title: Hepatic steatosis is associated with lower levels of physical activity measured via accelerometry.
abstract: OBJECTIVE
  Prior studies on the association of physical activity (PA) and nonalcoholic fatty liver disease are limited by reliance on subjective measures of PA. We examined the association between objectively measured PA and hepatic steatosis defined by computed tomography (CT).
  
  
  METHODS
  We conducted a cross-sectional study of 1,060 Framingham Heart Study participants who participated in the Multidetector CT 2 substudy and who underwent assessment of PA via accelerometry. Hepatic steatosis was estimated by liver attenuation, as measured by CT. We explored the relationship between liver attenuation and PA using multivariable regression models.
  
  
  RESULTS
  In multivariable-adjusted models, we observed an inverse association between PA and liver attenuation. Each 30 minutes/day increase in moderate to vigorous PA (MVPA) was associated with a reduced odds of hepatic steatosis (OR = 0.62, P < 0.001). This association was attenuated and no longer statistically significant after adjustment for body mass index (BMI) (OR = 0.77, P = 0.05) or visceral adipose tissue (VAT) (OR = 0.83, P = 0.18). Participants who met the national PA recommendations of engaging in ≥150 minutes/week of MVPA had the lowest odds of hepatic steatosis, even after adjusting for BMI (OR = 0.63, P = 0.007) or VAT (OR = 0.67, P = 0.03).
  
  
  CONCLUSIONS
  There is an inverse association between PA and hepatic steatosis. Participants who met the national PA guidelines had the lowest prevalence of hepatic steatosis.
authors.affiliation: Division of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.|National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Long
authors.affiliation: National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Pedley
authors.affiliation: National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.|Department of Mathematics and Statistics, Boston University, Boston, Massachusetts, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.affiliation: Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.affiliation: School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK.
authors.forename: Dale W
authors.initials: DW
authors.lastname: Esliger
authors.affiliation: National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.|Section of Preventive Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.affiliation: National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.|Division of Endocrinology, Hypertension, and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
authors.affiliation: National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.|Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Murabito
mesh_terms: D061725:Accelerometry / Q000379:methods; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D056128:Obesity, Abdominal / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D057185:Sedentary Behavior; D014057:Tomography, X-Ray Computed