Inadequate Physical Activity and Sedentary Behavior Are Independent Predictors of Nonalcoholic Fatty Liver Disease

Abstract

Background and Aims In general, physical activity (PA) and nonalcoholic fatty liver disease (NAFLD) have an inverse association. However, studies assessing the impact of the widely accepted Physical Activity Guidelines for Americans (PA Guidelines) on NAFLD are lacking. Approach and Results We performed a serial, cross‐sectional analysis among adults by using the 2007‐2016 US National Health and Nutrition Examination Survey. NAFLD and advanced fibrosis were defined by using various noninvasive panels. A PA questionnaire assessed the leisure‐time PA, occupation‐related PA, transportation‐related PA, and total sitting time as sedentary behavior. PA was categorized according to the PA Guidelines. Of the 24,588 individuals (mean age, 47.4 years; 47.9% males), leisure‐time PA (≥150 minutes per week) demonstrated 40% lower odds of NAFLD, whereas transportation‐related PA was associated with a 33% risk reduction in NAFLD. Analysis of total PA and sitting times simultaneously showed a dose‐response association between sitting time and NAFLD (P for trend < 0.001). Compliance with the PA Guidelines was lower in individuals with NAFLD versus those without NAFLD. The trends in compliance with the PA Guidelines for any type of PA remained stable in individuals with NAFLD except for a downtrend in transportation‐related PA. In contrast, an improvement in compliance with the PA Guidelines for leisure time was noted in the cohort without NAFLD. Although PA demonstrated a 10% stronger association with risk reduction of NAFLD in women, women showed a lower tendency of meeting the PA Guidelines. Trends in total sitting time increased significantly regardless of NAFLD status. Conclusions Sedentary behavior emerged as an independent predictor of NAFLD. Overall compliance with the PA Guidelines was lower in the cohort with NAFLD, with sex‐ and ethnicity‐based differences. Implementation of these observations in clinical practice may improve our understanding as well as clinical outcomes.

Unhealthy lifestyle habits and physical inactivity among Asian patients with non‐alcoholic fatty liver disease

“…We also identified lifestyle factors were associated with hepatic steatosis and fibrosis. Compared with previous studies, 16,26,27 the current study compares lifestyle habits of real‐world NAFLD patients from different countries and regions. While the lifestyle habits vary across regions, inadequate PA was observed consistently in all participating sites.…”

“…factors were associated with hepatic steatosis and fibrosis. Compared with previous studies, 16,26,27 the current study compares lifestyle habits of real-world NAFLD patients from different countries and regions.…”

The nonalcoholic steatohepatitis (NASH) drug development graveyard: established hurdles and planning for future success

“…Thus, NASH is more closely related to 'metabolic obesity' than to body weight [6]. Risk factors for NASH include excessive intake of calorie-dense food, reduced physical activity and exercise, and genetic susceptibility [7].…”

Evaluation and management of extrahepatic manifestations of nonalcoholic fatty liver disease

“…Further work has shown that more than 3 cups of coffee per day is associated with a lower risk of CVD and risk of death post-myocardial infarction. (20, 34- 36) Inadequate physical activity or sedentary lifestyle is a risk factor associated with NAFLD and CVD (37)(38)(39). A recent US population-based study showed that the prevalence of meeting the physical activity guidelines (≥150 minutes/week) was markedly higher in subjects without NAFLD than those with NAFLD, which was mostly attributable to the higher prevalence of leisure-time physical activity in those without NAFLD (37).…”

“…(20, 34- 36) Inadequate physical activity or sedentary lifestyle is a risk factor associated with NAFLD and CVD (37)(38)(39). A recent US population-based study showed that the prevalence of meeting the physical activity guidelines (≥150 minutes/week) was markedly higher in subjects without NAFLD than those with NAFLD, which was mostly attributable to the higher prevalence of leisure-time physical activity in those without NAFLD (37). Physical activity is a proven therapeutic strategy to improve liver fat content, insulin resistance, and decrease the risk of CVD.…”