US: Non-alcoholic Fatty Liver Disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The increasing prevalence of obesity has made NAFLD the most common chronic liver disease. As a consequence, NAFLD and especially its inflammatory form, nonalcoholic steatohepatitis (NASH), are the fastest increasing aetiology of end-stage liver disease and hepatocellular carcinoma.

Researchers have found that physical activity, specifically during leisure time and travel-to-work time, is associated with a lower prevalence of NAFLD in a new study. The study has been published in the journal Hepatology.

To assess this, the researchers conducted a cross-sectional study of 24,588 adults (mean age, 47.4 years) included in the 2007–2016 U.S. National Health and Nutrition Examination Survey. The study was published in the journal American Association For the Study of Liver Diseases.

Patients with NAFLD were identified using noninvasive panels. Physical Activity (PA) was defined, based on 2018 guidelines, as:

• >150 minutes/week of moderate-intensity PA
• >75 minutes/week of vigorous-intensity PA or an equivalent combination of the two

List of a questionnaire which was used for assessment were occupation-related PA, transportation-related PA, leisure-time PA, and sitting time. Of the 24,588 individuals (mean age 47.4 years; 47.9% males):

• Leisure‐time PA (≥150 minutes/week) demonstrated 40% lower odds of NAFLD, whereas transportation‐related PA was associated with 33% risk reduction in NAFLD.
• Compliance with the PA Guidelines was lower in NAFLD versus non‐NAFLD.
• The trends in compliance with the PA Guidelines for any type of PA remained stable in 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 non‐NAFLD cohort.
• Although PA demonstrated a 10% stronger association with a 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.

Sedentary behaviour emerged as an independent predictor of NAFLD. Overall compliance with the PA Guidelines was lower in the NAFLD cohort with sex‐ and ethnicity‐based differences. Implementation of these observations in clinical practice may improve our understanding as well as clinical outcomes.

For further reading, click on the following link: https://doi.org/10.1002/hep.31158