Sustainability of diet based on moderate calorie restriction among obese patients with metabolic-associated fatty liver disease

Abstract

Background and Aims:The long-term sustainability of weight loss remains questionable. We investigated the effects of weight loss and the long-term sustainability of lifestyle modifications among obese patients with metabolic-associated fatty liver disease (MAFLD). Materials and Methods: All patients were individually prescribed with a hypocaloric diet involving an ~500kcal deficit, and they were followed up for 12 weeks in four face-to-face interviews. At the end of follow-up evaluations, at the 36 th month of intervention, the patients were contacted, and their current weight was recorded. Results: The mean weight at baseline was 87 ± 13 kg, which decreased to 79 ± 11 kg after 12 weeks of intervention (P < 0.001). The mean weight at 36 th month did not significantly differ from that at baseline (P = 0.563). The mean CAP decreased from 320 ± 13 dB/m to 273 ± 37 dB/m (P < 0.001), while the median liver stiffness measurement (LSM) reduced from 8.7 (3.6-45.7) kPa to 5.7 (2.2-29.9) kPa (P < 0.001). Conclusions:A strict follow-up through nutritional consultation can help achieve weight loss in obese patients with MAFLD. However, for long-term results, a collaboration of nutritionists and gastroenterologists is essential for preventing weight regain.

Awareness of Non-Alcoholic Fatty Liver Disease Among Dieticians

“…Strict follow-up through nutritional consultation and the cooperation of nutritionists and gastroenterologists are essential for long-term positive outcomes in patients with NAFLD. 31 In the present study, 57% of the dieticians emphasized the need for long-term follow-up; however, only 11% were following up their patients for >6 months. Furthermore, only 3.4% of the dieticians who did not consider NAFLD a serious disease and 20% of those who considered NAFLD a serious disease were following up their patients for >6 months (P < 0.05).…”

Brazilian evidence-based guideline for screening, diagnosis, treatment, and follow-up of metabolic dysfunction-associated steatotic liver disease (MASLD) in adult individuals with overweight or obesity: A joint position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM), Brazilian Society of Hepatology (SBH), and Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso)

“…They are associated with improvements in hepatic inflammation, liver function tests, markers of insulin resistance, histological parameters, and quality of life (82). Even though considered as one of the pillars in the treatment of MASLD, studies have revealed that only a small percentage of patients maintain long-term lifestyle modifications and strategies are necessary to improve these numbers (83,84). In this sense, this therapeutic modality covers different goals according to the definition of what one wants to achieve with the therapy, as described below.…”