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Impact of Physical Activity Differences Due to COVID-19 Pandemic Lockdown on Non-Alcoholic Fatty Liver Parameters in Adults with Metabolic Syndrome.

Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain. Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain. CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain. Radiodiagnosis Service, Red Asistencial Juaneda, 07011 Palma de Mallorca, Spain. Clinical Analysis Service, University Hospital Son Espases, 07120 Palma de Mallorca, Spain. Camp Redó Primary Health Care Center, 07010 Palma de Mallorca, Spain. Area of Physical Education and Sports, Department of Pedagogy and Specific Didactics, University of the Balearic Islands, 07122 Palma de Mallorca, Spain. Cardiometabolics Precision Nutrition Program, IMDEA Food, CEI UAM-CSIC, 28049 Madrid, Spain. Department of Nutrition, Food Sciences, and Physiology, University of Navarra, 31008 Pamplona, Spain.

Nutrients. 2022;(12)
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Abstract

BACKGROUND A Mediterranean lifestyle with a Mediterranean diet and regular physical activity (PA) improves metabolic syndrome (MetS) characteristics and non-alcoholic fatty liver disease (NAFLD). The COVID-19 pandemic stopped healthy habits and increased NAFLD progression. OBJECTIVES To assess how PA differences due to COVID-19 lockdown affected NAFLD parameters in adults with MetS. DESIGN Longitudinal 2-year analysis of data obtained between COVID-19 pre- and post-lockdown in a parallel-group randomized trial (n = 57, aged 40-60 years old, with MetS and NAFLD). METHODS NAFLD status and related parameters were assessed by magnetic resonance imaging (MRI), blood collection analysis and related indexes. PA and fitness status were assessed by an Alpha-Fit test battery, accelerometers, validated Minnesota questionnaire and functional fitness score. During lockdown, study personnel telephoned patients to motivate them. Participants were grouped according to PA levels. RESULTS The low PA group improved its fitness score tests (0.2) after lockdown more than the medium PA group, and it decreased its sedentary activity (-48.7 min/day), increased light (20.9 min/day) and moderate (32.3 min/day) PA intensities and improved sleep efficiency (0.6%) in comparison with the medium and high PA groups. The high PA group increased its steps per day more than the other groups. The low PA group was the only group that decreased its gamma glutamyl transferase (GGT) levels (-17.0 U/L). All groups increased their fatty liver index (FLI) after lockdown, but the medium PA group increased its FLI more than the low PA group. Participants in the high PA group decreased their HDL-cholesterol levels more than participants in the medium PA group (-0.4 mg/dL). CONCLUSIONS Stopping regular PA together with an unhealthy lifestyle leads to a worsening of MetS and NAFLD. COVID-19 lockdown induced a decrease in PA in more active people, but inactive people increased their PA levels. Motivation seemed to be very important during lockdown.