Diet quality and physical activity affect metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction and etiology-associated steatohepatitis, and compensated advanced chronic liver disease among United States adults: NHANES 2017–2020

Summary

This cross-sectional study used NHANES 2017–2020 data to investigate the relationships between diet quality, physical activity, and three progressive stages of metabolic liver disease in a nationally representative US adult sample. Using the HEI-2015 as a measure of dietary quality, the study likely found that higher diet quality and greater physical activity were independently or jointly associated with reduced odds of MASLD, MetALD, and cACLD, though the cross-sectional design precludes causal inference. The findings contribute epidemiological evidence on modifiable lifestyle factors relevant to the prevention and management of metabolic liver disease.

UK applicability

Whilst conducted in a US population using NHANES data, the findings are broadly applicable to UK public health contexts given comparable trends in metabolic liver disease prevalence, sedentary lifestyles, and dietary patterns; UK clinicians and policymakers may draw on this evidence when designing dietary and physical activity interventions for liver disease prevention.

Key measures

Healthy Eating Index-2015 (HEI-2015) score; physical activity levels (WHO 2020 guidelines); prevalence of MASLD, MetALD, and cACLD; NHANES 2017–2020 data (n=7,125)

Outcomes reported

The study examined the prevalence of MASLD, MetALD, and compensated advanced chronic liver disease (cACLD) in a multi-ethnic US adult population, and assessed how diet quality (measured by HEI-2015) and physical activity levels are associated with the risk of each condition.

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