Intrahepatic Fat Content and COVID-19 Lockdown in Adults with NAFLD and Metabolic Syndrome

Abstract

Background: COVID-19 lockdowns had a significant impact on people’s health, triggering levels of anxiety, perceived stress, and changes in food and nutritional status. Objectives: To assess the changes in dietary habits, metabolic syndrome (MetS) and liver parameters before and after the COVID-19 lockdown according to changes in intrahepatic fat content in adults with non-alcoholic fatty liver disease (NAFLD) and MetS. Design: Pre- and post-lockdown observation of the COVID-19 lockdown on fifty-nine 40–60-year-old participants with MetS and NAFLD, in a parallel group, randomised experiment intended to treat NAFLD. Methods: Anthropometrics, liver and MetS biochemical parameters, intrahepatic fat content by abdominal magnetic resonance imaging, and dietary assessment using a validated 148-item Food Frequency Questionnaire were collected pre-COVID-19 lockdown and post-lockdown. Results: COVID-19 lockdown led to negative changes in the liver of patients with NAFLD and MetS, with weight gain and increases in glycemia, ALT and intrahepatic fat content post lockdown. Participants with worsened liver status had low consumption of fibre, cheese, nuts and coffee, and high consumption of sweets and pastries. Participants who improved liver status ameliorated ALT values, waist circumference, and intrahepatic fat content, assessed by magnetic resonance imaging post-lockdown. Conclusions: The maintenance of healthy lifestyle habits is vital, especially for populations with NAFLD and MetS, to reduce unhealthy lifestyle patterns displayed during lockdown.

COVID-19 and Fatty Liver Disorders

“…A retrospective cross-sectional study from the Yale Study of the Pathophysiology of Prediabetes/Type 2 Diabetes in youth showed an increased prevalence of NAFLD in adolescents with obesity (from 37.3% in 2017–2019 to 60.9% in 2020–2022) with a worsening of their metabolic status [ 15 ]. Accordingly, several studies showed an increase in body weight, glycemia, transaminases, and intrahepatic fat content in subjects during pandemic, with a growing risk of progression to NASH and fibrosis [ 16 , 17 ].…”

Nutritional and Lifestyle Therapy for NAFLD in People with HIV

“…Right after that, the 3-month period of the Coronavirus disease 2019 (COVID-19) national lockdown started, and both groups started to gain weight [180]. In fact, the COVID-19 lockdown posed a threat to healthy lifestyles, as proven by several studies reporting weight gains and the worsening of the disease control in the overall NAFLD population [181][182][183]. However, patients in the intervention group experienced less weight gain (3.1 ± 1.6 kg vs. 0.7 ± 1.7 kg, p < 0.001) and lower alterations in their dietary habit patterns compared to the controls, also being more likely to maintain their physical activity levels [180].…”