Relationship between Macronutrients and Energy Intake and Liver Serum Transaminase Levels in Elderly Athletes and Non-Athletes: Findings from the Neyshabur Longitudinal Study on Aging

Abstract

Background: Evaluating liver health and influential factors is crucial in the elderly population. Lifestyle factors like nutrition and exercise may impact liver function. This study aimed to investigate the association between macronutrients and energy intake with serum levels of aminotransferases in elderly Iranian athletes and non-athletes. Methods: This cross-sectional study included 811 elderly participants (369 athletes, 442 non-athletes) from the Neyshabur Longitudinal Study on Aging (NeLSA). Dietary intake was evaluated using a food frequency questionnaire. Serum Alanine aminotransferase and aspartate aminotransferase levels were measured. Regression Analyzes evaluated the associations between macronutrient intake and liver enzymes, adjusting for potential confounding variables. Results: For elderly athletes, higher calorie intake (β=0.0020, 95% CI: 0.0006, 0.0035, p=0.005), protein intake (β=0.0549, 95% CI: 0.0143, 0.0955, p=0.008), and carbohydrate intake (β=0.0107, 95% CI: 0.0033, 0.0181, p=0.005) were significantly associated with increased ALT levels in adjusted models. Higher carbohydrate intake (β=0.0061, 95% CI: 0.0021, 0.0100, p=0.003) and calorie intake (β=0.0009, 95% CI: 0.0001, 0.0017, p=0.018) were also associated with a notable increase in AST levels in elderly athletes. For elderly non-athletes, only higher protein intake (β=0.0411, 95% CI: 0.0046, 0.0777, p=0.027) was significantly associated with increased ALT levels, while none of the nutritional factors were associated with a notable change in AST levels in adjusted models for non-athletes. Conclusions: This study found higher calorie, protein, and carbohydrate intake were associated with increased liver enzymes ALT and AST in elderly individuals, particularly athletes. For athletes, all three nutrients were linked to elevated ALT, while only carbohydrates and calories impacted AST. For non-athletes, only protein affected ALT. These findings suggest tailored nutritional strategies may be needed to preserve liver health in active aging populations.