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Advanced fibrosis is associated with increased mortality. Physical activity (PA) is important in treatment and prevention, but its association with hepatic fibrosis is not well characterised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined the cross\u2010sectional association between accelerometer\u2010measured PA and fibrosis measured by vibration\u2010controlled transient elastography. Primary covariates included age, sex, cohort, smoking status, alcohol use and accelerometer wear time. Secondary covariates included body mass index (BMI) and hepatic steatosis. The primary dependent variable was continuous liver stiffness measurement (LSM), and the secondary dependent variable was dichotomous liver fibrosis (LSM &gt;\u20098.2\u2009kPa). We performed sex\u2010specific, age\u2010adjusted Pearson correlation coefficients, as well as multivariable\u2010adjusted linear and logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In our study sample (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092201, 54.1% women, average age 54\u2009years old, average BMI 27.1\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) the prevalence of fibrosis was 7.7%. Each additional 30\u2009min spent in moderate\u2010vigorous PA (MVPA)\/day was associated with a lower odds of fibrosis (odds ratio 0.57; 95% confidence interval 0.41, 0.79) even after adjusting for BMI (0.72; 0.53, 0.99) or steatosis (0.70; 0.51, 0.96). Those who achieved at least 150\u2009min\/week of MVPA had the lowest odds of hepatic fibrosis (0.51; 0.35, 0.75) even when adjusted for BMI (0.64; 0.44, 0.95) or steatosis (0.61; 0.42, 0.90).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our community\u2010based cross\u2010sectional cohort study, there was an inverse association between time spent in MVPA and liver fibrosis, even when adjusting for BMI or steatosis. Additional interventional studies are needed to determine if MVPA can reverse liver fibrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70380","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T12:39:21Z","timestamp":1759840761000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Physical Activity by Accelerometer Inversely Associated With Liver Fibrosis; Cross\u2010Sectional Analysis of a Longitudinal Cohort"],"prefix":"10.1111","volume":"45","author":[{"given":"Madeleine G.","family":"Haff","sequence":"first","affiliation":[{"name":"Section of Gastroenterology, Department of Medicine Boston Medical Center, Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne M.","family":"Murabito","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine, Boston Medical Center Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"},{"name":"Framingham Heart Study  Framingham Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramachandran S.","family":"Vasan","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine, Boston Medical Center Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"},{"name":"Framingham Heart Study  Framingham Massachusetts USA"},{"name":"Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole L.","family":"Spartano","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes, Nutrition and Weight Management Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0703-0742","authenticated-orcid":false,"given":"Ching\u2010Ti","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emelia J.","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Framingham Heart Study  Framingham Massachusetts USA"},{"name":"Whitaker Cardiovascular Institute and Cardiology Section, Department of Medicine Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"},{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle T.","family":"Long","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Department of Medicine Boston Medical Center, Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"},{"name":"Novo Nordisk A\/S  Soborg 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