Diet was less significant than physical activity in the prognosis of people with sarcopenia and metabolic dysfunction-associated fatty liver diseases: Analysis of the National Health and Nutrition Examination Survey III

Abstract

BackgroundSarcopenia is prevalent in metabolic dysfunction-associated fatty liver diseases (MAFLD), and the primary treatment for both diseases is lifestyle modification. We studied how dietary components and physical activity affect individuals with sarcopenia and MAFLD.Materials and methodsWe conducted a study utilizing National Health and Nutrition Examination Survey (NHANES) III (1988–1994) data with Linked Mortality file (through 2019). The diagnosis of fatty liver disease (FLD) was based on ultrasound images revealing moderate and severe steatosis. Using bioelectrical measures, sarcopenia was assessed. Using self-report data, dietary intake and physical activity levels were evaluated.ResultsAmong 12,259 participants, 2,473 presented with MAFLD, and 290 of whom had sarcopenia. Higher levels of physical activity (odds ratio [OR] = 0.51 [0.36–0.95]) and calorie (OR = 0.58 [0.41–0.83]) intake reduced the likelihood of sarcopenia in MAFLD patients. During a median follow-up period of 15.3 years, 1,164 MAFLD and 181 MAFLD patients with sarcopenia perished. Increased activity levels improved the prognosis of patients with sarcopenia (Insufficiently active, HR = 0.75 [0.58–0.97]; Active, HR = 0.64 [0.48–0.86]), which was particularly pronounced in older patients.ConclusionIn the general population, hyperglycemia was highly related to MAFLD prognosis. Physical inactivity and a protein-restricted diet corresponded to sarcopenia, with physical inactivity being connected to poor outcomes. Adding protein supplements would be beneficial for older people with sarcopenia who are unable to exercise due to frailty, while the survival benefits were negligible.

Dietary and lifestyle oxidative balance scores are independently and jointly associated with nonalcoholic fatty liver disease: a 20 years nationally representative cross-sectional study

“…Thus, lifestyle OBS appears to be associated with a greater reduction in NAFLD risk than dietary OBS. The underlying mechanisms remain unclear, but a recent study using NHANES III showed that physical activity is more important than diet for the prognosis of patients with metabolic-associated fatty liver disease (MAFLD) and sarcopenia ( 36 ). Future mechanistic studies are needed to further explore the relevant mechanisms.…”

Muscleness and fatness phenotypes for diabetes and hypertension prediction from the Chilean National Health Survey 2016-17

“…(3,4) Before diabetes and HTN diagnosed, the adult population transit through previous and prevented health symptoms such as skeletal muscle mass decline (SMM, i.e., sarcopenia) and higher adiposity accumulation, as for example, calf circumference decreases (4) and waist circumference increases (WC) to each outcome respectively. (6) Thus, it is well known that a phenotypical model of low SMM decreases glucose control, promotes adiposity accumulation, (7) and subsequently increases diabetes risk by intramyocellular fatty acids accumulation. (8) By contrast, healthy adults who are physically active and adhere to a healthy lifestyle, report better SMM levels.…”