Physical Activity Intensity, Genetic Predisposition, and Risk of Nonalcoholic Fatty Liver Disease: A Prospective Cohort Study

Nonalcoholic fatty liver disease (NAFLD) has emerged as the leading cause of chronic liver disease globally. 1 Younossi Z. et al. Nat Rev Gastroenterol Hepatol. 2018; 15: 11-20 Crossref PubMed Scopus (3079) Google Scholar Lifestyle modification is the cornerstone for preventing the onset of NAFLD and its further progression to liver cirrhosis, with physical activity (PA) playing an essential role. 2 Younossi Z.M. et al. Gastroenterology. 2021; 160: 912-918 Abstract Full Text Full Text PDF PubMed Scopus (214) Google Scholar The World Health Organization recommends that general adults should accumulate at least 150–300 minutes of moderate-intensity PA (MPA), 75–150 minutes of vigorous-intensity PA (VPA), or an equivalent combination of VPA and MPA per week for health benefits. 3 World Health OrganizationWHO Guidelines on Physical Activity and Sedentary Behaviour. WHO Press, Geneva, Switzerland2020 Google Scholar However, the current guidelines only included recommendations for the total amount of PA achieved through any activity regardless of intensity. Previous studies have shown that a higher level of PA, especially VPA, is associated with lower prevalence and incidence of NAFLD and cirrhosis. 4 Kim D. et al. Hepatology. 2020; 72: 1556-1568 Crossref PubMed Scopus (60) Google Scholar , 5 Kim D. et al. Clin Gastroenterol Hepatol. 2022; 20: e1438-e1455 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar , 6 Kistler K.D. et al. Am J Gastroenterol. 2011; 106 (quiz 469): 460-468 Crossref PubMed Scopus (287) Google Scholar In addition, preliminary intervention evidence showed extensive benefits of VPA on the improvement of liver fat or metabolic factors closely related to NAFLD development compared to the same amount of MPA. 7 Zhang H.J. et al. JAMA Intern Med. 2016; 176: 1074-1082 Crossref PubMed Scopus (184) Google Scholar ,8 Zhang H.J. et al. Diabetes Obes Metab. 2017; 19: 284-289 Crossref PubMed Scopus (41) Google Scholar These findings imply that higher PA intensity might exert additional benefits for NAFLD prevention.