Published online Nov 28, 2016. doi: 10.4254/wjh.v8.i33.1459
Peer-review started: May 31, 2016
First decision: July 20, 2016
Revised: August 4, 2016
Accepted: October 22, 2016
Article in press: October 24, 2016
Published online: November 28, 2016
To investigated in non-alcoholic-fatty-liver-disease (NAFLD), with ultrasound (US)-detected fatty liver, and in a group of non-alcoholic and otherwise healthy subjects, relationship of neglected features of lifestyle with NAFLD and obesity.
Five hundred and thirty-two NAFLD and 667 non-NAFLD healthy subjects, age 21-60 years were studied. Severity of liver steatosis was assessed by US bright liver score. The adherence to mediterranean diet score (AMDS) was assessed on the basis of a 1-wk recall computerized questionnaire which included a detailed physical activity reports (Baecke questionnaire). The western dietary profile score, as a simplified paradigm of unhealthy diet, a questionnaire quantifying sun exposure score and a sleep habits questionnaires provided a further comprehensive lifestyle assessment.
Body mass index (BMI), insulin resistance (HOMA), and triglycerides, poorer adherence to a mediterranean diet profile, sedentary habits, minor sun exposure and use of “western diet” foods are greater in NAFLD. Multiple linear regression analysis, weighted by years of age, displays BMI, HOMA and AMDS as the most powerful independent predictors of fatty liver severity; however, also the physical activity score, the western diet habit and the sun exposure score are acting inside the model with significant independent effects.
Articulated clinical intervention, according to our results, are justified in NAFLD and can be pursued addressing by focused intervention nutritional profile, physical exercise mainly in open-air subsets for enhancing sun exposure and healthier sleep duration and rhythm.
Core tip: Non-alcoholic-fatty-liver-disease (NAFLD) is a multifactorial condition associated with malnutrition and, mainly, with obesity, sedentary life and insulin resistance; some neglected factor, such as sleep and sun exposure curtailment, along with D vitamin deficiency, are associated with NAFLD; articulated clinical intervention, according to our results, is justified in NAFLD and can be pursued addressing by focused intervention nutritional profile, open-air physical exercise for enhancing sun exposure and healthy behaviour targeted to improved sleep duration and rhythm.