Lifestyle predictors of obese and non-obese patients with nonalcoholic fatty liver disease: A cross-sectional study

Joo Hee Kwak, Dae Won Jun, Seung Min Lee, Yong Kyun Cho, Kang Nyeong Lee, Hang Lak Lee, Oh Young Lee, Ho Soon Choi, Byung Chul Yoon

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background & aims: Most people with nonalcoholic fatty liver disease (NAFLD) are obese, and they usually eat more while being less physically active as compared to healthy individuals. However, little is known about the lifestyle patterns of non-obese or obese patients with NAFLD. The aim of this study was to investigate nutrition components and behavioral differences between non-obese and obese patients with NAFLD. Methods: This is a cross-sectional study comprising of 209 patients. Nutritional components and physical activity status were compared in obese and non-obese subjects with NAFLD against healthy controls. Dietary intake was assessed using the 5-day food diary. Physical activity was measured using the protocol of Korea Health and Nutrition Examination Survey. Total and regional body composition analysis was conducted using anthropometry and tetrapolar multi-frequency bio-impedance. Visceral adipose tissue, total abdominal adipose tissue, abdominal subcutaneous adipose tissue as well as liver fat were measured using abdomen tomography. Results: Non-obese subjects with NAFLD had higher levels of ALT, AST, GGT, triglyceride, fasting glucose; higher carbohydrate energy ratio; higher visceral fat area, subcutaneous area, body muscle mass, fat free mass and body fat compared to subjects without NAFLD. Subjects with obesity and NAFLD had higher ALT, AST, visceral fat, fasting glucose and HOMA-IR (homeostatic model assessment-insulin resistance), and less moderate-level physical activity compared to those with obesity who do not have NAFLD. Obese subjects with NAFLD also had higher blood pressure, visceral fat area, subcutaneous fat area, body fat, body fat percent and GGT compared to non-obese subjects with NAFLD. In multivariate analysis, carbohydrate energy ratio and physical activity less than moderate-level (<2 h/week) were predictors of NAFLD in non-obese subjects independent of the visceral fat, body muscle index, total energy intake, age and sex. Physical activity less than moderate-level was a predictor of NAFLD in obese subjects with NAFLD, independent of the HOMA-IR, visceral fat, total energy intake, fat energy percent, age and sex. Conclusions: Percentage of carbohydrate intake percent and physical activity, less than moderate-level were independent predictors of NAFLD in non-obese subjects. Meanwhile, physical activity, less than moderate-level, was an independent predictor in obese subjects.

Original languageEnglish
Pages (from-to)1550-1557
Number of pages8
JournalClinical Nutrition
Volume37
Issue number5
DOIs
StatePublished - 2018 Oct

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Life Style
Cross-Sectional Studies
Intra-Abdominal Fat
Exercise
Adipose Tissue
Fat Body
Fats
Carbohydrates
Non-alcoholic Fatty Liver Disease
Energy Intake
Insulin Resistance
Fasting
Obesity
Abdominal Subcutaneous Fat
Diet Records
Glucose
Muscles
Abdominal Fat
Anthropometry
Nutrition Surveys

Keywords

  • Carbohydrate
  • Non-alcoholic fatty liver
  • Non-obese

Cite this

@article{ff00d8c35cfd449e8247019cd433d5d1,
title = "Lifestyle predictors of obese and non-obese patients with nonalcoholic fatty liver disease: A cross-sectional study",
abstract = "Background & aims: Most people with nonalcoholic fatty liver disease (NAFLD) are obese, and they usually eat more while being less physically active as compared to healthy individuals. However, little is known about the lifestyle patterns of non-obese or obese patients with NAFLD. The aim of this study was to investigate nutrition components and behavioral differences between non-obese and obese patients with NAFLD. Methods: This is a cross-sectional study comprising of 209 patients. Nutritional components and physical activity status were compared in obese and non-obese subjects with NAFLD against healthy controls. Dietary intake was assessed using the 5-day food diary. Physical activity was measured using the protocol of Korea Health and Nutrition Examination Survey. Total and regional body composition analysis was conducted using anthropometry and tetrapolar multi-frequency bio-impedance. Visceral adipose tissue, total abdominal adipose tissue, abdominal subcutaneous adipose tissue as well as liver fat were measured using abdomen tomography. Results: Non-obese subjects with NAFLD had higher levels of ALT, AST, GGT, triglyceride, fasting glucose; higher carbohydrate energy ratio; higher visceral fat area, subcutaneous area, body muscle mass, fat free mass and body fat compared to subjects without NAFLD. Subjects with obesity and NAFLD had higher ALT, AST, visceral fat, fasting glucose and HOMA-IR (homeostatic model assessment-insulin resistance), and less moderate-level physical activity compared to those with obesity who do not have NAFLD. Obese subjects with NAFLD also had higher blood pressure, visceral fat area, subcutaneous fat area, body fat, body fat percent and GGT compared to non-obese subjects with NAFLD. In multivariate analysis, carbohydrate energy ratio and physical activity less than moderate-level (<2 h/week) were predictors of NAFLD in non-obese subjects independent of the visceral fat, body muscle index, total energy intake, age and sex. Physical activity less than moderate-level was a predictor of NAFLD in obese subjects with NAFLD, independent of the HOMA-IR, visceral fat, total energy intake, fat energy percent, age and sex. Conclusions: Percentage of carbohydrate intake percent and physical activity, less than moderate-level were independent predictors of NAFLD in non-obese subjects. Meanwhile, physical activity, less than moderate-level, was an independent predictor in obese subjects.",
keywords = "Carbohydrate, Non-alcoholic fatty liver, Non-obese",
author = "Kwak, {Joo Hee} and Jun, {Dae Won} and Lee, {Seung Min} and Cho, {Yong Kyun} and Lee, {Kang Nyeong} and Lee, {Hang Lak} and Lee, {Oh Young} and Choi, {Ho Soon} and Yoon, {Byung Chul}",
year = "2018",
month = "10",
doi = "10.1016/j.clnu.2017.08.018",
language = "English",
volume = "37",
pages = "1550--1557",
journal = "Clinical Nutrition",
issn = "0261-5614",
number = "5",

