Effect of a lifestyle intervention in patients with abnormal liver enzymes and metabolic risk factors

St.George, Alexis; Bauman, Adrian; Johnston, A.; Farrell, Geoffrey C.; Chey, Tien; George, Jacob

doi:10.1111/j.1440-1746.2008.05694.x

Cited by 103 publications

(111 citation statements)

References 40 publications

(77 reference statements)

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“…Though most patients remained overweight or obese at the 3-month and 6-month follow-up visits, our findings suggest that lifestyle change, even in the absence of weight loss, leads to metabolic improvement. This finding is supported by previous research where improvements liver enzymes were achieved with lifestyle change, independent of weight reduction or with minimal weight change [35][36][37].…”

Section: Discussionsupporting

confidence: 79%

Action-oriented obesity counseling attains weight stabilization and improves liver enzymes among overweight and obese children and adolescents

Sylvetsky¹,

Welsh²,

Walsh³

et al. 2012

OJPed

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Introduction: Pediatricians are encouraged to promote behavior modification to reduce childhood obesity and its co-morbidities, yet the effectiveness of office counseling is unclear. We aimed to evaluate if a low-intensity intervention (action-oriented counseling) in a clinic setting results in weight stabilization, and if the effect is modified by a diagnosis of non-alcoholic fatty liver disease (NAFLD). We hypothesized that patients with NAFLD would be more motivated to adhere to the lifestyle goals set in clinic, due to the diagnosis of an obesity-related condition; and, would therefore achieve greater weight reduction compared to similarly overweight and obese patients without a diagnosis of NAFLD. Methods: A retrospective chart review was conducted on 73 (35 male, 38 female) overweight and obese patients (BMI ≥ 85th percentile) attending a pediatric GI clinic between January 2006 and October 2011. Analysis was conducted to determine if lifestyle goals discussed with the patient at each clinic visit were associated with improved BMI, BMI z-score, and liver enzymes. Treatment outcomes among NAFLD patients and similarly obese patients without NAFLD were compared using t-tests and chi-square tests. Results: Of the children evaluated, 74.0% achieved a reduction or stabilization in BMI z-score after 3 months of follow-up. Among NAFLD patients, liver enzymes improved in 72% of those who were able to stabilize or reduce their BMI and among 43% of those who gained weight. Treatment outcome did not significantly differ based on having a diagnosis of NAFLD, although there was a trend towards greater improvements. Conclusion: Our study suggests that action oriented counseling including goalsetting in a low intensity, clinic based approach is effective in improving patient BMI, in the presence or absence of an obesity-related co-morbidity, such as NAFLD. Further, we demonstrated that lifestyle modification led to improvement of liver enzymes in NAFLD patients and may result in other clinically relevant improvements. Longer studies will be needed to determine if the improvements are sustained.

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Section: Discussionsupporting

confidence: 79%

Action-oriented obesity counseling attains weight stabilization and improves liver enzymes among overweight and obese children and adolescents

Sylvetsky¹,

Welsh²,

Walsh³

et al. 2012

OJPed

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“…In a recent study, 152 subjects (141 with NAFLD and 11 with chronic hepatitis C) with elevated liver enzymes, abdominal obesity, and a range of metabolic risk factors were randomized to either a moderate or low-frequency lifestyle counseling intervention or to a control group. 4 Improvements in all metabolic risk factors and liver enzymes were observed in the moderate-frequency counseling group, versus a smaller number of changes in the low-frequency intervention group and no change in any risk factors in control subjects. 4 Such intensive approaches imply the need to reevaluate the traditional role of the clinician and suggests the need for multidisciplinary teams.…”

Section: Nafld Pathophysiology and The Mechanism Of An Exercise Effectmentioning

confidence: 95%

“…4 Improvements in all metabolic risk factors and liver enzymes were observed in the moderate-frequency counseling group, versus a smaller number of changes in the low-frequency intervention group and no change in any risk factors in control subjects. 4 Such intensive approaches imply the need to reevaluate the traditional role of the clinician and suggests the need for multidisciplinary teams. Table 5.…”

