ArticleHepatology (Baltimore, Md.)2022
High-quality diet, physical activity, and college education are associated with low risk of NAFLD among the US population.
Article in Hepatology (Baltimore, Md.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 162 papers, 6 of them syntheses that pooled it.
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Who cites it
162 citing papers in PubMed, 6 syntheses or guidelines pooled it, 278 citations in OpenAlex.
- The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.Hepatology international · 2025Guideline
- Causal relationships between neuropsychiatric disorders and nonalcoholic fatty liver disease: A bidirectional Mendelian randomization study.BMC gastroenterology · 2024Pooled it
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- A Healthy Diet is Associated with a Lower Risk of Hepatic Fibrosis.The Journal of nutrition · 2023Pooled it
- Lifestyle and metabolic factors for nonalcoholic fatty liver disease: Mendelian randomization study.European journal of epidemiology · 2022Pooled it
- Key hepatic signatures of human and mouse nonalcoholic steatohepatitis: A transcriptome-proteome data meta-analysis.Frontiers in endocrinology · 2022Pooled it
- Article
- Metabolic dysfunction-associated steatotic liver disease assessment and management: Clinical practice guidance from the Canadian Association for the Study of the Liver.Canadian liver journal · 2026Article
- Article
- Socioeconomic Factors and Their Role in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Comprehensive Review.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- The association between physical activity and metabolic dysfunction-associated steatotic liver disease: Evidence from the National Health and Nutrition Examination Survey and UK Biobank.The Journal of international medical research · 2026Article
- Association of combined healthy lifestyle factors with the risk of metabolic dysfunction-associated steatotic liver disease: the Korean National Health and Nutrition Examination Survey 2016-2021.BMC public health · 2026Article
- Impact of Air Pollution on Metabolic Dysfunction-Associated Fatty Liver Disease.International journal of molecular sciences · 2026Review
- Associations between socioeconomic factors and mental symptoms highlight whole-body correlates and pathways.iScience · 2026Article
- A narrative review of lifestyle management guidelines for metabolic dysfunction-associated steatotic liver disease.Hepatology (Baltimore, Md.) · 2026Review
- Association of Life's Essential 8 with Hepatic Fibrosis, MASLD, and MetALD in the Framingham Heart Study.Nutrients · 2026Article
- The Association Between Physical Activity, Sedentary Time, and Sleep with Risk of Hepatocellular Carcinoma in Patients with Cirrhosis.Digestive diseases and sciences · 2026Article
- The global cardiovascular-liver-metabolic syndemic: epidemiology, trends and challenges.Nature reviews. Cardiology · 2026Review
- Biological aging partly mediates the association between physical activity and overactive bladder: evidence from NHANES 2007-2020.Clinical epigenetics · 2026Article
- Cumulative lipid exposure in young adulthood and risk of midlife MASLD.JHEP reports : innovation in hepatology · 2026Article
102 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsThe effects of diet quality (DQ), physical activity (PA), and socioeconomic status (SES) on the risk of NAFLD are unclear. We examined the association among DQ, PA, SES, and NAFLD risk. APPROACH AND
resultsThis is a cross-sectional analysis of the National Health and Nutrition Examination Surveys, 2017-2018, which included 3589 participants with reliable information on vibration-controlled transient elastography (VCTE) measurements, 24-h dietary recalls, PA, and SES. DQ was assessed by the Healthy Eating Index (HEI)-2015. PA was determined by the Global Physical Activity Questionnaire. SES was assessed by the educational attainment and family poverty income ratio (PIR). Risk of NAFLD was considered by means of a composite outcome using VCTE measurements: non-NAFLD versus NAFLD without clinically significant fibrosis (CSF) versus NAFLD with CSF. The NAFLD risk was lower in physically active (≥600 metabolic equivalent of task [MET] min/week) versus inactive participants (<600 MET min/week) (OR: 0.71, p = 0.043). A high-quality diet (HQD) (HEI > 56.64) was associated with a lower risk of NAFLD (OR: 0.58, p < 0.01) compared with a non-HQD. The lowest NAFLD risk was observed in those physically active with HQD (OR: 0.43, p < 0.01). Body mass index and waist circumference significantly mediated the effect of DQ and PA on NAFLD risk. Education (college or above) (OR: 0.65, p = 0.034), but not PIR, was associated with a reduced NAFLD risk. HQD and increased PA partially mediated the effect of education on NAFLD risk. The total effect of education on NAFLD risk mediated by DQ was 29% and by PA was 8%.
conclusionsHQD, increased physical activity, and college education were associated with lower NAFLD risk in the US population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.