Higher Healthy Lifestyle Score is associated with lower presence of non-alcoholic fatty liver disease in middle-aged and older Chinese adults: a community-based cross-sectional study

Abstract

Objective: Previous studies have reported inverse associations between certain healthy lifestyle factors and Non-alcoholic fatty liver disease (NAFLD), but limited evidence showed the synergistic effect of those lifestyles. This study examined the relationship of a combination of lifestyles, expressed as Health Lifestyle Score (HLS), with NAFLD. Design: A community-based cross-sectional study. Questionnaires and body assessments were used to collect data on the 6-item HLS (ranging from 0-6, where higher scores indicate better health). The HLS consists of non-smoking (no active or passive smoking), normal BMI (18.5-23.9 kg/m2), physical activity (moderate or vigorous physical activity ≥ 150 min/week), healthy diet pattern, good sleep (no insomnia or < 6 months), and no anxiety (Self-rating Anxiety Scale < 50), one point each. NAFLD was diagnosed by ultrasonography. Setting: Guangzhou, China. Participants: 2981 participants aged 40-75 years. Results: The overall prevalence of NAFLD was 50.8%. After adjusting for potential covariates, HLS was associated with lower presence of NAFLD. The ORs (95% CI) of NAFLD for subjects with higher HLS (3, 4, 5-6 vs. 0-1 points) were 0.68 (0.51,0.91), 0.58 (0.43,0.78) and 0.35 (0.25,0.51), respectively (P-values < 0.05). Among the 6 items, BMI and physical activity were the strongest contributors. Sensitivity analyses showed that the association was more significant after weighting the HLS. The beneficial association remained after excluding any one of the 6 components or replacing BMI with waist circumference. Conclusion: Higher HLS was associated with lower presence of NAFLD, suggesting that a healthy lifestyle pattern might be beneficial to liver health.

Insomnia Promotes Hepatic Steatosis in Rats Possibly by Mediating Sympathetic Overactivation

“…Therefore, that is one reason short sleep duration is associated with diabetes, obesity, and fatty liver. Consistent results have also been found in a population-based observational study, showing that good sleep is associated with lower presence of NAFLD (Deng et al, 2021). However, the mechanisms for this result remain unclear.…”

Effect of healthy lifestyle index and lifestyle patterns on the risk of mortality: A community-based cohort study

“…In addition, this study also considered sleep quality and mental status, as they were important elements affecting the occurrence and death of chronic diseases ( 20 , 35 – 38 ). Consistently, other studies on the combined or overall effects of lifestyle factors had also highlighted the contribution of sleep condition ( 9 , 10 , 13 , 39 ) and mental status ( 9 , 10 ). Our study found that both moderate level (3–5 score) and high level (6–7 score) of HLI decreased the risk of all-cause mortality, which was consistent with many other studies ( 13 , 34 , 39 ).…”

“…However, we found that combined healthy lifestyle factors decreased the risk of all-cause mortality. The possible reason for such discrepancies may be that when multiple lifestyle factors were combined, the synergistic effect of various components might be greater than the effect of each component ( 9 ). This further demonstrates the critical importance of considering a variety of healthy lifestyles when maintaining and promoting health.…”

A healthy lifestyle during adolescence was inversely associated with fatty liver indices in early adulthood: findings from the DONALD cohort study

“…To the best of our knowledge, there is no previous epidemiological study investigating this hypothesis in a longitudinal design covering associations in adolescence and young adulthood. Studies in adults combined between four and six lifestyle factors, whereby all studies included anthropometric markers (BMI or waist circumference), PA, smoking, and diet or dietary factors (15)(16)(17) . One study additionally included sleeping habits and anxiety neurosis (15) .…”

“…A lifestyle score can be created to combine a number of lifestyle factors in one variable with higher scorings relating to more favourable behaviour. Indeed, several studies showed inverse associations between a healthy lifestyle score and NAFLD risk in adult populations (15)(16)(17) . In addition, some studies have investigated single lifestyle factors and indicators of NAFLD in adolescents such as insulin resistance (18) or increased liver enzyme activities (19) .…”