Abstract
Considering the increasing prevalence of non-alcoholic fatty liver disease (NAFLD), this study aimed to evaluate the association between NAFLD and dietary habits, stress, and health-related quality of life (HRQoL) in Korean individuals by using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI 2013–2015. NAFLD was defined in individuals with a hepatic steatosis index (HSI) value ≥36. Eating habits were assessed based on the frequencies of eating and eating out; stress was assessed through the stress perception rate; and the EuroQol-5D (EQ-5D) questionnaire was used to assess the HRQoL. We performed a complex sample logistic regression analysis and estimated the odds ratios by adjusting for significant factors to evaluate associations between NAFLD and dietary habits, stress, and HRQoL. Occurrence of NAFLD was not significantly associated with meal frequencies over one week. With an increase in stress, based on the stress perception rate, the risk of NAFLD increased 1.316-fold (95% confidence interval (CI): 1.175–1.469, p < 0.05). Additionally, a decrease in the EQ-5D score by 1 increased the risk of NAFLD 3.38-fold (95% CI: 1.893–4.844, p < 0.05). Thus, NAFLD treatment should include stress management, and underlying HRQoL should be considered during treatment.
Highlights
The incidence of non-alcoholic fatty liver disease (NAFLD) has been increasing globally, including in children and adolescents
The rate of practice of aerobic exercise was lower among individuals with than in those without NAFLD
This study investigated the association between NAFLD occurrence and dietary habits, stress, and
Summary
The incidence of non-alcoholic fatty liver disease (NAFLD) has been increasing globally, including in children and adolescents. NAFLD has been linked to obesity, various metabolic diseases, and even cardiovascular diseases and mortality. NAFLD occurs independently of alcohol consumption and is associated with an abnormality in insulin sensitivity and fatty acid uptake in the liver, and metabolic alterations mediated by an inflammatory mechanism [2,4]. Lifestyle habits, such as lack of exercise and unhealthy diet, have a great impact on the development and exacerbation of NAFLD [1,3,5]. High intake of carbohydrates, contributing to over 60% of daily energy consumption, or excessive simple sugar intake have been reported to exacerbate NAFLD [3,6,7]
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