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synergistic effect of lifestyle factors. Our aim is to derive a healthy lifestyle score (HLS) and estimate its association with NAFLD. In this nationwide cross-sectional study, we derived a five-item HLS including dietary pattern, body mass index, physical activity, cigarette smoking, and sleep duration. NAFLD and clinically significant fibrosis (CSF) were assessed based on vibration-controlled transient elastography (VCTE). Liver function parameters were also tested. Multivariable logistic and linear regressions were applied to investigate the association between HLS and liver diseases. Of the 3893 participants with VCTE examination, approximately 14.1% of participants possessed zero or one healthy lifestyle, 62.5% possessed two or three healthy lifestyles, and 23.4% possessed four or five healthy lifestyles. Compared with participants with a low HLS (0\u20131 score), the adjusted odds ratios and 95% confidence intervals for those with a high HLS (4\u20135 score) were 0.25 (0.19~0.33, Ptrend &lt; 0.001) for NAFLD and 0.30 (0.18~0.50, Ptrend &lt; 0.001) for CSF. HLS was positively associated with albumin, total protein, and total bilirubin (all Ptrend \u2264 0.001), and was inversely associated with globulin, alanine aminotransferase, and gamma-glutamyl transaminase (all Ptrend \u2264 0.003). Higher adherence to HLS is associated with lower odds of NAFLD and CSF and may improve liver function. Strategies for the promotion of a healthy lifestyle should be considered as part of NAFLD prevention.<\/jats:p>","DOI":"10.3390\/nu14214462","type":"journal-article","created":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T08:19:06Z","timestamp":1666599546000},"page":"4462","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Higher Adherence to Healthy Lifestyle Score Is Associated with Lower Odds of Non-Alcoholic Fatty Liver Disease"],"prefix":"10.3390","volume":"14","author":[{"given":"Yu","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"School of Public Health, Wannan Medical College, Wuhu 241002, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoxian","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufeng","family":"Mo","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songxian","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaozong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Practice, Suzhou Hospital of Anhui Medical University, Suzhou 234000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-2689","authenticated-orcid":false,"given":"Wanshui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Public Health, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1146\/annurev-pathol-012615-044224","article-title":"Nonalcoholic Fatty Liver Disease: Pathogenesis and Disease Spectrum","volume":"11","author":"Hardy","year":"2016","journal-title":"Annu. Rev. Pathol."},{"key":"ref_2","first-page":"76","article-title":"Non-alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations","volume":"8","author":"Kumar","year":"2020","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/S2468-1253(22)00165-0","article-title":"The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis","volume":"7","author":"Riazi","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1136\/gutjnl-2019-318813","article-title":"Epidemiology of chronic liver diseases in the USA in the past three decades","volume":"69","author":"Younossi","year":"2020","journal-title":"Gut"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.3748\/wjg.v21.i5.1650","article-title":"Central obesity and nonalcoholic fatty liver disease risk after adjusting for body mass index","volume":"21","author":"Pang","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.jhep.2010.07.040","article-title":"Smoking and severity of hepatic fibrosis in nonalcoholic fatty liver disease","volume":"54","author":"Zein","year":"2011","journal-title":"J. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"73","DOI":"10.15403\/jgld.2014.1121.281.alc","article-title":"Short sleep duration is a risk of incident nonalcoholic fatty liver disease: A population-based longitudinal study","volume":"28","author":"Okamura","year":"2019","journal-title":"J. Gastrointestin. Liver Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1111\/apt.12038","article-title":"Non-alcoholic fatty liver disease (NAFLD) is associated with low level of physical activity: A population-based study","volume":"36","author":"Gerber","year":"2012","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Abenavoli, L., Boccuto, L., Federico, A., Dallio, M., Loguercio, C., Di Renzo, L., and De Lorenzo, A. (2019). Diet and Non-Alcoholic Fatty Liver Disease: The Mediterranean Way. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16173011"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1038\/hr.2016.119","article-title":"Adherence to a healthy lifestyle and a DASH-style diet and risk of hypertension in Chinese individuals","volume":"40","author":"Bai","year":"2017","journal-title":"Hypertens. