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Original research
Joint effect of changes in physical activity and weight on incident non-alcoholic fatty liver disease
  1. Yi-Lin Tsai1,
  2. Sean Chun-Chang Chen2
  1. 1 Department of Business Administration, Alfred Lerner College of Business and Economics, University of Delaware, Newark, Delaware, USA
  2. 2 Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
  1. Correspondence to Dr Sean Chun-Chang Chen, Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan; seanchen{at}tmu.edu.tw

Abstract

Background Increases in physical activity (PA) and weight have opposite effects on the risk of non-alcoholic fatty liver disease (NAFLD), but their joint effect remains unknown. We examined the dose-effect of PA increase for NAFLD prevention and the amount of PA increase required to offset the deleterious effect of weight gain.

Methods We analysed 47 058 participants who were extracted from the Taiwan MJ cohort, aged 20–50 years, without NAFLD at baseline, and followed at 1–5 years between 1997 and 2016. The outcome was incident NAFLD, diagnosed by ultrasonography. PA was measured by metabolic equivalents (METs) and duration (hour/week). We used flexible parametric survival models to estimate the HRs of annual change in PA and body mass index (BMI), controlling for their interaction and baseline covariates.

Results During 138 646 person-years of follow-up, 12 836 participants (40.6% men and 20.1% women) developed incident NAFLD. The HR (95% CI) of annual PA increase of 1 MET-hour/week was 0.88 (0.85–0.92) after controlling for weight change. Moreover, 28 min/week of moderate-intensity PA could neutralise NAFLD risk elevated by annual BMI increase of 0.1 kg/m2 at the end of year 3. We also observed an extra 35% risk reduction when PA increase (1 MET-hour/week) and weight loss (0.1 kg/m2) occurred simultaneously.

Conclusions Annual PA increase of 1 MET-hour/week was associated with a 12% lower NAFLD risk. PA increase can counteract the harmful effect of weight gain and there is a synergistic effect from PA increase and weight loss.

  • exercise
  • life style
  • epidemiology
  • prevention

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Deidentified participant data that support the findings of this study are accessible through the MJ Health Research Foundation.

https://doi.org/10.1136/jech-2021-216728

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    Data availability statement

    Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Deidentified participant data that support the findings of this study are accessible through the MJ Health Research Foundation.

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    Footnotes

    • Twitter @ytsai

    • Contributors SC-CC conceived the study. SC-CC and Y-LT collected the data, performed the analyses and wrote the manuscript. Both authors read and approved the final manuscript.

    • Funding This study was funded by Taipei Medical University (108-3805-002-111), Ministry of Science and Technology of Taiwan (MOST) (107-2311-B-038-003-MY3).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.