}

TY - JOUR

T1 - Lifestyle predictors of obese and non-obese patients with nonalcoholic fatty liver disease

T2 - A cross-sectional study

AU - Kwak, Joo Hee

AU - Jun, Dae Won

AU - Lee, Seung Min

AU - Cho, Yong Kyun

AU - Lee, Kang Nyeong

AU - Lee, Hang Lak

AU - Lee, Oh Young

AU - Choi, Ho Soon

AU - Yoon, Byung Chul

PY - 2018/10

Y1 - 2018/10

N2 - Background & aims: Most people with nonalcoholic fatty liver disease (NAFLD) are obese, and they usually eat more while being less physically active as compared to healthy individuals. However, little is known about the lifestyle patterns of non-obese or obese patients with NAFLD. The aim of this study was to investigate nutrition components and behavioral differences between non-obese and obese patients with NAFLD. Methods: This is a cross-sectional study comprising of 209 patients. Nutritional components and physical activity status were compared in obese and non-obese subjects with NAFLD against healthy controls. Dietary intake was assessed using the 5-day food diary. Physical activity was measured using the protocol of Korea Health and Nutrition Examination Survey. Total and regional body composition analysis was conducted using anthropometry and tetrapolar multi-frequency bio-impedance. Visceral adipose tissue, total abdominal adipose tissue, abdominal subcutaneous adipose tissue as well as liver fat were measured using abdomen tomography. Results: Non-obese subjects with NAFLD had higher levels of ALT, AST, GGT, triglyceride, fasting glucose; higher carbohydrate energy ratio; higher visceral fat area, subcutaneous area, body muscle mass, fat free mass and body fat compared to subjects without NAFLD. Subjects with obesity and NAFLD had higher ALT, AST, visceral fat, fasting glucose and HOMA-IR (homeostatic model assessment-insulin resistance), and less moderate-level physical activity compared to those with obesity who do not have NAFLD. Obese subjects with NAFLD also had higher blood pressure, visceral fat area, subcutaneous fat area, body fat, body fat percent and GGT compared to non-obese subjects with NAFLD. In multivariate analysis, carbohydrate energy ratio and physical activity less than moderate-level (<2 h/week) were predictors of NAFLD in non-obese subjects independent of the visceral fat, body muscle index, total energy intake, age and sex. Physical activity less than moderate-level was a predictor of NAFLD in obese subjects with NAFLD, independent of the HOMA-IR, visceral fat, total energy intake, fat energy percent, age and sex. Conclusions: Percentage of carbohydrate intake percent and physical activity, less than moderate-level were independent predictors of NAFLD in non-obese subjects. Meanwhile, physical activity, less than moderate-level, was an independent predictor in obese subjects.

AB - Background & aims: Most people with nonalcoholic fatty liver disease (NAFLD) are obese, and they usually eat more while being less physically active as compared to healthy individuals. However, little is known about the lifestyle patterns of non-obese or obese patients with NAFLD. The aim of this study was to investigate nutrition components and behavioral differences between non-obese and obese patients with NAFLD. Methods: This is a cross-sectional study comprising of 209 patients. Nutritional components and physical activity status were compared in obese and non-obese subjects with NAFLD against healthy controls. Dietary intake was assessed using the 5-day food diary. Physical activity was measured using the protocol of Korea Health and Nutrition Examination Survey. Total and regional body composition analysis was conducted using anthropometry and tetrapolar multi-frequency bio-impedance. Visceral adipose tissue, total abdominal adipose tissue, abdominal subcutaneous adipose tissue as well as liver fat were measured using abdomen tomography. Results: Non-obese subjects with NAFLD had higher levels of ALT, AST, GGT, triglyceride, fasting glucose; higher carbohydrate energy ratio; higher visceral fat area, subcutaneous area, body muscle mass, fat free mass and body fat compared to subjects without NAFLD. Subjects with obesity and NAFLD had higher ALT, AST, visceral fat, fasting glucose and HOMA-IR (homeostatic model assessment-insulin resistance), and less moderate-level physical activity compared to those with obesity who do not have NAFLD. Obese subjects with NAFLD also had higher blood pressure, visceral fat area, subcutaneous fat area, body fat, body fat percent and GGT compared to non-obese subjects with NAFLD. In multivariate analysis, carbohydrate energy ratio and physical activity less than moderate-level (<2 h/week) were predictors of NAFLD in non-obese subjects independent of the visceral fat, body muscle index, total energy intake, age and sex. Physical activity less than moderate-level was a predictor of NAFLD in obese subjects with NAFLD, independent of the HOMA-IR, visceral fat, total energy intake, fat energy percent, age and sex. Conclusions: Percentage of carbohydrate intake percent and physical activity, less than moderate-level were independent predictors of NAFLD in non-obese subjects. Meanwhile, physical activity, less than moderate-level, was an independent predictor in obese subjects.

KW - Carbohydrate

KW - Non-alcoholic fatty liver

KW - Non-obese

UR - http://www.scopus.com/inward/record.url?scp=85029225730&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2017.08.018

DO - 10.1016/j.clnu.2017.08.018

M3 - Article

C2 - 28918170

AN - SCOPUS:85029225730

VL - 37

SP - 1550

EP - 1557

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 5

ER -