Diet was less significant than physical activity in the prognosis of people with sarcopenia and metabolic dysfunction-associated fatty liver diseases: Analysis of the National Health and Nutrition Examination Survey III

Yun Yi; Chun Wang; Yang Ding; JiangHua He; YuQing Lv; Ying Chang

doi:10.3389/fendo.2023.1101892

Diet was less significant than physical activity in the prognosis of people with sarcopenia and metabolic dysfunction-associated fatty liver diseases: Analysis of the National Health and Nutrition Examination Survey III

Front Endocrinol (Lausanne). 2023 Feb 23:14:1101892. doi: 10.3389/fendo.2023.1101892. eCollection 2023.

Authors

Yun Yi^{1

2}, Chun Wang^{1

2}, Yang Ding^{1

2}, JiangHua He^{1

2}, YuQing Lv^{1

2}, Ying Chang^{1

2}

Affiliations

¹ Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China.
² Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China.

Abstract

Background: Sarcopenia is prevalent in metabolic dysfunction-associated fatty liver diseases (MAFLD), and the primary treatment for both diseases is lifestyle modification. We studied how dietary components and physical activity affect individuals with sarcopenia and MAFLD.

Materials and methods: We conducted a study utilizing National Health and Nutrition Examination Survey (NHANES) III (1988-1994) data with Linked Mortality file (through 2019). The diagnosis of fatty liver disease (FLD) was based on ultrasound images revealing moderate and severe steatosis. Using bioelectrical measures, sarcopenia was assessed. Using self-report data, dietary intake and physical activity levels were evaluated.

Results: Among 12,259 participants, 2,473 presented with MAFLD, and 290 of whom had sarcopenia. Higher levels of physical activity (odds ratio [OR] = 0.51 [0.36-0.95]) and calorie (OR = 0.58 [0.41-0.83]) intake reduced the likelihood of sarcopenia in MAFLD patients. During a median follow-up period of 15.3 years, 1,164 MAFLD and 181 MAFLD patients with sarcopenia perished. Increased activity levels improved the prognosis of patients with sarcopenia (Insufficiently active, HR = 0.75 [0.58-0.97]; Active, HR = 0.64 [0.48-0.86]), which was particularly pronounced in older patients.

Conclusion: In the general population, hyperglycemia was highly related to MAFLD prognosis. Physical inactivity and a protein-restricted diet corresponded to sarcopenia, with physical inactivity being connected to poor outcomes. Adding protein supplements would be beneficial for older people with sarcopenia who are unable to exercise due to frailty, while the survival benefits were negligible.

Keywords: MAFLD; NHANES; mortality; nutrition; physical activity; sarcopenia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Diet, Protein-Restricted
Exercise
Humans
Non-alcoholic Fatty Liver Disease*
Nutrition Surveys
Prognosis
Sarcopenia*

Grants and funding

The publishing of this study was supported by the National Natural Science Foundation of China (Grant No. 82172983; No. 81670554); the Wuhan Science and Technology Project (Grant No. 2020020601012208). The data that support the findings of this study are available on request from the corresponding authors.