Differential Exercise Requirements for Nonalcoholic Fatty Liver Disease Resolution Across Age Groups: A Longitudinal Study of Korean Military Officers.

Background: Nonalcoholic fatty liver disease (NAFLD) is a global health concern, and despite its high prevalence, lifestyle modifications such as exercise play a pivotal role in resolving this condition. This study aims to identify factors associated with NAFLD resolution, with a focus on the role of exercise, in different age groups.

Methods: Longitudinal data from Korean military officers, during the period 2019-2021, were obtained from the National Health Information Database. NAFLD was defined as a hepatic steatosis index ≥36, and NAFLD resolution was defined as individuals achieving hepatic steatosis index <36 in the subsequent year of diagnosis. Information on alcohol consumption, exercise frequency, and family history of diabetes was collected through self-reported questionnaires.

Results: The analysis included a total of 163,728 individuals, with a mean age of 36.87, predominantly male (91.62%). The prevalence of NAFLD was 27.04%. Favorable factors for NAFLD resolution encompassed moderate-intensity exercise for more than 180 minutes per week, vigorous-intensity exercise for more than 90 minutes per week, female sex, age, and resistance exercise for more than 3 days per week. Hypertension, family history of diabetes, and smoking were identified as factors against NAFLD resolution. The exercise requirements for NAFLD resolution varied among age groups, with those <30 years old requiring more than 180 minutes per week of moderate- or vigorous-intensity exercise and those >50 years old needing only 90 minutes per week of such exercise.

Conclusion: The exercise requirements for NAFLD resolution exhibit age-related differences. Individualized guidance for NAFLD management should consider these variations and be tailored to specific age groups.