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Abstract Details
Breaking Down Barriers to Physical Activity in Patients with Nonalcoholic Fatty Liver Disease
Jonathan G Stine12345, Christopher Soriano6, Ian Schreibman78, Gloriany Rivas7, Breianna Hummer7, Esther Yoo6, Kathryn Schmitz9101112, Christopher Sciamanna9106
Author information
1Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA. jstine@pennstatehealth.psu.edu.
2Department of Public Health Sciences, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA. jstine@pennstatehealth.psu.edu.
3Liver Center, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA. jstine@pennstatehealth.psu.edu.
4Cancer Institute, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA. jstine@pennstatehealth.psu.edu.
5Penn State Cancer Institute, Hershey, USA. jstine@pennstatehealth.psu.edu.
6Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA.
7Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
8Liver Center, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA.
9Department of Public Health Sciences, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA.
10Cancer Institute, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA.
11Department of Kinesiology, The Pennsylvania State University- College of Medicine, Hershey, PA, USA.
12Department of Physical Medicine & Rehabilitation, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA.
Abstract
Background: Lifestyle changes, including physical activity, are the cornerstones of the treatment of nonalcoholic fatty liver disease (NAFLD). For unclear reasons, most NAFLD patients do not achieve the recommended amount of weekly activity.
Aims: Our aim was to measure perceived barriers to physical activity and enablers to exercise intervention.
Methods: Consecutive subjects aged 18-70 with NAFLD were prospectively enrolled. An exercise motivation questionnaire was administered to assess current behaviors and perceived barriers.
Results: Eighty-seven subjects (60% female) were enrolled with mean age 52 years and mean body mass index (BMI) 34.5 kg/m2. Metabolic comorbidities were common: 49% had hyperlipidemia, 42% hypertension, and 40% diabetes. The majority (75%) did not achieve ≥ 150 min/week of physical activity. Ninety-one percent agreed that activity was important in improving NAFLD; 88% desired to be more active. Lack of exercise resources and education from treating provider (47%), physical discomfort during exercise (44%), and time constraints (32%) were the most common barriers. Rates of fitness tracker (34%), gym (33%), exercise program (33%), and personal trainer (17%) use were low.
Conclusions: While nearly all subjects with NAFLD identify physical activity to be important and desire to be more active, only a few meet activity recommendations. This discordance is due to a perceived lack of resources and education, physical discomfort, and time constraints. Better understanding of these barriers and behaviors are important to improve morbidity and mortality in NAFLD. Future behavioral research removing the identified barriers is of great importance to global public health and should be prioritized.