Abstract
Background: Lifestyle interventions aimed at weight loss have been associated with improved liver enzymes, reduced intrahepatic triglyceride content, and improved histology (including reduced fibrosis stage).
Objective: To revise the evidence on the beneficial effects of lifestyle changes accumulated since 2015, following the publication of the pivotal Cuban experience with histologic outcome.
Methods: A PubMed search covering the period 2015 to July 2019 was carried out. All retrieved references were analyzed and double-checked by authors.
Results: 20 new studies were identified; in addition, two relevant studies provided new evidence. Thirteen studies were classified as randomized, controlled studies, three as proof-of-concept/pilot studies, four as cohort observational studies. In an attempt to maintain a closer contact between participants and the treatment center, a study implemented regular phone calls, another an e-mail service, a third was based on text messages, and finally, a study was totally web-based. Notably, the web-based treatment, accessed following intense motivational interviewing, was not less effective than a standard group-based behavior program.
Conclusion: Lifestyle changes should form the basis of any NAFLD intervention. Information technology provides the opportunity to expand treatment, bypassing job and time constraints in younger patients, and to maintain long-term contact between patients and therapists in the NAFLD population.
Keywords: Behavior therapy, cirrhosis, fibrosis, food intake, information technology, physical activity steatosis.
[http://dx.doi.org/10.1097/MCG.0000000000000116] [PMID: 24921212]
[http://dx.doi.org/10.1111/j.1751-2980.2010.00476.x] [PMID: 21276207]
[http://dx.doi.org/10.1016/j.jhep.2015.11.004] [PMID: 27062661]
[http://dx.doi.org/10.1016/j.dld.2017.01.147] [PMID: 28215516]
[http://dx.doi.org/10.1002/hep.29367] [PMID: 28714183]
[http://dx.doi.org/10.1002/hep.23276] [PMID: 19827166]
[http://dx.doi.org/10.2337/diacare.25.12.2165] [PMID: 12453955]
[http://dx.doi.org/10.1016/j.jhep.2018.08.011] [PMID: 30142427]
[http://dx.doi.org/10.1053/j.gastro.2015.04.014] [PMID: 25917783]
[http://dx.doi.org/10.1002/hep.22009] [PMID: 18098321]
[http://dx.doi.org/10.1016/j.cgh.2016.04.036] [PMID: 27155553]
[http://dx.doi.org/10.1111/liv.13435] [PMID: 28371239]
[http://dx.doi.org/10.1016/j.jhep.2013.07.037] [PMID: 23933265]
[http://dx.doi.org/10.1039/c1fo10133a] [PMID: 22008843]
[http://dx.doi.org/10.1002/hep.28392] [PMID: 26663351]
[http://dx.doi.org/10.3748/wjg.v17.i29.3377] [PMID: 21876630]
[http://dx.doi.org/10.1016/j.jhep.2017.05.016] [PMID: 28545937]
[http://dx.doi.org/10.3390/ijms161025168] [PMID: 26512643]
[http://dx.doi.org/10.1016/j.jhep.2013.04.013] [PMID: 23623998]
[http://dx.doi.org/10.1053/j.gastro.2015.04.005]
[http://dx.doi.org/10.1371/journal.pone.0147149] [PMID: 26788923]
[http://dx.doi.org/10.1111/liv.12990] [PMID: 26503843]
[http://dx.doi.org/10.1038/srep36783] [PMID: 27830836]
[http://dx.doi.org/10.1038/ijo.2016.123] [PMID: 27439593]
[http://dx.doi.org/10.1210/jc.2016-2353] [PMID: 27583475]
[http://dx.doi.org/10.2169/internalmedicine.56.8187] [PMID: 28674352]
[http://dx.doi.org/10.1002/hep.28992] [PMID: 27997989]
[http://dx.doi.org/10.3748/wjg.v23.i17.3150] [PMID: 28533672]
[http://dx.doi.org/10.1016/j.cgh.2016.07.031]
[http://dx.doi.org/10.1111/dom.13007] [PMID: 28503750]
[http://dx.doi.org/10.1038/s41366-018-0010-8] [PMID: 29453464]
[http://dx.doi.org/10.1016/j.jhep.2018.07.013] [PMID: 30290973]
[http://dx.doi.org/10.1002/hep.30076] [PMID: 29729189]
[http://dx.doi.org/10.3390/nu10091299] [PMID: 30217048]
[http://dx.doi.org/10.1111/liv.13622] [PMID: 29117472]
[http://dx.doi.org/10.1097/MD.0000000000014918] [PMID: 30896648]
[http://dx.doi.org/10.3748/wjg.v25.i9.1116] [PMID: 30862999]
[http://dx.doi.org/10.3390/jcm8060851] [PMID: 31207986]
[http://dx.doi.org/10.1111/jgh.12656] [PMID: 25040896]
[http://dx.doi.org/10.1002/hep.28484] [PMID: 26849287]
[http://dx.doi.org/10.1111/apt.13860] [PMID: 27862096]
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.107.089458] [PMID: 17698724]
[http://dx.doi.org/10.2337/diacare.26.2.404] [PMID: 12547870]
[http://dx.doi.org/10.1038/oby.2010.254] [PMID: 20966900]
[http://dx.doi.org/10.1111/liv.14065] [PMID: 30721572]
[http://dx.doi.org/10.1002/edm2.82] [PMID: 31592154]
[http://dx.doi.org/10.1002/hep.24418] [PMID: 21567436]
[http://dx.doi.org/10.3748/wjg.15.1809] [PMID: 19370776]
[PMID: 29141573]
[http://dx.doi.org/10.1016/j.jhep.2019.04.013] [PMID: 31075323]
[http://dx.doi.org/10.1053/j.gastro.2018.03.038] [PMID: 29604292]
[http://dx.doi.org/10.1038/ajg.2017.371] [PMID: 29063908]
[http://dx.doi.org/10.1056/NEJMoa1200303] [PMID: 23432189]
[http://dx.doi.org/10.1016/j.jhep.2012.11.031] [PMID: 23201248]
[http://dx.doi.org/10.1111/liv.12483] [PMID: 24521540]
[http://dx.doi.org/10.1146/annurev-publhealth-031914-122855] [PMID: 25785892]
[http://dx.doi.org/10.1111/jhn.12207] [PMID: 24480032]
[http://dx.doi.org/10.1111/joim.12802] [PMID: 29974563]