Background Non-alcoholic fatty liver disease is a liver condition that is increasing worldwide and expected to become the number one cause of cirrhosis and hepatocellular carcinoma in the next 5 years. Currently there are no successful or approved pharmacological treatments. Weight loss is the first-line therapy as a 7 to 10% reduction improves steatosis, inflammation, hepatocyte ballooning, and fibrosis. To achieve this, lifestyle interventions including daily exercise and diet must be encouraged. We aimed to assess the effects of diet, exercise, or a combination of both compared to conventional treatment in patients with non-alcoholic fatty liver disease. Methods and finding A literature search was performed in CENTRAL, EMBASE, and PubMed. Randomized controlled trials comparing lifestyle changes with conventional treatment were included, without date restriction. Two authors searched studies according to eligibility criteria, extracted data, and assessed study quality. Subgroup analysis was made by type of intervention, duration of intervention and supervision. We calculated mean differences between the intervention and the control group with their corresponding 95% confidence intervals. Quality of the evidence was assessed using the Cochrane Risk of bias tool. This study is registered in PROSPERO, number CRD42020184241, and checked with the PRISMA checklist. 30 RCTs met the inclusion criteria. Compared to conventional treatment, combined exercise with diet seems to elicit greater reductions in ALT (MD: -13.27 CI 95% -21.39, -5.16), AST (MD: -7.02 CI 95% -11.26, -2.78) and HOMA-IR (MD: -2.07 CI 95% -2.61, -1.46) than diet (ALT MD: -4.48 CI 95% -1.01, -0.21; HOMA-IR MD: -0.61 CI 95% -1.01, -0.21) and exercise (ALT and AST non-significant; HOMA-IR MD = -0.46 CI 95% -0.8, -0.12) alone. Additionally, exercise improved quality of life, cardiorespiratory fitness, and weight (MD: -2.64 CI 95% -5.18, -0.09). Conclusion Lifestyle changes are effective in the treatment of NAFLD. Diet and exercise combined are superior to these interventions alone in improving liver enzymes and HOMA-IR.

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Background: Despite recent initiatives and efforts, gender inequality still exists in medicine and academia. There is a higher proportion of male authors in international scientific publications. Aim: To compare the proportion of female and male authors in the scientific publications of the main medical journals in Chile. Material and Methods: We reviewed 1,643 Scientific articles published between 2015 and 2020 in two medical journals from Chile.

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Non-alcoholic fatty liver disease (NAFLD) represents an excessive fat accumulation within the liver, usually associated with excess body weight. A liver biopsy is the gold standard for diagnosis, but it is inapplicable in population-based studies. In large populations, non-invasive methods could be used, which may also serve to identify potential protective factors. We aimed to: [a] estimate NAFLD prevalence in the adult population in Chile by using non-invasive methods; and [b] determine the association between the presence of NAFLD and lifestyle habits. The National Health Survey of Chile 2016-2017 was analysed. We included individuals aged 21-75 years, without infectious diseases nor risky alcohol consumption. NAFLD was detected by either Fatty Liver Index (FLI; considers circulating triglycerides, circulating gamma-glutamyl-transferase, body mass index, and waist circumference), Lipid Accumulation Product (LAP; considers sex, circulating triglycerides, and waist circumference), or their combination. Lifestyle habits were determined by questionnaires. We included 2,774 participants, representative of 10,599,094 [9,831,644–11,366,544] adults in Chile. NAFLD prevalence [95%CI] was 39.4% [36.2–42.8] by FLI, 27.2% [24.2–30.4] by LAP, and 23.5% [20.7–26.5] by their combination. The prevalence progressively increased with increasing body mass index. Less smoking, and more moderate-vigorous physical activity and whole-grain consumption were associated with lower odds of having NAFLD, independently of body mass index. At least one out of four adults in Chile is afflicted with NAFLD. Health promotion strategies focused on controlling excess body weight and promoting specific lifestyle habits are urgently required.