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1038\/s41416-021-01645-x","article-title":"Adherence to Healthy Lifestyle and Liver cancer in Chinese: A prospective cohort study of 0.5 million people","volume":"126","author":"Song","year":"2022","journal-title":"Br. J. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Sun, C., Li, K., Xu, H., Wang, X., Qin, P., Wang, S., Liang, B., and Xu, L. (2021). Association of healthy lifestyle score with all-cause mortality and life expectancy: A city-wide prospective cohort study of cancer survivors. BMC Med., 19.","DOI":"10.1186\/s12916-021-02024-2"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"n604","DOI":"10.1136\/bmj.n604","article-title":"Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: Two prospective cohort studies","volume":"373","author":"Zhang","year":"2021","journal-title":"BMJ"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1136\/jech-2014-204989","article-title":"Association of a lifestyle index with MRI-determined liver fat content in a general population study","volume":"69","author":"Koch","year":"2015","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"5081","DOI":"10.1017\/S1368980021000902","article-title":"Higher Healthy Lifestyle Score is associated with lower presence of non-alcoholic fatty liver disease in middle-aged and older Chinese adults: A community-based cross-sectional study","volume":"24","author":"Deng","year":"2021","journal-title":"Public Health Nutr."},{"key":"ref_16","unstructured":"Centers for Disease Control and Prevention (2021, April 11). NHANES Procedure Manuals, Available online: https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/continuousnhanes\/manuals.aspx?BeginYear=2017."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1123\/jpah.6.6.790","article-title":"Global physical activity questionnaire (GPAQ): Nine country reliability and validity study","volume":"6","author":"Bull","year":"2009","journal-title":"J. Phys. Act. Health"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Keating, X.D., Zhou, K., Liu, X., Hodges, M., Liu, J., Guan, J., Phelps, A., and Castro-Pinero, J. (2019). Reliability and Concurrent Validity of Global Physical Activity Questionnaire (GPAQ): A Systematic Review. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16214128"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"l6669","DOI":"10.1136\/bmj.l6669","article-title":"Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: Prospective cohort study","volume":"368","author":"Li","year":"2020","journal-title":"BMJ"},{"key":"ref_20","unstructured":"Centers for Disease Control and Prevention (2021, April 11). NHANES Laboratory Methods, Available online: https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/continuousnhanes\/labmethods.aspx?BeginYear=2017."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1002\/hep.32207","article-title":"High-quality diet, physical activity, and college education are associated with low risk of NAFLD among the US population","volume":"75","author":"Nephew","year":"2022","journal-title":"Hepatology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.cgh.2018.04.043","article-title":"Vibration-Controlled Transient Elastography to Assess Fibrosis and Steatosis in Patients with Nonalcoholic Fatty Liver Disease","volume":"17","author":"Siddiqui","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Al Thani, M., Al Thani, A.A., Al-Chetachi, W., Al Malki, B., Khalifa, S.A., Haj Bakri, A., Hwalla, N., Nasreddine, L., and Naja, F. (2016). A \u2018High Risk\u2019 Lifestyle Pattern Is Associated with Metabolic Syndrome among Qatari Women of Reproductive Age: A Cross-Sectional National Study. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17060698"},{"key":"ref_24","first-page":"2223","article-title":"Special considerations in interpreting liver function tests","volume":"59","author":"Johnston","year":"1999","journal-title":"Am. Fam. Physician"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1136\/postgradmedj-2015-133715","article-title":"Evaluation of abnormal liver function tests","volume":"92","author":"Agrawal","year":"2016","journal-title":"Postgrad. Med. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"383","DOI":"10.3350\/cmh.2012.18.4.383","article-title":"Serum bilirubin levels are inversely associated with nonalcoholic fatty liver disease","volume":"18","author":"Kwak","year":"2012","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/j.jhep.2021.06.010","article-title":"Bilirubin: The yellow hormone?","volume":"75","author":"Vitek","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1186\/s13018-020-01959-1","article-title":"Serum globulin and albumin to globulin ratio as potential diagnostic biomarkers for periprosthetic joint infection: A retrospective review","volume":"15","author":"Ye","year":"2020","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1002\/hep.22109","article-title":"Serum activity of alanine aminotransferase (ALT) as an indicator of health and disease","volume":"47","author":"Kim","year":"2008","journal-title":"Hepatology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1111\/liv.13221","article-title":"Gamma-glutamyltransferase-friend or foe within?","volume":"36","author":"Kunutsor","year":"2016","journal-title":"Liver Int."