This cross-sectional study investigated how different sources of dietary protein relate to the odds of metabolic dysfunction-associated fatty liver disease (MAFLD) in 505 overweight or obese Iranian children and adolescents aged 6–18 years. Dietary intake was assessed via a validated 147-item food frequency questionnaire, and MAFLD was diagnosed using ultrasonography in accordance with international consensus criteria.
Results showed that higher animal protein intake was significantly associated with increased odds of MAFLD (highest vs. lowest quartile OR: 2.31; 95% CI: 1.01–5.30), even after adjusting for confounders such as age, sex, BMI-for-age z-score, and dietary energy intake. Conversely, higher plant protein intake was associated with reduced odds of MAFLD (highest vs. lowest quartile OR: 0.48; 95% CI: 0.23–0.96). No significant association was found for total protein intake.
The findings highlight the importance of protein source quality in pediatric dietary guidance. Shifting toward higher plant protein consumption and moderating animal protein intake may reduce MAFLD risk among overweight and obese youth.