Questionnaire survey on lifestyle of patients with nonalcoholic steatohepatitis

Abstract

Lack of exercise and excessive food intake are known to be the important causes of nonalcoholic steatohepatitis (NASH). To elucidate the relationship between lifestyle and NASH, we surveyed exercise and dietary habits, comparing them among 171 biopsy-proven NASH patients, 29 nonalcoholic fatty liver (NAFL) patients and 49 normal subjects. Dietary habits including the duration of dinner time, amount of rice at dinner, and weekly frequencies of meat, fries, Chinese noodles, sweets, and instant food consumption were significantly different in male NASH patients compared to normal male subjects. In women, differences were seen in the amount of rice at dinner, frequency of eating out, and proclivity for sweets. In male NASH patients, the frequency of physical exercise was significantly lower. The lifestyle tendencies of NASH were almost similar to those of NAFL. In the comparison between obese NASH and non-obese NASH, no clear lifestyle differences were found. In conclusion, the most striking result of this survey was that the lifestyle of males contributed significantly to the development of NASH. These results point to treatment of NASH in males. In female NASH patients, lifestyle differences were minimal, and the effects of other factors such as genetic background will need to be investigated.

Association between physical activity and risk of nonalcoholic fatty liver disease: a meta-analysis

“… 18 – 25 Among them, two had sex-specific data. 22 , 24 As a result, 10 studies were included in the meta-analysis, with 6 cohort 18 – 22 and 4 case-control studies. 23 – 25 …”

“…All studies utilized questionnaires for assessment of PA, and the majority of them used ultrasonography for ascertainment of NAFLD except two using liver biopsy. 24 Overall, five studies provided effect estimates adjusted for confounding factors, although the consideration of these factors was different from each study. The methodological quality of included cohort studies was high, with a mean score of 7.7.…”

“…Several lines of evidence recently suggest that there might be a sex difference in the association between PA and risk of fatty liver including NAFLD. 24 , 39 But, their findings were inconsistent. Our results as indicated by the subgroup and meta-regression analyses therefore provided a piece of evidence in addressing this concern, showing that men did not substantially differ from women regarding the NAFLD risk reduction from PA. Interestingly, our results showed that the magnitude of risk reduction of NAFLD was larger in participants with older age.…”

“… 6 , 7 Since increased PA plays a protective role against the development of type 2 diabetes and central obesity as well as against other risk factors related to NAFLD such as hypertension and dyslipidemia, 8 – 11 it is assumed that increased PA might be also effective in preventing NAFLD. Indeed, in recent years there is a notably growing interest in examining the association between PA and risk of NAFLD, 12 – 25 with most of them demonstrating a significant beneficial effect of PA in preventing NAFLD. However, no systematic reviews or meta-analyses have been conducted to quantify their association to date, which may provide a higher level of evidence than the individual study in general.…”

Nonalcoholic fatty liver disease remission in men through regular exercise

“…( 14 ) Several cross-sectional studies revealed that regular exercise is associated with a lower NAFLD prevalence. ( 15 – 19 ) However, the impact of regular exercise on the natural history of NAFLD remains to be elucidated, because there is no large longitudinal study addressing the effect size of regular exercise on remission of NAFLD. Therefore, in this study we investigated a longitudinal analysis of the effect of regular exercise on the natural history of NAFLD in a large-scale Japanese population using standardized ultrasonographic diagnosis for fatty liver as well as standardized questionnaires for lifestyle.…”