The effect of lifestyle modification on liver steatosis and fibrosis in patients with non-alcoholic fatty liver disease
ORIGINAL PAPERS
Abstract
Introduction. In recent years, the problems of overweight and obesity have become increasingly relevant, leading to the need to develop effective solutions. Nonalcoholic fatty liver disease develops against the background of metabolic syndrome, which is characterized by the presence of obesity, insulin resistance, arterial hypertension, and dyslipidemia. Pathologies associated with metabolic syndrome significantly impair the quality of life and shorten its duration, increasing the mortality rate of the world's population. All this ensures the enormous social significance and relevance of metabolic syndrome. Treatment of nonalcoholic fatty liver disease is limited and mainly associated with lifestyle changes. Solving this problem requires a comprehensive approach that includes motivating the patient to lead a healthy lifestyle and developing a lasting commitment to personalized recommendations for nutrition and physical activity. This article presents preliminary results of a clinical study involving three groups of participants using different approaches to weight loss, with an emphasis on the effectiveness of a combination of low-calorie, high-protein diet, physical activity, and intermittent fasting. The aim of the study — to substantiate the use and evaluate the effectiveness of various personalized lifestyle modification and weight loss regimens in patients with nonalcoholic fatty liver disease. Materials and methods. The data of 24 patients of both sexes with excess weight, included in the study to date, were studied. Patients aged 27 to 69 years (average age 42.8±6.57 years) were divided into three groups depending on the methods of weight loss. To reduce body weight, they were prescribed an individual low-calorie, high-protein diet, taking into account the basic metabolic rate, gender, age, lifestyle, and physical activity. Results. Group 1: average weight loss was 2.3–3.7% from baseline; group 2: average weight loss was 4–5.2% from baseline; group 3: Average weight loss was 5.5–6.8% from baseline, which is the best result among all groups. Conclusion. The study showed that a comprehensive approach, including diet, physical activity, and intermittent fasting, is the most effective for weight loss and improving metabolic parameters. A comprehensive and individualized approach to weight loss is important, taking into account metabolism, gender, age, lifestyle, and physical activity.
References
1. Sheka A.C. et al. Nonalcoholic steatohepatitis: a review. JAMA. 2020;323(12):1175–1183.
2. Younossi Z.M. et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335–1347.
3. Liang M. et al. Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis. Rev Cardiovasc Med. 2021;22(4):1523–1533.
4. Bogdanova O.G., Myl’nikova I.V. Metabolic syndrome: situation in the world, clinical-diagnostic criteria and risk factors (review of literature). Gigiena i Sanitariya. 2020;99(10):1165–1169.
5. Franco I. et al. Physical activity and low glycemic index Mediterranean diet: main and modification effects on NAFLD score. Results from a randomized clinical trial. Nutrients. 2020;13(1):1–24.
6. Le M.H. et al. 2019 Global NAFLD prevalence: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2022;20(12):2809–2817.e28.
7. Younossi Z. et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15(1):11–20.
8. Chalasani N. et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328–357.
9. Hannah W.N., Harrison S.A. Lifestyle and dietary interventions in the management of nonalcoholic fatty liver disease. Dig Dis Sci. 2016;61(5):1365–1374.
10. Jennison E. et al. Diagnosis and management of non-alcoholic fatty liver disease. Postgrad Med J. 2019;95(1124):314–322.
11. Vos M.B. et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr. 2017;64(2):319–334.
12. Marchesini G. et al. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64(6):1388–1402.
