Physical Activity and Mediterranean Diet Adherence in Patients with Metabolic Syndrome and Alcohol-Related Liver Disease: A 12-Month Prospective Study
5 affiliations
- 1Doctoral School of Medicine, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550024 Sibiu, Romania
- 2Department of Internal Medicine, “Dr. Alexandru Augustin” Military Clinical Emergency Hospital Sibiu, 550024 Sibiu, Romania
- 3Surgical Clinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550024 Sibiu, Romania
- 4Clinical Department of Surgery, “Dr. Alexandru Augustin” Military Clinical Emergency Hospital Sibiu, 550024 Sibiu, Romania
- 5Department of Dental Medicine and Nursing, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550024 Sibiu, Romania
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.
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BibTeX
@article{mihaila2026physical,
title = {{Physical Activity and Mediterranean Diet Adherence in Patients with Metabolic Syndrome and Alcohol-Related Liver Disease: A 12-Month Prospective Study}},
author = {Daniela Mihăilă and Horațiu-Paul Domnariu and Doru-Florian-Cornel Moga and Carmen-Daniela Domnariu},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197652},
url = {https://europepmc.org/article/PMC/PMC13665958},
note = {CC BY},
}
RIS
TY - JOUR
TI - Physical Activity and Mediterranean Diet Adherence in Patients with Metabolic Syndrome and Alcohol-Related Liver Disease: A 12-Month Prospective Study
AU - Daniela Mihăilă
AU - Horațiu-Paul Domnariu
AU - Doru-Florian-Cornel Moga
AU - Carmen-Daniela Domnariu
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197652
UR - https://europepmc.org/article/PMC/PMC13665958
AB - 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.
SN - 2077-0383
ER -