Diet, exercise, ALD and Liver mortality - J of Hepatology-Jan 26

The context you provided discusses the impact of diet quality (DQ) and physical activity (PA) on alcohol-related liver mortality, which is a critical aspect of alcohol-related liver disease (ALD). Although the specific article from the *Journal of Hepatology* on January 26 is not directly referenced in the context, the study described aligns closely with the themes of diet, exercise, ALD, and liver mortality.

### Key Findings Related to Diet, Exercise, and Liver Mortality in ALD

1. **Healthy Diet and Liver Mortality:**

• A healthier diet, defined as being in the top quartile of the Healthy Eating Index (HEI), significantly reduces the risk of liver-related mortality among individuals with varying levels of alcohol consumption.
• Specifically, diets rich in vegetables, fruits, whole grains, seafood, plant-based proteins, and unsaturated fats—and low in solid fats, alcohol, and added sugars—are protective against liver mortality.
• Among heavy and binge drinkers, a healthy diet reduced liver mortality risk by up to 86% (aSHR: 0.14 for heavy drinkers) and 84% (aSHR: 0.16 for binge drinkers), respectively, compared to those with unhealthier diets.

2. **Physical Activity and Liver Mortality:**

• Regular physical activity (at least 150 minutes of moderate-intensity exercise, 75 minutes of vigorous-intensity exercise, or a combination per week) is associated with a significantly lower risk of liver-related mortality.
• Physically active individuals had a reduced risk of liver mortality, even among heavy drinkers (aSHR: 0.64) and binge drinkers (aSHR: 0.31).

3. **Combined Impact of Diet and Exercise:**

• The combined effects of a healthy diet and regular physical activity provide substantial protective benefits against alcohol-related liver mortality.
• These lifestyle factors are particularly impactful for women, who experienced greater survival benefits compared to men.

4. **Alcohol Consumption and Risk:**

• Alcohol consumption, particularly heavy drinking and binge drinking, significantly increases the risk of liver-related mortality. However, the adoption of a healthy diet and regular exercise can mitigate some of this risk.

### Implications for ALD Prognosis:

• For individuals with alcohol-related liver disease or at risk of alcohol-related liver mortality, adopting a healthy diet and engaging in regular physical activity can substantially improve prognosis.
• These lifestyle modifications may help reduce liver inflammation, improve metabolic health, and enhance overall liver function, thereby lowering mortality risk.
• The findings also highlight the importance of public health interventions to promote dietary improvements and physical activity, particularly among populations with high alcohol consumption.

### Conclusion:

Healthy eating and increased physical activity are highly impactful in mitigating the prognosis of alcohol-related liver disease (ALD) and reducing liver-related mortality. These lifestyle factors provide a non-invasive, cost-effective approach to improving outcomes for individuals at risk of or suffering from ALD.