Protective Effect of Leisure-Time Physical Activity and Resistance Training on Nonalcoholic Fatty Liver Disease: A Nationwide Cross-Sectional Study

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease. The present study aimed to investigate the association of NAFLD with leisure-time physical activity (PA) levels and resistance training (RT). Methods: We used data from large nationwide cohorts in Korea. NAFLD was defined based on the Framingham steatosis index. Participants were categorized into four groups based on RT frequency and adherence to PA guidelines (≥150 min/week of moderate-intensity PA): Low-PA, Low-PA+RT, High-PA, and High-PA+RT. Multiple logistic regression models were used to assess the risk of NAFLD according to leisure-time PA levels and regularity of RT. Results: When compared with Low-PA, High-PA decreased the risk of NAFLD by 17%, and High-PA+RT further decreased the risk by 30%. However, the additional reduction in risk associated with the addition of RT was observed in men (19%), but not in women. In the High-PA group, men had a significantly higher training frequency and period for RT than women. Conclusions: Following the PA guideline may confer protective effects against NAFLD, while adding RT to High-PA can further decrease the risk of NAFLD. Sex-based differences in NAFLD risk in the High-PA+RT group may be due to the differences in the frequency and period of RT.

Socioeconomic status and health disparities drive differences in accelerometer-derived physical activity in fatty liver disease and significant fibrosis

“…Furthermore, our study shows that among individuals with NAFLD, the risk for significant fibrosis decreases with more time spent in MVPA, TLAC. These data corroborate previous findings based on self-reports that physical activity was inversely associated with NAFLD and associated significant fibrosis [ 8 ], and higher intensities of physical activity showed larger protective effects [ 43 – 45 ]. Additionally, our predictive models quantify the relationship between the time engaged in MVPA, thereby, providing foundational data to better investigate these relationships in larger datasets that included both objective and self-reported measures of physical activity.…”

Association Between Physical Activity and Prevalence/Mortality of Non-Alcoholic Fatty Liver Disease in Different Socioeconomic Settings

“…In another study, they showed that total PA, measured by accelerometers over a 7-day period, were associated with lower all-cause and cardiovascular mortality in participants with NAFLD from NHANES 2003–2006 ( 26 ). In addition, several recent studies have demonstrated the inverse associations of PA with NAFLD prevalence based on different populations ( 11 – 13 ). Specially, Park, et al found that resistance training (characterized by muscle contraction against external resistance) combined with PA was relatively effective in reducing the risk of NAFLD ( 13 ).…”

“…In addition, several recent studies have demonstrated the inverse associations of PA with NAFLD prevalence based on different populations (11)(12)(13). Specially, Park, et al found that resistance training (characterized by muscle contraction against external resistance) combined with PA was relatively effective in reducing the risk of NAFLD (13). Chun, et al observed that PA had a protective effect against fibrosis, sarcopenia, and CVD in NAFLD (11).…”

“…Physical activity (PA) showed beneficial effects in decrease NAFLD incidence in a number of studies. However, these findings were based on diverse and heterogeneous populations regarding sex, age, race, and medical comorbidities (9,(11)(12)(13). Therefore, studies based on larger populations were still needed.…”

Association between Stages of Hepatic Steatosis and Physical Activity Performance in Adults with Metabolic Syndrome: A Cross-Sectional Analysis in FLIPAN Study

“…Schneider et al pointed out that increased PA is related to a decrease in NAFLD, even independent of adiposity [17]. Park et al recently added that, in addition to regular PA practice, resistance training and high levels of PA decreases the risk of NAFLD [18]. Although there are more studies assessing these relationships, studies reporting the relationship between different PA parameters and NAFLD are still scarce.…”