Cirrhosis-Related Death Risk Lowered with Physical Activity

A recent study has found that walking, combined with resistance training, could dramatically decrease a person’s chance cirrhosis-related mortality.

The study, which was presented at Digestive Disease Week 2019 in San Diego, CA, found that physical activity was associated with a 73% lower risk of dying from liver disease after studying more than 117,000 people over a 26-year period.

“In the US, mortality due to cirrhosis is increasing dramatically, with rates expected to triple by the year 2030. In the face of this alarming trend, information on modifiable risk factors that might prevent liver disease is needed,” said Tracey Simon, MD, lead researcher on the study and instructor of medicine at Harvard Medical School and Massachusetts General Hospital, Boston.

Investigators sought to determine the association between physical activity and a decreased risk of cirrhosis-related mortality. They observed 68,449 women, from the Nurses’ Health Study, and 48,748 men, from the Health Professionals Follow-up Study, who reported weekly time spent on resistance exercise, walking, and individual aerobic activities from 1986 through 2012. Medical records, death certificates, and next of kin were used to confirm all deaths.

While past studies and research have been limited, usually only assessing physical activity at one point or have had short follow-up periods. This study represented the first prospective study in a large US population to included updated measurements of physical activity over such a prolonged period. The longer study period allowed investigators to more accurately estimate the relationship between physical activity.

Investigators recorded 269 deaths, of which 148 were women and 121 were men, over 26 years of follow-up. Investigators found that physical activity was inversely associated with risk for cirrhosis-related death. Adults in the highest quintile of physical activity were at a 73% lower risk of cirrhosis-related death compared to adults in the lowest quintile.

Investigators noted that equivalent energy expenditures from vigorous aerobic activity and from walking resulted in comparable magnitudes of risk reduction. The adjusted hazard ratios for 10 metabolic equivalent task hours of vigorous activity and walking were 0.68 and 0.52, respectively. Additionally, weekly resistance training was independently associated with reduced risk for liver-related deaths.

After performing joint analyses, investigators found that adults engaging in more than 9 MET-hours per week of walking together with any resistance training had significantly lower risk of dying from chronic liver disease when compared adults with fewer than 3 MET hours per week of walking and no resistance training.

“The benefit of exercise is not a new concept, but the impact of exercise on mortality from cirrhosis and from liver cancer has not yet been explored on this scale,” Simon said. “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.”

This study, titled “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,” was presented during DDW 2019 in San Diego, CA.