Physical Activity May Decrease Risk for Cirrhosis-Related Death

Individuals who exercise more have a lower risk of death related to liver disease compared with individuals who exercise less, according to a study¹ presented at Digestive Disease Week (DDW) 2019 on Sunday, May 19, in San Diego, California.

“Our findings show that both walking and strength training contribute to substantial reductions in risk of cirrhosis-related death, which is significant because we know very little about modifiable risk factors,” study lead author Tracey G. Simon, MD, an instructor of medicine at Harvard Medical School and Massachusetts General Hospital, said in a press release.²

Simon and colleagues prospectively followed 68,449 women from the Nurses’ Health Study and 48,748 men from the Health Professionals Follow-Up Study. All participants provided information on their physical activity via well-validated questionnaires every 2 years from 1986 through 2012. All participants had no known liver disease at baseline.

Over 26 years of follow-up, 269 deaths were attributed to cirrhosis (148 women, 121 men).

Overall, participants who reported the highest rate of weekly walking activity had a 73% lower risk of cirrhosis-related death compared with those who reported lower rates of weekly walking activity (adjusted hazard ratio [HR], 0.27; 95% CI, 0.14-0.54). Further risk reduction was observed with combined walking and muscle-strengthening exercises.

The adjusted HRs for 10 metabolic equivalent of task (MET) hours of vigorous aerobic activity and walking were 0.68 (95% CI, 0.60-0.88) and 0.52 (95% CI 0.38-0.69), respectively. An increasing walking MET score was associated with a reduced risk of cirrhosis-related death. Additionally, weekly resistance training was independently associated with reduced risk of liver-related death compared with no resistance training (adjusted HR, 0.47; 95% CI 0.28-0.76).

According to joint analyses, active individuals with more than 9 MET hours per week of walking—together with any resistance training—had significantly lower risk of death than those who had less than 3 MET hours per week of walking and no resistance training (adjusted HR, 0.38; 95% CI 0.15-0.79).

Simon said that US mortality due to cirrhosis is increasing dramatically, with rates expected to triple by 2030.

“In the face of this alarming trend, information on modifiable risk factors that might prevent liver disease is needed,” she said, adding that the study findings support research to define the optimal physical activity to prevent adverse outcomes in patients at risk of cirrhosis.²

—Melinda Stevens

References:

1. Simon TG, Giovannucci E, Corey KE, Zhang X, Chan AT. Physical activity, including walking and strength training, are associated with reduced risk of cirrhosis-related mortality: results from two prospective cohorts of U.S. men and women. Paper presented at: Digestive Disease Week 2019; May 18-21; San Diego, CA. 
2. Walking and strength training may decrease the risk of dying from liver disease [press release]. San Diego, CA: Digestive Disease Week; May 19, 2019.