{
  "abstract": "Background: Physical activity and Mediterranean diet adherence are important components of lifestyle management in patients with metabolic syndrome (MetS) and alcohol-related liver disease (ALD). We evaluated 12-month changes in lifestyle, metabolic parameters, and non-invasive fibrosis-related markers and explored their associations. Methods: In this 12-month prospective observational study, 50 adults with MetS and ALD were assessed at baseline, 6 months, and 12 months. Physical activity (IPAQ-SF), Mediterranean diet adherence (MEDAS-14), alcohol consumption status, liver stiffness, FIB-4, and APRI were evaluated. Exploratory multivariable analyses adjusted for sustained alcohol abstinence, baseline liver disease severity, age, sex, and change in waist circumference. Results: Physical activity increased from 455.2 ± 154.1 to 910.3 ± 275.4 MET-min/week and MEDAS-14 from 4.32 ± 0.62 to 7.92 ± 0.92 (both p < 0.001). Waist circumference, fasting glucose, LDL cholesterol, and triglycerides decreased significantly (all p < 0.001). At 12 months, physical activity and Mediterranean diet adherence were inversely correlated with liver stiffness, FIB-4, and APRI (all p ≤ 0.010). However, changes in IPAQ-SF and MEDAS-14 were not significantly associated with changes in non-invasive fibrosis-related markers after multivariable adjustment. Sustained alcohol abstinence (74.0%) was consistently associated with more favorable changes in all three markers. Conclusions: Improvements in physical activity and Mediterranean diet adherence occurred alongside favorable metabolic and liver-related changes, but their associations with non-invasive fibrosis-related markers were not maintained after adjustment for major potential confounders. Sustained alcohol abstinence was consistently associated with more favorable changes in these markers.",
  "abstract_shown": true,
  "affiliations": [
    "Doctoral School of Medicine, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550024 Sibiu, Romania",
    "Department of Internal Medicine, “Dr. Alexandru Augustin” Military Clinical Emergency Hospital Sibiu, 550024 Sibiu, Romania",
    "Surgical Clinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550024 Sibiu, Romania",
    "Clinical Department of Surgery, “Dr. Alexandru Augustin” Military Clinical Emergency Hospital Sibiu, 550024 Sibiu, Romania",
    "Department of Dental Medicine and Nursing, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550024 Sibiu, Romania"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Daniela Mihăilă",
      "orcid": "0009-0001-9597-3766"
    },
    {
      "affs": [
        2
      ],
      "name": "Horațiu-Paul Domnariu"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Doru-Florian-Cornel Moga"
    },
    {
      "affs": [
        4
      ],
      "name": "Carmen-Daniela Domnariu",
      "orcid": "0000-0002-7098-5525"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6emkjf8hrs9ht.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15197652",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665958/?tool=EBI",
  "id": "6emkjf8hrs9ht",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13665958",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Liver Disease Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7216458711",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665958/pdf/?tool=EBI",
  "pmcid": "PMC13665958",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/6emkjf8hrs9ht.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:35Z",
      "native_id": "PMC:PMC13665958",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13665958"
    },
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15197652",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/19/7652"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Liver Disease Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Physical Activity and Mediterranean Diet Adherence in Patients with Metabolic Syndrome and Alcohol-Related Liver Disease: A 12-Month Prospective Study",
  "title_text": "Physical Activity and Mediterranean Diet Adherence in Patients with Metabolic Syndrome and Alcohol-Related Liver Disease: A 12-Month Prospective Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:00Z",
  "url": "https://research.draconitic.com/paper/6emkjf8hrs9ht",
  "venue": "Journal of clinical medicine",
  "versions": []
}