An internet-based approach for lifestyle changes in patients with NAFLD: Two-year effects on weight loss and surrogate markers

Mazzotti, Arianna; Caletti, Maria Turchese; Brodosi, Lucia; Domizio, Silvia Di; Forchielli, Maria Luisa; Petta, Salvatore; Bugianesi, Elisabetta; Bianchi, Giampaolo; Marchesini, Giulio

doi:10.1016/j.jhep.2018.07.013

Cited by 93 publications

(140 citation statements)

References 47 publications

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“… 32 Similarly, in a study with an internet-based approach for lifestyle changes, the weight loss of 10% was achieved in 15–20% of the patients. 37 In our non-interventional cohort, 17% of patients achieved a >5% weight reduction at 1 year. However, approximately the same number of patients gained weight.…”

Section: Discussionmentioning

confidence: 73%

The Fatty Liver Assessment in Germany (FLAG) cohort study identifies large heterogeneity in NAFLD care

et al. 2020

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A German real world NAFLD cohort Standard of care intervention Highlights This is the first report on NAFLD from a secondarycare real-world cohort in Germany. In this outpatient cohort, diagnostics rely heavily on non-invasive surrogate scores and elastography to stage NAFLD. Every 10th patient presents with advanced fibrosis at baseline. Management of NAFLD in Germany consists predominantly of general lifestyle recommendations and best supportive care. The study underlines the applicability of noninvasive tests to identify patients at risk of advanced fibrosis in secondary care in Germany. Lay summary FLAG is a real-world cohort study that examined the liver disease burden in secondary and tertiary care. Herein, 10% of patients referred to secondary care for NAFLD exhibited advanced liver disease, whilst 64% had no significant liver scarring. These findings underline the urgent need to define patient referral pathways for suspected liver disease.

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Section: Discussionmentioning

confidence: 73%

The Fatty Liver Assessment in Germany (FLAG) cohort study identifies large heterogeneity in NAFLD care

et al. 2020

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“…Although lifestyle-induced weight loss has the potential to be highly efficacious, clinical trials based in tertiary centres, community-based interventions and novel internet-based interventions consistently demonstrate that only 10-20% of individuals are able to lose ≥10% of their body weight over a 1-2 year period. 6,10,12 Patient and disease factors influence the efficacy of lifestyle-induced weight loss, with NASH resolution less likely if individuals are morbidly obese (BMI ≥35 kg/m 2 ), have type 2 diabetes (T2DM) or severe NASH demonstrated by significant hepatocyte ballooning. 10 Interestingly, the PNPLA3 rs738409 gene polymorphism which is associated with an increased risk of developing NAFLD, was also associated with a 3-fold greater reduction in hepatic triglyceride in response to lifestyle intervention, suggesting that these individuals may be more sensitive to the benefits of lifestyle treatment.…”

Section: Lifestyle-induced Weight Lossmentioning

confidence: 99%

Lifestyle modification in NAFLD/NASH: Facts and figures

2019

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The development of non-alcoholic fatty liver disease is closely linked to lifestyle factors, namely excessive caloric intake coupled with reduced physical activity and exercise. This review aims to examine the evidence behind lifestyle change as a tool to improve hepatic steatosis and liver histology in patients with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. Furthermore, potential barriers to adopting lifestyle changes and strategies to overcome these barriers in the clinical setting are discussed.

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“…However, the findings of a recent study suggest that a structured web-based program may be equally as effective as a face-to-face group-based program. Mazzotti et al [66] investigated weight loss and surrogate NAFLD indices in patients who underwent group counselling compared to those who underwent a web-based program. Both programs encouraged adherence to a Mediterranean diet and increased physical activity.…”

Section: Impact Of Patient Engagement and Supportmentioning

confidence: 99%

Managing NAFLD in Type 2 Diabetes: The Effect of Lifestyle Interventions, a Narrative Review

Parry

Hodson

2020

Adv Ther

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The prevalence of non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D) is increasing. As a strong association between these two diseases exist, it is unsurprising that the number of patients with coexisting NAFLD and T2D is also increasing. These patients display a deleterious metabolic profile (e.g. hypertriglyceridemia), and increased mortality rates relative to those with only NAFLD or T2D in isolation; therefore, effective treatment strategies are required. Here we review the available intervention studies that have investigated the effects of changes in lifestyle (diet and exercise/physical activity) on NAFLD in patients with both NAFLD and T2D. On the basis of the available evidence, it appears that the addition of any kind of exercise (i.e. resistance, aerobic, or high-intensity intermittent exercise) is beneficial for patients with both NAFLD and T2D. These effects appear to occur independently of changes in body weight. Hypocaloric diets leading to weight loss are also effective in improving metabolic parameters in patients with both NAFLD and T2D, with data indicating that * 7-10% weight loss is required in order to observe beneficial effects. It is unclear if multidisciplinary interventions incorporating changes in both diet and physical activity levels are a more effective treatment strategy in this population than diet or exercise interventions in isolation. In conclusion, it is clear that lifestyle interventions are an effective treatment strategy in patients with both NAFLD and T2D, although further research is required to optimise these interventions and determine their scalability.

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An internet-based approach for lifestyle changes in patients with NAFLD: Two-year effects on weight loss and surrogate markers

Cited by 93 publications

References 47 publications

The Fatty Liver Assessment in Germany (FLAG) cohort study identifies large heterogeneity in NAFLD care

The Fatty Liver Assessment in Germany (FLAG) cohort study identifies large heterogeneity in NAFLD care

Lifestyle modification in NAFLD/NASH: Facts and figures

Managing NAFLD in Type 2 Diabetes: The Effect of Lifestyle Interventions, a Narrative Review

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