Sedentary children risk liver disease in young adulthood
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Key takeaways:
- Each 30-minute increase in sedentary time above 6 hours per day raised young adults’ risk for liver damage by 15%.
- At least 3 hours of light physical activity per day can reverse that risk.
BOSTON — Accumulating sedentary time during childhood was associated with increased risk for liver disease in young adulthood, but boosting light physical activity may lessen the risk, according to data presented at ENDO 2024.
“This study suggests that sedentariness might be as strong as obesity in its deleterious effect on the liver,” Andrew Agbaje, MD, MPH, PhD, FESC, FAHA, associate professor of clinical epidemiology and child health at the University of Eastern Finland in Kuopio, told Healio. “Children spent 6 hours per day sedentary, which increased to 9 hours per day by young adulthood. This significant increase in sedentary time increased the risk of severe liver steatosis and liver cirrhosis, which are precursors of liver cancers and liver transplants. Every additional 30 minutes of sedentary time beyond 6 hours per day increased the risk of liver damage by 15%. The prevalence of excess liver fat, or liver steatosis, increased eightfold during growth from adolescence to young adulthood necessitating an urgent need for screening the pediatric population for liver disease.”
Agbaje analyzed data from the Avon Longitudinal Study of Parents and Children, U.K. birth cohort, from 2,684 children aged 11 years at baseline (57.3% girls). During 13 years of follow-up, researchers assessed sedentary time, light physical activity and moderate to vigorous activity for participants, who wore an accelerometer at the waist. At age 17 and 24 years, triglycerides, inflammation, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase levels, as well as fat mass and lean mass, were recorded. Participants underwent transient elastography to assess liver fibrosis at age 24 years.
Participants performed about 1 hour of moderate to vigorous activity per day throughout the study period. Average sedentary time for the cohort was 6 hours per day during childhood and increased to 9 hours per day in young adulthood. At the same time, light physical activity decreased from an average of 6 hours to 3 hours per day.
At age 17 years, 2.6% of the cohort had liver steatosis; that number increased to 20.5% of participants at age 24 years. The prevalence of sever liver steatosis, defined as at least 280 dB/m, was 11% at age 24 years. Advanced fibrosis was seen in 0.9% and 3% of participants at age 17 and 24 years, respectively.
The increase in sedentary time during follow-up was associated with increases in liver enzymes and liver disease. A cumulative 1-minute per day increase in sedentary time increased odds of liver cirrhosis (OR = 1.004; 95% CI, 1.002-1.005; P < .001) and severe liver steatosis (OR = 1.001; 95% CI, 1.001-1.002; P = .002).
Conversely, an increase in light physical activity from age 11 to 24 years was associated with decreases in liver enzymes and liver disease. A cumulative 1-minute per day in light physical activity lowered likelihood of liver cirrhosis (OR = 0.99; 95% CI, 0.99-0.991) and severe liver steatosis (OR = 0.999; 95% CI, 0.998-0.999; P < .001 for both).
Any effect of moderate to vigorous physical activity on liver steatosis was attenuated by fat mass, according to Agbaje.
“The premature and clinically significant liver damage caused by childhood sedentariness is indeed sobering,” Agbaje said.
“Light-intensity physical activity of at least 3 hours per day is the minimum duration of physical activity that must be accumulated to reverse the adverse effect of sedentariness on the liver,” Agbaje said. “Unfortunately, the latest World Health Organization physical activity guideline has no recommendation for light-intensity physical activity due to insufficient evidence. Hopefully, these new studies provide evidence for updating future guidelines and recommendations.”
Reference:
Agbaje AO. npj Gut Liver. 2024;doi:10.1038/s44355-024-00002-y.
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Agbaje AO. OR06-02. Presented at: ENDO annual meeting; June 1-4, 2024; Boston.
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