{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:02:45Z","timestamp":1780473765998,"version":"3.54.1"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Lifestyle Medicine"],"abstract":"<jats:p>\n                    Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease globally, with increasing prevalence among adults. Despite its growing burden, limited research has examined the influence of psychosocial factors, including unhealthy behavior on NAFLD in the USA. Retrospective cross-sectional study was conducted using data from the 2013\u20132018 National Health and Nutrition Examination Survey. Descriptive statistics, stratified prevalence estimates, and Poisson regression models were used to assess unadjusted and adjusted associations. The results showed that among 5804 eligible participants, the overall prevalence of NAFLD was 42%. Higher prevalence was observed among males (48%), individuals with obesity (37%), those reporting unhealthy behaviors (48%), and those with depressive disorders (47%). In adjusted models, unhealthy behavior (PR = 1.35; 95% CI: 1.22\u20131.49;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001) and depression (PR = 1.13; 95% CI: 1.04\u20131.22;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.005) were independently associated with an increased prevalence of NAFLD among young US adults and is independently associated with modifiable behavioral and psychological factors. These findings underscore the need for integrated public health strategies as well as nutritional interventions that could address lifestyle behaviors and mental health to mitigate the burden of NAFLD in this population.\n                  <\/jats:p>","DOI":"10.1177\/15598276261449749","type":"journal-article","created":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T11:37:31Z","timestamp":1780227451000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Interrelationship Between Depression, Unhealthy Behavior, and Non-Alcoholic Fatty Liver Disease in the United States of America"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5840-701X","authenticated-orcid":false,"given":"Grace Taiwo","family":"Otitoju","sequence":"first","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Benitez","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shekeel","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Molokwu","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alok Kumar","family":"Dwivedi","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2022.0365"},{"key":"e_1_3_3_3_2","volume-title":"Epidemiologic and etiologic considerations of obesity","author":"Singh A","year":"2025","unstructured":"Singh A, Hardin BI, Keyes D. Epidemiologic and etiologic considerations of obesity. StatPearls - NCBI Bookshelf. 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK585067\/"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.5009\/gnl20127"},{"key":"e_1_3_3_5_2","unstructured":"American Liver Foundation (2025). Metabolic dysfunction-associated steatotic liver disease (MASLD). https:\/\/liverfoundation.org\/liver-diseases\/fatty-liver-disease\/nonalcoholic-fatty-liver-disease-nafld"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/dsi23-0010"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-313884"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.12.012"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2013.41"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00375-2"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-022-00635-5"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.08.189"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.985803"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32542"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.10.027"},{"key":"e_1_3_3_16_2","volume-title":"NCHS Research Ethics Review Board (ERB) Approval","author":"National Center for Health Statistics, Centers for Disease Control and Prevention","year":"2010","unstructured":"National Center for Health Statistics, Centers for Disease Control and Prevention. NCHS Research Ethics Review Board (ERB) Approval. National Center for Health Statistics; 2010. Available from: https:\/\/www.cdc.gov\/nchs\/nhanes\/irba98.htm"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.86767"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/diseases12070134"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12242520"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7341a2"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.089284"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.4082\/kjfm.24.0099"},{"key":"e_1_3_3_23_2","volume-title":"What Colleges Need to Know now","author":"National Institute on Alcohol Abuse and Alcoholism","year":"2007","unstructured":"National Institute on Alcohol Abuse and Alcoholism. Defining binge drinking. In: What Colleges Need to Know now.: National Institutes of Health: Bethesda, MD; 2007. Retrieved August 19, 2025, from. https:\/\/www.collegedrinkingprevention.gov\/sites\/cdp\/files\/documents\/1College_Bulletin-508_361C4E.pdf"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1062-1458(02)00670-0"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25762"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11901-020-00552-8"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1760"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-1902"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2016.01.001"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2022.1605215"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.1042442"},{"issue":"24","key":"e_1_3_3_34_2","first-page":"5081","article-title":"Psychological factors associated with NAFLD\/NASH: a systematic review","volume":"20","author":"Macavei B","year":"2016","unstructured":"Macavei B, Baban A, Dumitrascu DL. Psychological factors associated with NAFLD\/NASH: a systematic review. Eur Rev Med Pharmacol Sci. 2016;20(24):5081-5097.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjpmh.2023.08.001"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2025.04.086"}],"container-title":["American Journal of Lifestyle Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15598276261449749","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15598276261449749","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15598276261449749","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:16:16Z","timestamp":1780470976000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15598276261449749"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,31]]},"references-count":35,"alternative-id":["10.1177\/15598276261449749"],"URL":"https:\/\/doi.org\/10.1177\/15598276261449749","relation":{},"ISSN":["1559-8276","1559-8284"],"issn-type":[{"value":"1559-8276","type":"print"},{"value":"1559-8284","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,31]]},"article-number":"15598276261449749"}}