Stage of change and motivation to healthier lifestyle in non-alcoholic fatty liver disease

Centis, Elena; Moscatiello, Simona; Bugianesi, Elisabetta; Bellentani, Stefano; Fracanzani, Anna Ludovica; Calugi, Simona; Petta, Salvatore; Grave, Riccardo Dalle; Marchesini, Giulio

doi:10.1016/j.jhep.2012.11.031

Cited by 76 publications

(63 citation statements)

References 40 publications

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“…However, published evidence, in accordance with usual clinical practice, reports that the efficacy of this approach is often diminished by poor implementation and reduced adherence to the prescribed regimen of diet and exercise [16]. The results of the present 3-month observational study, conducted with non-diabetic subjects diagnosed with liver steatosis and also characterised by the presence of insulin resistance and other signs of metabolic syndrome, confirm that lifestyle intervention alone may not be sufficient to achieve significant objective improvements which may be important to favour the necessary long-term adherence to such a regimen.…”

Section: Discussionmentioning

confidence: 99%

“…However, actual long-term compliance of subjects with NAFLD to lifestyle intervention protocols is usually reported to be unsatisfactory. Reinforcing the ‘motivation to change’ in these subjects seems to be a critical factor, and strategies of targeted behavioural counselling, to provide these subjects not only with motivation but also with tools to monitor improvements and therefore to sustain the lifestyle changes, have been proposed for evaluation in clinical trials [16]. In a similar perspective, with the aim of improving the subjective and objective results of lifestyle changes in subjects with liver steatosis, and therefore to possibly reinforce their motivation to compliance, the present study has observed the effects of a nutraceutical product as an adjunct to the standard diet and exercise regimen.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Lifestyle Changes in Subjects with Non-Alcoholic Liver Steatosis and Metabolic Syndrome May Be Improved with an Antioxidant Nutraceutical: A Controlled Clinical Study

Sorrentino¹,

Crispino²,

Coppola³

et al. 2015

Drugs R D

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IntroductionThe prevalence of liver steatosis is particularly high in subjects with signs of the metabolic syndrome, and current therapeutic guidelines mostly rely on lifestyle changes alone, which rarely achieve significant objective improvements. In the present study, we evaluated the possibility of monitoring objective improvements in these subjects, before and after a dietary regimen.MethodsOverall, 78 subjects with metabolic syndrome and ultrasound confirmation of liver steatosis were included in an open, controlled study; all of these subjects were treated for 90 days with the standard regimen of diet and exercise. One group of 43 subjects (Group A) also received a Eurosil 85®-based nutraceutical (silymarin + vitamin E) as a dietary adjunct, whereas the remaining 35 subjects (Group B) represented the control group. Changes from baseline values were recorded in biometric, biochemical, and ultrasound data. For assessments and monitoring of liver steatosis, two indexes were utilised—Hepatic Steatosis Index (HSI) and Lipid Accumulation Product (LAP) index.ResultsThe absolute changes from baseline were significantly higher in Group A in biometric parameters (reduction of abdominal circumference, Body Mass Index, ultrasound measurement of right liver lobe) and in both the HSI and LAP indexes. Both treatments were well tolerated.ConclusionThe results observed suggest that the use of a Eurosil 85®-based nutraceutical as a dietary adjunct with antioxidant properties potentially favours the efficacy of the dietary regimen alone and may possibly improve the subjects’ motivation to sustain such lifestyle changes over time.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of Lifestyle Changes in Subjects with Non-Alcoholic Liver Steatosis and Metabolic Syndrome May Be Improved with an Antioxidant Nutraceutical: A Controlled Clinical Study

Sorrentino¹,

Crispino²,

Coppola³

et al. 2015

Drugs R D

View full text Add to dashboard Cite

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“…The limits are the selection of motivated individuals – with minor differences between groups –, the non-randomized nature of the study, the so far time-limited experience, and the methods used to estimate energy expenditure. The selection of subjects after motivational interviewing may be justified by the very low motivation to physical activity commonly observed in individuals with type 2 diabetes [43], also reported in Italian subjects with diabetes [23] as well as other metabolic disorders [24], with a high risk of attrition in unselected patients. The lack of randomization was justified by inherent difficulties in directing individuals to dancing independently of their willingness.…”

Section: Discussionmentioning

confidence: 99%

“…At baseline, all subjects were tested for motivation to habitual physical activity by the EMME-3 test [22], as previously reported [23,24]. The test consists of two parts: a) an 18-item questionnaire (MAC 2) on a Likert scale from 0 (totally false) to 6 (totally true); b) a set of 6 visual analogue scales (VAS) from 0 to 100.…”

Section: Methodsmentioning

confidence: 99%

A standard ballroom and Latin dance program to improve fitness and adherence to physical activity in individuals with type 2 diabetes and in obesity

