Management of Non-alcoholic Fatty Liver Disease: Lifestyle Changes

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2024 Jul 1

PMID 38947294

Authors

Hao Lv

Yang Liu

Affiliations

Soon will be listed here.

Abstract

In this editorial, we commented on a recently released manuscript by Zeng in the W. We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease (NAFLD). NAFLD is a hepatic manifestation of the metabolic syndrome, which ultimately leads to advanced hepatic fibrosis, cirrhosis, and hepatocellular carcinoma and affects more than 25% of the population globally. Existing therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection, anti-inflammation, and regulating disease-related metabolic disorder symptoms. Although several drugs are in late-stage development, potent drugs against the diseases are lacking. Additionally, existing surgical approaches such as bariatric surgery are not routinely used to treat NAFLD. Intervening in patients' unhealthy lifestyles, such as weight loss through dietary changes and exercises to ameliorate patient-associated metabolic disorders and metabolic syndrome, is the first-line treatment for patients with NAFLD. With sufficient intrinsic motivation and adherence, the management of unhealthy lifestyles can reduce the severity of the disease, improve the quality of life, and increase the survival expectancy of patients with NAFLD.

References

Rinella M, Lieu H, Kowdley K, Goodman Z, Alkhouri N, Lawitz E . A randomized, double-blind, placebo-controlled trial of aldafermin in patients with NASH and compensated cirrhosis. Hepatology. 2023; 79(3):674-689. PMC: 10871650. DOI: 10.1097/HEP.0000000000000607. View

Ma Y, Yang W, Simon T, Smith-Warner S, Fung T, Sui J . Dietary Patterns and Risk of Hepatocellular Carcinoma Among U.S. Men and Women. Hepatology. 2018; 70(2):577-586. PMC: 6545168. DOI: 10.1002/hep.30362. View

Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, Torres-Gonzalez A, Gra-Oramas B, Gonzalez-Fabian L . Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis. Gastroenterology. 2015; 149(2):367-78.e5. DOI: 10.1053/j.gastro.2015.04.005. View

Cohen C, Li K, Alazraki A, Beysen C, Carrier C, Cleeton R . Dietary sugar restriction reduces hepatic de novo lipogenesis in adolescent boys with fatty liver disease. J Clin Invest. 2021; 131(24). PMC: 8670836. DOI: 10.1172/JCI150996. View

Tosti V, Bertozzi B, Fontana L . Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms. J Gerontol A Biol Sci Med Sci. 2017; 73(3):318-326. PMC: 7190876. DOI: 10.1093/gerona/glx227. View

Abenavoli L, Milic N, Di Renzo L, Preveden T, Medic-Stojanoska M, De Lorenzo A . Metabolic aspects of adult patients with nonalcoholic fatty liver disease. World J Gastroenterol. 2016; 22(31):7006-16. PMC: 4988304. DOI: 10.3748/wjg.v22.i31.7006. View

Lu F, Zheng K, Rios R, Targher G, Byrne C, Zheng M . Global epidemiology of lean non-alcoholic fatty liver disease: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2020; 35(12):2041-2050. DOI: 10.1111/jgh.15156. View

Elias M, Parise E, de Carvalho L, Szejnfeld D, Prola Netto J . Effect of 6-month nutritional intervention on non-alcoholic fatty liver disease. Nutrition. 2009; 26(11-12):1094-9. DOI: 10.1016/j.nut.2009.09.001. View

Ye Q, Zou B, Yeo Y, Li J, Huang D, Wu Y . Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020; 5(8):739-752. DOI: 10.1016/S2468-1253(20)30077-7. View

10.

Long M, Massaro J, Hoffmann U, Benjamin E, Naimi T . Alcohol Use Is Associated With Hepatic Steatosis Among Persons With Presumed Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol. 2019; 18(8):1831-1841.e5. PMC: 7569606. DOI: 10.1016/j.cgh.2019.11.022. View

11.

Allen A, Hicks S, Mara K, Larson J, Therneau T . The risk of incident extrahepatic cancers is higher in non-alcoholic fatty liver disease than obesity - A longitudinal cohort study. J Hepatol. 2019; 71(6):1229-1236. PMC: 6921701. DOI: 10.1016/j.jhep.2019.08.018. View

12.

Laursen T, Hagemann C, Wei C, Kazankov K, Thomsen K, Knop F . Bariatric surgery in patients with non-alcoholic fatty liver disease - from pathophysiology to clinical effects. World J Hepatol. 2019; 11(2):138-149. PMC: 6393715. DOI: 10.4254/wjh.v11.i2.138. View

13.

Paik J, Henry L, de Avila L, Younossi E, Racila A, Younossi Z . Mortality Related to Nonalcoholic Fatty Liver Disease Is Increasing in the United States. Hepatol Commun. 2019; 3(11):1459-1471. PMC: 6824058. DOI: 10.1002/hep4.1419. View

14.

Aberg F, Farkkila M . Drinking and Obesity: Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Interactions. Semin Liver Dis. 2020; 40(2):154-162. DOI: 10.1055/s-0040-1701443. View

15.

Younossi Z, Koenig A, Abdelatif D, Fazel Y, Henry L, Wymer M . Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2015; 64(1):73-84. DOI: 10.1002/hep.28431. View

16.

Anekwe C, Chandrasekaran P, Stanford F . Ketogenic Diet-induced Elevated Cholesterol, Elevated Liver Enzymes and Potential Non-alcoholic Fatty Liver Disease. Cureus. 2020; 12(1):e6605. PMC: 7008768. DOI: 10.7759/cureus.6605. View

17.

Ratziu V, Ghabril M, Romero-Gomez M, Svegliati-Baroni G . Recommendations for Management and Treatment of Nonalcoholic Steatohepatitis. Transplantation. 2018; 103(1):28-38. DOI: 10.1097/TP.0000000000002483. View

18.

Zeng M, Shi Q, Xu L, Mi Y . Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease. World J Gastroenterol. 2024; 30(10):1393-1404. PMC: 11000086. DOI: 10.3748/wjg.v30.i10.1393. View

19.

Chalasani N, Younossi Z, Lavine J, Charlton M, Cusi K, Rinella M . The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2017; 67(1):328-357. DOI: 10.1002/hep.29367. View

20.

Markova M, Pivovarova O, Hornemann S, Sucher S, Frahnow T, Wegner K . Isocaloric Diets High in Animal or Plant Protein Reduce Liver Fat and Inflammation in Individuals With Type 2 Diabetes. Gastroenterology. 2016; 152(3):571-585.e8. DOI: 10.1053/j.gastro.2016.10.007. View