Physical activity support or weight loss counseling for nonalcoholic fatty liver disease?

Montesi, Luca; Caselli, C.; Centis, Elena; Nuccitelli, Chiara; Moscatiello, Simona; Suppini, Alessandro; Marchesini, Giulio

doi:10.3748/wjg.v20.i29.10128

Cited by 26 publications

(20 citation statements)

References 39 publications

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“…Considering the reduction observed for the NAFLD grade, this result was expected, as NAFLD worsens the state of IR and may lead on to type 2 diabetes in the predisposed subjects[48]. Improvement of IR was expected considering that it was already observed in previous studies as a consequence of treatment centered either on MedDiet[46] or increased physical activity[37]. …”

Section: Discussionmentioning

confidence: 87%

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

Gelli

Tarocchi

Abenavoli

et al. 2017

WJG

110

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AIMTo determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease (NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.METHODSForty-six adults with NAFLD received a 6-mo clinical and a dietary intervention (based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting (about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound (US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid- and end-interventions and US was repeated at end-intervention.RESULTSThe percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients (20%). At the end of the treatment the end-point concerning the weight (i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients (i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme (altered values reduced from 67% down to 11%). Several parameters, i.e., BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement (P < 0.01) between baseline and end-treatment.CONCLUSIONOutcomes of this study further strengthen the hypothesis that MedDiet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients.

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Section: Discussionmentioning

confidence: 87%

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

Gelli

Tarocchi

Abenavoli

et al. 2017

WJG

110

View full text Add to dashboard Cite

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“…He concluded that lifestyle modifications that led to weight reduction and/or increased physical activity greatly reduced liver fat and improved insulin sensitivity. More recently a study led by Montesi et al [47] found that intensive psychological counseling for physical activity improves physical fitness and liver fat independent of weight loss. Similar effects have been also verified by a recent meta-analysis study [48] .…”

Section: Dietary Modifications and Exercisementioning

confidence: 99%

“…The type of weight loss with a traditional low fat diet or calorie restriction is still debatable. All of these studies though, have particularly in lean NAFLD patients where large weight loss cannot be systematically pursued [47,65] .…”

Section: Dietary Modifications and Exercisementioning

confidence: 99%

Role of diet on non-alcoholic fatty liver disease: An updated narrative review

Papandreou

Andreou

2015

WJH

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The purpose of this article review is to update what is known about the role of diet on non-alcoholic fatty liver disease (NAFLD). NAFLD is the most common cause of chronic liver disease in the developed world and is considered to be a spectrum, ranging from fatty infiltration of the liver alone (steatosis), which may lead to fatty infiltration with inflammation known as non alcoholic steatohepatitis While the majority of individuals with risk factors like obesity and insulin resistance have steatosis, only few people may develop steatohepatitis. Current treatment relies on weight loss and exercise, although various insulin-sensitizing medications appear promising. Weight loss alone by dietary changes has been shown to lead to histological improvement in fatty liver making nutrition therapy to become a cornerstone of treatment for NAFLD. Supplementation of vitamin E, C and omega 3 fatty acids are under consideration with some conflicting data. Moreover, research has been showed that saturated fat, trans-fatty acid, carbohydrate, and simple sugars (fructose and sucrose) may play significant role in the intrahepatic fat accumulation. However, true associations with specific nutrients yet to be clarified.

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“…While exercise improves hepatic steatosis and underlying metabolic abnormalities in NAFLD, more studies are needed to define the most beneficial form and duration of exercise treatment [112,113]. Exercise should be promoted in motivated individuals, particularly in lean NAFLD patients where large weight loss cannot be pursued [114]. An experimental study in mice has also shown that regular exercise may protect from HCC development and this could be a further rationale for promoting regular PA in human NASH [115].…”

mentioning

confidence: 94%