title: Non-alcoholic fatty liver disease is associated with higher levels ofobjectivelymeasured sedentary behaviour and lower levels of physical activity than matched healthy controls.
abstract: OBJECTIVE
  Physical activity is a key determinant of metabolic control and is recommended for people with non-alcoholic fatty liver disease (NAFLD), usually alongside weight loss and dietary change. To date, no studies have reported the relationship betweenobjectivelymeasured sedentary behaviour and physical activity, liver fat and metabolic control in people with NAFLD, limiting the potential to target sedentary behaviour in clinical practice. This study determined the level of sedentary behaviour and physical activity in people with NAFLD, and investigated links between physical activity, liver fat and glucose control.
  
  
  METHODS
  Sedentary behaviour, physical activity and energy expenditure were assessed in 37 adults with NAFLD using a validated multisensor array over 7 days. Liver fat and glucose control were assessed, respectively, by1H-MRS and fasting blood samples. Patterns of sedentary behaviour were assessed by power law analyses of the lengths of sedentary bouts fitted from raw sedentary data. An age and sex-matched healthy control group wore the activity monitor for the same time period.
  
  
  RESULTS
  People with NAFLD spent approximately half an hour extra a day being sedentary (1318±68 vs1289±60 mins/day; p<0.05) and walked 18% fewer steps (8483±2926 vs 10377±3529 steps/day; p<0.01). As a consequence, active energy expenditure was reduced by 40% (432±258 vs 732±345 kcal/day; p<0.01) and total energy expenditure was lower in NAFLD (2690±440 vs 2901±511 kcal/day; p<0.01). Power law analyses of the lengths of sedentary bouts demonstrated that patients with NAFLD also have a lower number of transitions from being sedentary to active compared with controls (13±0.03 vs15±0.03%; p<0.05).
  
  
  CONCLUSIONS
  People with NAFLD spend more time sedentary and undertake less physical activity on a daily basis than healthy controls. High levels of sedentary behaviour and low levels of physical activity represent a therapeutic target that may prevent progression of metabolic conditions and weight gain in people with NAFLD and should be considered in clinical care.
authors.affiliation: Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Hallsworth
authors.affiliation: Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Christian
authors.initials: C
authors.lastname: Thoma
authors.affiliation: Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Moore
authors.affiliation: The School of Computing Science, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ploetz
authors.affiliation: Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Quentin M
authors.initials: QM
authors.lastname: Anstee
authors.affiliation: Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Roy
authors.initials: R
authors.lastname: Taylor
authors.affiliation: Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Day
authors.affiliation: Institute of Cellular Medicine, Newcastle University , Newcastle upon Tyne , UK.
authors.forename: Michael I
authors.initials: MI
authors.lastname: Trenell
keywords: FATTY LIVER; NONALCOHOLIC STEATOHEPATITIS; OBESITY