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Cited by 39Liver Disease Diagnosis and TreatmentPhysical Activity and HealthNutritional Studies and Diet

The DOI matches its Crossref record; 69 of the 74 references it cites were found in a registry or an index.

Significant Dose-Response Association of Physical Activity and Diet Quality With Mortality in Adults With Suspected NAFLD in a Population Study

Vilar-Gomez, Eduardo, Vuppalanchi, Raj, Gawrieh, Samer, Pike, Francis, Samala, Niharika, Chalasani, Naga·2023·American Journal of Gastroenterology
DOI 10.14309/ajg.0000000000002222
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Abstract

INTRODUCTION: We aimed to determine whether higher levels (volume and intensity) of physical activity (PA) and diet quality (DQ) are associated with better survival rates in nonalcoholic fatty liver disease (NAFLD). METHODS: Using data from the 2011-2014 National Health and Nutrition Examination Survey, 3,548 participants with a Fatty Liver Index ≥60 were included. PA was collected using a wrist-worn triaxial accelerometer and expressed as 2 metrics using Monitor-Independent Movement Summary (MIMS) units: the average of daily MIMS, which represents volume, and peak 30-minute MIMS, which is the average of the highest 30 MIMS min/d and represents intensity. DQ was assessed by the Healthy Eating Index-2015. Mortality follow-up was recorded using the National Death Index linkage through December 31, 2019. RESULTS: Our analyses revealed a dose-dependent, nonlinear association of PA (volume and intensity) with all-cause mortality and a dose-dependent, linear association of DQ with all-cause mortality. The maximum protective dose of PA volume was observed at 14,300 MIMS/min (adj. HR: 0.20, 95% CI: 0.11-0.38). The maximum protective dose of PA intensity was observed at 54.25 MIMS/min (adj. HR: 0.10, 95% CI: 0.05-0.23), beyond which mortality risks flattened. The Healthy Eating Index-2015 showed its maximum protective effect at 66.17 (adj. HR: 0.54, 95% CI: 0.40-0.74). Higher PA (volume and intensity) levels were associated with a lower risk of cardiovascular-related but not cancer-related mortality. A healthier diet was linked to a reduced risk of cardiovascular-specific and cancer-specific mortality. Sensitivity analyses showed that the beneficial effects of PA and DQ on survival rates remained significant across sex, racial/ethnic, and age groups as well as in participants without NAFLD. DISCUSSION: Our findings suggest that higher daily accumulated and peak effort PA and DQ are associated with lower all-cause and cardiovascular mortality in US adults with NAFLD.

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Crossref · 10.14309/ajg.0000000000002222

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  1. Liu, 2021, Assessment of physical activity in adults using wrist accelerometers, Epidemiol Rev, 43, 65, 10.1093/epirev/mxab004 · DOI

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Metadata

Authors
Vilar-Gomez, E., Vuppalanchi, R., Gawrieh, S., Pike, F., Samala, N., & Chalasani, N.
Affiliations
  • Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana;
  • Indiana University Indianapolis (US)
  • Indiana University Health (US)
Corresponding author
Chalasani, Naga
ORCID
Venue
American Journal of Gastroenterology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2023-02-16
Volume
118
Issue
9
Pages
1576-1591
ISSN
  • 0002-9270 (ISSN-L)
  • 1572-0241
DOI
10.14309/ajg.0000000000002222
OpenAlex
W4321164391
Cited by
39
References
74
Citations by year
2026: 8 · 2025: 15 · 2024: 12 · 2023: 4
FWCI
7.78
Type
journal article
Language
en
Open access
closed
Locations
  • The American Journal of Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
non-alcoholic fatty liver disease, physical activity, diet quality, all-cause mortality, cardiovascular mortality, cancer mortality, dose-response relationship, physical activity intensity, physical activity volume, Healthy Eating Index, accelerometer-measured activity, fatty liver index
MeSH terms
Adult, Diet, Humans, Nutrition Surveys, Risk, Exercise, Non-alcoholic Fatty Liver Disease

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