Mangeri¹,

Montesi

Forlani

et al. 2014

Diabetol Metab Syndr

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ObjectiveTo test the effectiveness of a dance program to improve fitness and adherence to physical activity in subjects with type 2 diabetes and obesity.Research Design and MethodsFollowing a motivational interviewing session, 100 subjects with diabetes and/or obesity were enrolled either in a dance program (DP, n = 42) or in a self-selected physical activity program (SSP, n = 58), according to their preferences. Outcome measures were reduced BMI/waist circumference, improved metabolic control in type 2 diabetes (−0.3% reduction of HbA1c) and improved fitness (activity expenditure >10 MET-hour/week; 10% increase in 6-min walk test (6MWT)). Target achievement was tested at 3 and 6 months, after adjustment for baseline data (propensity score).ResultsAttrition was lower in DP. Both programs significantly decreased body weight (on average, −2.6 kg; P < 0.001) and waist circumference (DP, −3.2 cm; SSP, −2.2; P < 0.01) at 3 months, and the results were maintained at 6 months. In DP, the activity-related energy expenditure averaged 13.5 ± 1.8 MET-hour/week in the first three months and 14.1 ± 3.0 in the second three-month period. In SSP, activity energy expenditure was higher but highly variable in the first three-month period (16.5 ± 13.9 MET-hour/week), and decreased in the following three months (14.2 ± 12.3; P vs. first period < 0.001). At three months, no differences in target achievement were observed between groups. After six months the odds to attain the MET, 6MWT and A1c targets were all significantly associated with DP.ConclusionDance may be an effective strategy to implement physical activity in motivated subjects with type 2 diabetes or obesity (Clinical trial reg. no.NCT02021890, clinicaltrials.gov).

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“…Our group recently showed that NAFLD patients do not think of themselves as sick and accordingly do not utilize more health services[9]. Not surprisingly, NAFLD patients were found to have limited readiness to lifestyle changes[10]. …”

Section: Introductionmentioning

confidence: 99%

Role of illness perception and self-efficacy in lifestyle modification among non-alcoholic fatty liver disease patients

Zelber‐Sagi¹,

Bord²,

Dror-Lavi³

et al. 2017

WJG

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AIMTo describe the relationships between non-alcoholic fatty-liver disease (NAFLD) patient’s disease consequences and treatment perceptions, self-efficacy, and healthy lifestyle maintenance.METHODSA cross-sectional study among 146 ultrasound diagnosed NAFLD patients who visited the fatty liver clinic at the Tel-Aviv Medical Center. Eighty-seven of these individuals, participated in a clinical trial of physical activity and underwent fasting blood tests, analyzed at the same lab. Exclusion criteria included positivity for serum HBsAg or anti-HCV antibodies; fatty liver suspected to be secondary to hepatotoxic drugs; excessive alcohol consumption (≥ 30 g/d in men or ≥ 20 g/d in women) and positive markers of genetic or immune-mediated liver diseases. Patients were asked to complete a self-report structured questionnaire, assembled by the Israeli Center for Disease Control. Nutrition habits were measured using six yes/no questions (0 = no, 1 = yes) adopted from the national survey questionnaire. Participants in the clinical trial completed a detailed semi-quantitative food frequency questionnaire (FFQ) reporting their habitual nutritional intake during the past year. Self-efficacy was assessed by the Self-Efficacy Scale questionnaire, emotional representation, degree of illness understanding, timeline perception, treatment perception and symptoms were measured by the Brief Illness Perception questionnaire. Illness consequences were measured by the Personal Models of Diabetes Interview questionnaire. A path analysis was performed to describe the interrelationships between the patients’ illness perceptions, and assess the extent to which the data fit a prediction of nutritional habits.RESULTSThe study sample included 54.1% men, with a mean age of 47.76 ± 11.68 years (range: 20-60) and mean body mass index of 31.56 ± 4.6. The average perceived nutrition habits score was 4.73 ± 1.45 on a scale between 0-6, where 6 represents the healthiest eating habits. Most of the study participants (57.2%) did not feel they fully understood what NAFLD is. Better nutritional habits were positively predicted by the degree of illness understanding (β = 0.26; P = 0.002) and self-efficacy (β = 0.25; P = 0.003). Perceptions of more severe illness consequences were related with higher emotional representation (β = 0.55; P < 0.001), which was related with lower self-efficacy (β = -0.17; P = 0.034). The perception of treatment effectiveness was positively related with self-efficacy (β = 0.32; P < 0.001). In accordance with the correlation between self-efficacy and the perceived nutrition habits score, self-efficacy was also correlated with nutrient intake evaluated by the FFQ; negatively with saturated fat (percent of saturated fat calories from total calories) (r = -0.28, P = 0.010) and positively with fiber (r = 0.22, P = 0.047) and vitamin C intake (r = 0.34, P = 0.002). In a sub analysis of the clinical trial participants, objectively measured compliance to physical activity regimen was positively correlated with the self-efficacy level (...

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Stage of change and motivation to healthier lifestyle in non-alcoholic fatty liver disease

Cited by 76 publications

References 40 publications

Efficacy of Lifestyle Changes in Subjects with Non-Alcoholic Liver Steatosis and Metabolic Syndrome May Be Improved with an Antioxidant Nutraceutical: A Controlled Clinical Study

Efficacy of Lifestyle Changes in Subjects with Non-Alcoholic Liver Steatosis and Metabolic Syndrome May Be Improved with an Antioxidant Nutraceutical: A Controlled Clinical Study

A standard ballroom and Latin dance program to improve fitness and adherence to physical activity in individuals with type 2 diabetes and in obesity

Role of illness perception and self-efficacy in lifestyle modification among non-alcoholic fatty liver disease patients

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