Leisure-time physical activity helps prevent hepatic steatosis

Leisure-time physical activity (PA) offers protection against hepatic steatosis, with greater benefits seen among women and young people, suggests a study. Additionally, increasing leisure-time PA in men helps prevent liver fibrosis.

On the other hand, occupation-related PA shows no association with hepatic steatosis and cannot replace leisure-time PA.

A total of 5,933 adults were included in the study. In multiple linear regression analysis, leisure-time PA demonstrated a significantly negative association with the controlled attenuation parameter (CAP), whereas the correlation between occupation-related, transportation-related-PA, and CAP was not significant. [J Clin Gastroenterol 2025;59:168-176]

In subgroup analysis, leisure-time PA negatively correlated with CAP in women and younger age groups (under 60 years old), but the association did not reach significance in men and older adults. Moreover, leisure-time PA showed a significantly negative association with liver fibrosis in men.

“Leisure-time PA is significantly negatively correlated with hepatic steatosis, and there is a threshold saturation effect, with the breaking point being 6 hours of moderate-intensity activity or 3 hours of vigorous-intensity activity per week,” the researchers said.

Occupation-related PA

Physical activity provides a beneficial effect on liver fat content reduction even in the absence of dietary intervention. However, occupation-related PA appears to show no benefits on nonalcoholic fatty liver disease (NAFLD). [J Hepatol 2012;57:157-166; Hepatology 2020;72:1556-1568; Sci Rep 2023;13:4724; Am J Gastroenterol 2019;114:907-915]

A previous study has also shown the significantly negative association of leisure-time and transportation-related PA with NAFLD, with benefits being more pronounced in women than in men. In contrast, occupation-related PA shows no significant association with NAFLD. [J Hepatol 2012;57:157-166]

“The reason for this may be that improving cardiovascular health requires vigorous-intensity physical activity (>60 percent to 80 percent maximum oxygen consumption) over a short period of time,” the researchers said. “However, occupation-related PA that is of low intensity or prolonged duration may not maintain or improve cardiovascular and pulmonary health.” [Ergonomics 1985;28:365-369]

Furthermore, the prolonged lack of recovery from PA, such as long work weeks or extreme endurance training, can result in fatigue and exhaustion and may even contribute to an increase in the risk of cerebrovascular disease. [Br J Sports Med 2011;45:185-188]

Inflammation

The development and progression of NAFLD are often driven by inflammation, as confirmed by several epidemiological studies. [Eur J Sport Sci 2019;19:994-1003; J Hepatol 2019;70:710-721]

“Inflammatory markers, such as C-reactive protein, rise during physical activity, and remain heightened until the body has recovered,” the researchers said. “Prolonged and continuous physical activity without sufficient recovery time can result in sustained inflammation.” [J Am Coll Cardiol 2005;45:1563-1569]

The present cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Researchers used a multiple linear regression model to explore the linear relationship between different PA types, the CAP, and liver stiffness measurement (LSM). They also used smoothing curve fitting and threshold effect analysis to depict nonlinear association.