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Sedentary activities associated with NAFLD
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In the Kangbuk Samsung Health Study, researchers in South Korea found that the longer a person sits down combined with limited physical activity, the more likely they will develop nonalcoholic fatty liver disease, according to newly published data.
“The amount of time spent doing sedentary activities such as sitting at a computer or watching TV has dramatically increased in recent years,” Seungho Ryu, MD, PhD, Center for cohort studies, department of occupational and environmental medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, told Healio.com/Hepatology. “More than half of the average person’s waking day involves sedentary activities. … From the viewpoint of public health, reducing sitting time could have a substantial impact in liver metabolic health in the general population.”
Seungho Ryu
Ryu and colleagues, including Yoosoo Chang, MD, PhD, Center for cohort studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, conducted a cross-sectional study of 139,056 Korean adults who underwent a physical exam between March 2011 and December 2013. They measured physical activity level and sitting time using the Korean version of the International Physical Activity Questionnaire Short Form.
“The goal of this study was to examine the association of sitting time and physical activity level with NAFLD in a large sample of Korean men and women, and to explore whether any observed associations were due to adiposity or insulin resistance,” the researchers wrote.
Yoosoo Chang
Among 66,142 women and 72,914 men, the mean age was 39.9 years, mean BMI was 23 kg/m2, and mean sitting time was 7.6 hours. Sitting time correlated with physical activity level (– 0.15; P < .001).
Of all the adults, 39,257 had NAFLD. Physical activity levels were negatively associated with the prevalence of NAFLD, even after making adjustments (P < .001).
Multivariable-adjusted analysis showed that both prolonged sitting time and classification as minimally active vs. health-enhancing physically active (HEPA) were independently associated with increasing prevalence of NAFLD. The prevalence ratio (PR) for NAFLD between adults who sat between 5 and 9 hours a day or more than 10 hours a day was 1.04 (1.02-1.07) and the PR for adults who sat for less than 5 hours per day was 1.09 (1.06-1.11; P < .001). These associations were also observed in those with a BMI less than 23.
The PR for NAFLD in adults who were minimally active was 0.94 (0.92-0.95) and 0.8 (0.78-0.82) in the adults who did do HEPA (P < .001).
“It is important to encourage both increased physical activity and reducing sitting time for controlling the risk of NAFLD,” Ryu said. “In addition, doctors may need to educate patients not only about physical activity but also about reducing time spent sitting.”
In an accompanying editorial, Michael I. Trenell, PhD, professor of metabolism and lifestyle medicine at Newcastle University, United Kingdom, stated that the research performed by Ryu and Chang adds to the “alarming” evidence that sitting and lack of physical activity negatively impact one’s health.
“The report by Ryu and colleagues expands the relationship between sedentary behavior and cardiometabolic health to include people with NAFLD. … [It] adds to the strong and alarming evidence that sitting too much and moving too little has significant negative consequences for cardiometabolic health. The challenge for us now is to ‘stand up’ and move for NAFLD, both physically and metaphorically.”
Disclosures: The researchers report no relevant financial disclosures.
Perspective
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Dina Halegoua-De Marzio, MD
Sedentary behavior has emerged as a potential risk factor for several chronic diseases. Recent data has hypothesized that sedentary behavior causes these negative effects by promoting metabolic syndrome. In this very large prospective study, [researchers] found that extended sedentary behavior. At every level of physical activity the participants reported, those who spent more time sitting showed higher rates of NAFLD than those who sat less. This was specifically true of more than 10 hours of sedentary time per day. One key part is that regardless of exercise, the effects of sedentary behavior were not reversible. This needs to be studied further in other populations.
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