Supplementary Material for: Lifestyle measures and the risk of Metabolic Dysfunction-Associated Steatotic Liver Disease: a cross-sectional study

Introduction: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is intricately related with Metabolic Syndrome (MetS), where diet and lifestyle play central roles. We aimed to explore associations between lifestyle habits and hepatic steatosis and fibrosis.
Methods: This is a cross-sectional study including patients from the microDHNA cohort, which comprises adults diagnosed with MetS, followed at the Endocrinology outpatient setting of University Hospital Centre of São João. Participants underwent liver elastography and completed lifestyle questionnaires, including the Mediterranean Diet Adherence Screener and the International Physical Activity Questionnaire. Patients were categorized according to the presence of steatosis and fibrosis, as well as by liver stiffness tertiles. Logistic regression models were performed to evaluate the associations between lifestyle and hepatic elastography parameters.
Results: The population included (n=58) had a mean age of 62.1±9.2 years, and 58.6% were female. The non-steatosis group reported higher levels of vigorous physical activity (240.0 vs 0.0 MET-min/week, p<0.01), and less weekend sedentary time (264.7±87.6 vs 349.2±115.1 minutes, p<0.01). Red fruits were associated with a lower odd of hepatic steatosis (OR=0.47; 95%CI(0.23–0.95), p=0.034). Across elastography tertiles, weekend sedentary time increased (p=0.012), while tea consumption decreased (p=0.048).
Conclusion: Our findings suggest that physical activity and preferential consumption of red fruits and tea may be associated with more favorable hepatic elastography parameters, while sedentary time may lead to less favorable outcomes.