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Mantovani, A., and Dalbeni, A. (2021). Treatments for NAFLD: State of Art. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22052350"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"9330","DOI":"10.3748\/wjg.v20.i28.9330","article-title":"Non-alcoholic fatty liver disease and obesity: Biochemical, metabolic and clinical presentations","volume":"20","author":"Milic","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1038\/s42255-021-00493-6","article-title":"Lipolysis: Cellular mechanisms for lipid mobilization from fat stores","volume":"3","author":"Grabner","year":"2021","journal-title":"Nat. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s00125-011-2446-4","article-title":"Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis of randomised trials","volume":"55","author":"Musso","year":"2012","journal-title":"Diabetologia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1053\/j.gastro.2015.04.005","article-title":"Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis","volume":"149","author":"Friedman","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/liv.15057","article-title":"Higher dietary insulinaemic potential is associated with increased risk of liver steatosis and fibrosis","volume":"42","author":"Zhu","year":"2022","journal-title":"Liver Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1111\/jhn.12865","article-title":"Association of dietary insulinaemic potential and odds of non-alcoholic fatty liver disease among adults: A case-control study","volume":"34","author":"Sohouli","year":"2021","journal-title":"J. Hum. Nutr. Diet"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1111\/jhn.12962","article-title":"The Dietary Inflammatory Index and hepatic health in the US adult population","volume":"35","author":"Izquierdo","year":"2022","journal-title":"J. Hum. Nutr. Diet"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1017\/S1368980019002568","article-title":"Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is associated with lower presence of non-alcoholic fatty liver disease in middle-aged and elderly adults","volume":"23","author":"Xiao","year":"2020","journal-title":"Public Health Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/j.jand.2018.05.021","article-title":"Update of the Healthy Eating Index: HEI-2015","volume":"118","author":"Pannucci","year":"2018","journal-title":"J. Acad. Nutr. Diet"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3361","DOI":"10.3748\/wjg.v24.i30.3361","article-title":"Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis","volume":"24","author":"Leoni","year":"2018","journal-title":"World J. Gastroenterol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1111\/jgh.13391","article-title":"Short sleep duration and risk of nonalcoholic fatty liver disease: A systematic review and meta-analysis","volume":"31","author":"Wijarnpreecha","year":"2016","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/S2468-1253(21)00169-2","article-title":"Sleep and liver disease: A bidirectional relationship","volume":"6","author":"Marjot","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"115","DOI":"10.2188\/jea.JE20120067","article-title":"Active smoking, passive smoking, and risk of nonalcoholic fatty liver disease (NAFLD): A population-based study in China","volume":"23","author":"Liu","year":"2013","journal-title":"J. Epidemiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e1438","DOI":"10.1016\/j.cgh.2021.06.029","article-title":"Physical Activity Is Associated With Nonalcoholic Fatty Liver Disease and Significant Fibrosis Measured by FibroScan","volume":"20","author":"Kim","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1080\/21655979.2021.1933302","article-title":"The association between hypertension and nonalcoholic fatty liver disease (NAFLD): Literature evidence and systems biology analysis","volume":"12","author":"Ma","year":"2021","journal-title":"Bioengineered"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1161\/HYPERTENSIONAHA.120.15220","article-title":"Nonalcoholic Fatty Liver Disease and Advanced Fibrosis in US Adults Across Blood Pressure Categories","volume":"76","author":"Ciardullo","year":"2020","journal-title":"Hypertension"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/21\/4462\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:01:33Z","timestamp":1760144493000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/21\/4462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,24]]},"references-count":48,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["nu14214462"],"URL":"https:\/\/doi.org\/10.3390\/nu14214462","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,24]]}}}