The Effect of Lifestyle Changes in Non-Alcoholic Fatty Liver Disease

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a clinical/biochemical condition associated with the metabolic syndrome. As the disease stems from excess calorie intake and lack of physical activity, the correction of unhealthy lifestyles is the background of any prevention and treatment strategy; drugs should remain a second-line treatment. Several studies have shown that weight loss and physical activity, the cornerstones of a healthy lifestyle, have a specific therapeutic role in NAFLD, preventing disease progression and reducing the burden of disease. Prescriptive diets have a limited long-term efficacy; after a short period, most patients resume their old habits and weight regain is the rule. Physical activity, usually in combination with diet, but also independent of weight loss, improves liver enzymes and reduces liver fat, with uncertain results on hepatic necroinflammation; however, making patients increase their physical activity is very difficult. Only a behavioral approach may give patients the practical instruments to achieve their eating and exercise goals, incorporate them into lifestyle, and maintain the results for a long period, thereby possibly guaranteeing long-term durability of change. Cognitive-behavior treatment should be provided to patients at risk of advanced liver disease, and this action should be coupled with prevention strategies at the population level. Only a synergistic approach and a global societal response might be effective in reducing the burden of advanced liver disease and premature death due to NAFLD/NASH (non-alcoholic steatohepatitis).

Spontaneous onset of nonalcoholic steatohepatitis and hepatocellular carcinoma in a mouse model of metabolic syndrome

“…3 As effective treatments for NASH have not yet been established, dietary counseling and therapeutic New spontaneous animal model of NASH T Nishida et al exercise are usually considered as the first options. [22][23][24] However, adhering to a continuous and strict therapy based on lifestyle improvements is difficult, and the response rate is not always high. In the case of NASH with a background of metabolic syndrome, administration of medications that treat underlying diseases, such as diabetes and obesity, has also been attempted.…”

Web-Based Exercise as an Effective Complementary Treatment for Patients With Nonalcoholic Fatty Liver Disease: Intervention Study (Preprint)

“…Intensive exercise interventions, carried out under supervision in hospitals or fitness centers, [32,34,65,67] impose an unnatural lifestyle on the patients for a short period of time. After the intervention, patients very quickly lose motivation and fall back into their old habits [45]. There is a strong need and a high potential for Web-based intervention designs [79,80].…”

“…shift work or family responsibilities) or no access to a fitness center (e.g. distance, high costs, or lack of sound advice) [37,43,45] could be circumvented using additional training equipment like pulse watches and elastic bands. Furthermore, a regular, close communication with a team of experts was realized by the communication via the specially designed website.…”

“…Time and place constraints, for instance, are common problems for a regular activity [4,37,43,44]. Changing one's lifestyle is not easy, especially for patients with highly sedentary habits [45]. Consequently, regular motivational support from experts is needed [45].…”

“…Changing one's lifestyle is not easy, especially for patients with highly sedentary habits [45]. Consequently, regular motivational support from experts is needed [45]. Thus, advances in modern technologies should be taken into account for promoting health-conscious behavior [43].…”