Variation in Lifestyle-Related Behavior Among Obese Indian Patients With Non-alcoholic Fatty Liver Disease

Charu Arora; Anita Malhotra; Piyush Ranjan; Naval K Vikram; S N Dwivedi; Namrata Singh; Shalimar; Vishwajeet Singh

doi:10.3389/fnut.2021.655032

Variation in Lifestyle-Related Behavior Among Obese Indian Patients With Non-alcoholic Fatty Liver Disease

Front Nutr. 2021 Apr 14:8:655032. doi: 10.3389/fnut.2021.655032. eCollection 2021.

Authors

Charu Arora¹, Anita Malhotra², Piyush Ranjan³, Naval K Vikram³, S N Dwivedi⁴, Namrata Singh⁵, Shalimar⁵, Vishwajeet Singh⁶

Affiliations

¹ Department of Home Science, University of Delhi, New Delhi, India.
² Department of Home Science, Lakshmibai College, University of Delhi, New Delhi, India.
³ Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
⁴ Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
⁵ Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
⁶ Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Lifestyle modification is the mainstay of treatment in Non-Alcoholic Fatty Liver Disease (NAFLD). Published Indian data on the diet and lifestyle of Indian NAFLD patients is scarce. This study explored variation in lifestyle-related behavior among obese patients with NAFLD. Ultrasonography (USG) diagnosed obese NAFLD patients (n = 140) were assessed for dietary intake [1-day 24 hours recall, food-frequency questionnaire (FFQ)] and physical activity (PA) [Global Physical Activity Questionnaire (GPAQ)]. Diet quality score (0-30) and physical activity (PA) levels were used to study variation in lifestyle and assess the effect of lifestyle on the severity of NAFLD. Compared to the recommendation, calorie consumption was 25.2% higher in nearly half (53.6%) of the subjects and mean macronutrient intake was imbalanced (60.3% carbohydrates, 12.4% protein, 25.5% fats). Variation was seen in terms of diet quality-good (3%), moderate (54.3%), or poor (43.5%) and intensity of PA-high (15%), moderate (47.9%), or low (37.1%). No patient had a combination of high PA and good diet quality within all grades of NAFLD. Our study suggests wide variation in lifestyles of obese patients with NAFLD and need for a more flexible and individualized modification of their diet and PA.

Keywords: NAFLD; diet; lifestyle; obese; physical activity; variation.