Life's Simple 7 and Nonalcoholic Fatty Liver Disease: The Multiethnic Study of Atherosclerosis Article

Oni, E, Ogunmoroti, O, Allen, N et al. (2021). Life's Simple 7 and Nonalcoholic Fatty Liver Disease: The Multiethnic Study of Atherosclerosis . 134(4), 519-525. 10.1016/j.amjmed.2020.09.023

cited authors

  • Oni, E; Ogunmoroti, O; Allen, N; A-Mallah, MH; Blankstein, R; Martin, SS; Zeb, I; Cushman, M; Joshi, PH; Budoff, MJ; Blaha, MJ; Blumenthal, RS; Veledar, E; Nasir, K



  • Background: The American Heart Association (AHA) has defined Life's Simple 7 (LS7) as a measure of overall cardiovascular health. Nonalcoholic fatty liver disease (NAFLD) has been involved as a risk factor for cardiovascular disease. We evaluated the association between LS7 and NAFLD. Methods: We evaluated participants form the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Cardiovascular health score was calculated from the Life's Simple 7 metrics. A score of 0-8 was considered inadequate, 9-10 average, and 11-14 optimal. NAFLD was defined using noncontrast cardiac computed tomography (CT) and a liver/spleen attenuation ratio (L/S) < 1. Multivariable regression were performed to evaluate the association. Results: Our cross-sectional analysis of 3901 participants showed 19% (n = 747) had optimal cardiovascular health, 33% (n = 1270) had average, and 48% (n = 1884) had inadequate. White participants were most likely to have an optimal score (51%, n = 378), whereas African American participants had the lowest proportion with optimal scores (16%, n = 120; P < 0.001). The overall prevalence of NAFLD was 18% with a distribution of 7%, 14%, and 25% in the optimal, average, and inadequate score categories, respectively (P < 0.001). Adjusted for risk factors, average and optimal health categories had lower odds of NAFLD compared to those with inadequate scores: odds ratio for average, 0.44 (95% confidence interval 0.36-0.54); optimal, odds ratio 0.19 (95% confidence interval 0.14-0.26). This association was similar across gender, race and age groups. Conclusion: A more favorable cardiovascular health score was associated with a lower prevalence of NAFLD. This study may suggest a potential of Life's Simple 7 in the prevention of liver disease.

publication date

  • April 1, 2021

Digital Object Identifier (DOI)

start page

  • 519

end page

  • 525


  • 134


  • 4