles guiding sleep and metabolism, as a primary driver of the connection. The liver maintains its own internal timekeeping, handling nutrients, balancing blood glucose, and regulating energy storage. Digesting calories late at night, when the body prepares for rest, can reduce insulin sensitivity and impair fat processing.
“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,” said lead study author Dr. Robert Wilechansky, a hepatologist at OHSU.
Simple Timing Adjustments Over Strict Diets
Co-author Andrew McHill, an associate professor of sleep and circadian physiology at OHSU, noted that biological clocks significantly dictate how calories are metabolized. Processing food during the biological night can decrease energy utilization and worsen metabolic markers, McHill said.
The study adjusted for several confounding health variables, such as body mass index, age, and physical exercise. Nevertheless, researchers emphasized that the findings cannot prove direct causation. The research was observational and relied on self-reported food timelines rather than strictly logged meal items, while sleep quality and precise sleep schedules were not examined in the data.
The research received funding from the American Association for the Study of Liver Diseases Foundation. Looking forward, Wilechansky and his colleagues at OHSU have begun recruiting participants for a clinical trial that will directly control and monitor meal times to determine if restricting food intake earlier in the day produces measurable improvements for patients with fatty liver disease.
