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Physical Activity and Mediterranean Diet Adherence in Patients with Metabolic Syndrome and Alcohol-Related Liver Disease: A 12-Month Prospective Study

Year: 2026

Type: article

Abstract: Background: Physical activity and Mediterranean diet adherence are important components of lifestyle management in patients with metabolic syndrome (MetS) and alcohol-related liver disease (ALD). We evaluated 12-month changes in lifestyle, metabolic parameters, and non-invasive fibrosis-related markers and explored their associations. Methods: In this 12-month prospective observational study, 50 adults with MetS and ALD were assessed at baseline, 6 months, and 12 months. Physical activity (IPAQ-SF), Mediterranean diet adherence (MEDAS-14), alcohol consumption status, liver stiffness, FIB-4, and APRI were evaluated. Exploratory multivariable analyses adjusted for sustained alcohol abstinence, baseline liver disease severity, age, sex, and change in waist circumference. Results: Physical activity increased from 455.2 ± 154.1 to 910.3 ± 275.4 MET-min/week and MEDAS-14 from 4.32 ± 0.62 to 7.92 ± 0.92 (both p < 0.001). Waist circumference, fasting glucose, LDL cholesterol, and triglycerides decreased significantly (all p < 0.001). At 12 months, physical activity and Mediterranean diet adherence were inversely correlated with liver stiffness, FIB-4, and APRI (all p ≤ 0.010). However, changes in IPAQ-SF and MEDAS-14 were not significantly associated with changes in non-invasive fibrosis-related markers after multivariable adjustment. Sustained alcohol abstinence (74.0%) was consistently associated with more favorable changes in all three markers. Conclusions: Improvements in physical activity and Mediterranean diet adherence occurred alongside favorable metabolic and liver-related changes, but their associations with non-invasive fibrosis-related markers were not maintained after adjustment for major potential confounders. Sustained alcohol abstinence was consistently associated with more favorable changes in these markers.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm15197652

Authors: Daniela Mihăilă, Horațiu-Paul Domnariu, Doru-Florian-Cornel Moga, Carmen-Daniela Domnariu

Institutions: Lucian Blaga University of Sibiu, Spitalul Clinic Judetean de Urgenta Sibiu

Language: English

Topic: Liver Disease Diagnosis and Treatment

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137