Healthy living in early adulthood may prevent steatotic liver disease in midlife

Maintaining a healthy lifestyle or making lifestyle changes in early adulthood helps reduce the risk of developing steatotic liver disease in midlife, even for individuals with genetic predisposition, as shown in a study.

Researchers used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to construct a healthy lifestyle score in young adults ages 18–30 years. The score consisted of smoking, alcohol intake, physical activity, and dietary quality. Scores of 0 or 1 indicated an unhealthy lifestyle, while scores of 2–4 indicated healthy. Lifestyle scores were measured at baseline and at 7 years.

The primary outcome of steatotic liver disease was ascertained via noncontrast abdominal computed tomography at 25-year follow-up.

A total of 2,401 participants were included in the analysis, of which 545 had steatotic liver disease at the follow-up.

The risk of steatotic liver disease was 36-percent lower among participants with an initially unhealthy lifestyle at baseline but who subsequently improved vs those who maintained a persistently unhealthy lifestyle over a period of 7 years (17.7 percent vs 28.2 percent; adjusted relative risk [RR], 0.64, 95 percent confidence interval [CI], 0.48–0.85). Similarly, those with a persistently healthy lifestyle had a 21-percent lower risk (adjusted RR, 0.79, 95 percent CI, 0.67–0.94).

Each 1-point increase in healthy lifestyle score over 7 years was associated with a 15-percent steatotic liver disease risk reduction.

The associations persisted across genetic risk subgroups (eg, >median vs ≤median of polygenic risk score, PNPLA3 rs738409 G allele carriers vs noncarriers).