Section: Nafld Pathophysiology and The Mechanism Of An Exercise Effectmentioning

confidence: 95%

“…1 Concomitant with pharmacotherapy trials, there is increased interest in the efficacy of lifestyle interventions to reduce liver fat and steatohepatitis. [2][3][4][5] In this context, weight reduction and behavior therapy-based interventions have been reviewed in HEPATOLOGY, 6 but there is little information on the role and importance of physical activity in NAFLD.…”

mentioning

confidence: 99%

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Fitness Versus Fatness: Moving Beyond Weight Loss in Nonalcoholic Fatty Liver Disease

2010

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The rapid emergence of nonalcoholic fatty liver disease (NAFLD) as a cause of both liverrelated morbidity and mortality and cardiometabolic risk has led to the search for effective lifestyle strategies to reduce liver fat. Lifestyle intervention comprising dietary restriction in conjunction with increased physical activity has shown clear hepatic benefits when weight loss approximating 3%-10% of body weight is achieved. Yet, the poor sustainability of weight loss challenges the current therapeutic focus on body weight and highlights the need for alternative strategies for NAFLD management. Epidemiologic data show an independent relationship between liver fat, physical activity, and fitness, and a growing body of longitudinal research demonstrates that increased physical activity participation per se significantly reduces hepatic steatosis and serum aminotransferases in individuals with NAFLD, independent of weight loss. Mechanistic insights to explain this interaction are outlined, and recommendations for the implementation of lifestyle intervention involving physical activity are discussed. In light of the often poor sustainability of weight loss strategies, and the viability of physical activity therapy, clinicians should assess physical fitness and physical activity habits, educate patients on the benefits of fitness outside of weight loss, and focus on behavior change which promotes physical activity adoption. (HEPATOLOGY 2010;52:370-381)

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“…Maul shaer is also better for these conditions. 31,32 Restricted diet: The first thing to leave is alcohol consumption. Alcohol abstinence is first line of treatment for this.…”

mentioning

confidence: 99%

Alcoholic Hepatitis - Concept and Management in Unani Medicine: A Review

Ahmad¹,

Iqbal²,

Nazamuddin³

2017

J. Pharm. Sci. Innov.

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Alcoholic hepatitis is a much more severe lesion than alcoholic fatty liver and is often a precursor to the development of cirrhosis. Excessive alcohol consumption is the third leading preventable cause of death in the world. It is associated with many short term and long term liver damage. The association between alcohol intake and alcoholic liver diseases are well known documented. Alcohol consumption exceeding 60 -80 gm/ day in men and 20 gm/day in women increases the risk of liver disease. If we trace back the genesis of this problem we came to know that the ancient Unani scholars were well acquainted with the basic concept of this disorder. Warm KabidHarSafravi as described in literatures are supposed to be caused due to excessive alcohol consumption. The symptom and signs of alcoholic hepatitis are abdominal pain, anorexia, low grade fever, nausea, vomiting, enlarged liver, yellow coloured urine, breathlessness etc depending upon the site of involvement. The full picture of a flori d, acute alcoholic hepatitis is relatively rare. There are all gradations of severity. The hepatitis may be separate or can be combined with an established cirrhosis. Despite the advancement in modern pharmacotherapy, the figure in terms of remission of disease, withdrawal symptoms and adverse side effects grossly suggest the limitation in its management.

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Effect of a lifestyle intervention in patients with abnormal liver enzymes and metabolic risk factors

Cited by 103 publications

References 40 publications

Action-oriented obesity counseling attains weight stabilization and improves liver enzymes among overweight and obese children and adolescents

Action-oriented obesity counseling attains weight stabilization and improves liver enzymes among overweight and obese children and adolescents

Fitness Versus Fatness: Moving Beyond Weight Loss in Nonalcoholic Fatty Liver Disease

Alcoholic Hepatitis - Concept and Management in Unani Medicine: A Review

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