Time to Step It Up: Mobile Health Intervention for Lifestyle Modification in Patients with Nonalcoholic Fatty Liver Disease

Faust, Alison; Stine, Jonathan G.

doi:10.1007/s10620-021-07018-x

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…Each has been used to help improve the delivery of quality health care to patients with chronic liver disease. 8 , 9 In patients with NAFLD, intervention with fitness activity trackers 10 , 11 and directly supervised exercise training programs through real-time secure audio-visual technology 12 have been successfully utilized in several small pilot studies. While these technologies appear feasible and safe, their impact on clinical outcomes, including body weight, remains unclear as <20% of individuals achieved clinically significant body weight loss.…”

Section: Introductionmentioning

confidence: 99%

Mobile health lifestyle intervention program leads to clinically significant loss of body weight in patients with NASH

Stine

Rivas

Hummer

et al. 2023

Hepatology Communications

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Background & Aims: Lifestyle intervention remains the foundation of clinical care for patients with NASH; however, most patients are unsuccessful in enacting sustained behavioral change. There remains a clear unmet need to develop lifestyle intervention programs to support weight loss. Mobile health (mHealth) programs offer promise to address this need, yet their efficacy remains unexplored. Approach & Results: We conducted a 16-week randomized controlled clinical trial involving adults with NASH. Patients were randomly assigned (1:1 ratio) to receive Noom Weight (NW), a mHealth lifestyle intervention program, or standard clinical care. The primary end point was a change in body weight. Secondary end points included feasibility (weekly app engagement), acceptability (>50% approached enrolled), and safety. Of 51 patients approached, 40 (78%) were randomly assigned (20 NW and 20 standard clinical care). NW significantly decreased body weight when compared to standard clinical care (-5.5 kg vs. -0.3 kg, p = 0.008; -5.4% vs. -0.4%, p = 0.004). More NW subjects achieved a clinically significant weight loss of ≥5% body weight (45% vs. 15%, p = 0.038). No adverse events occurred, and the majority (70%) of subjects in the NW arm met the feasibility criteria. Conclusions: This clinical trial demonstrated that NW is not only feasible, acceptable, and safe but also highly efficacious because this mHealth lifestyle intervention program led to significantly greater body weight loss than standard clinical care. Future large-scale studies are required to validate these findings with more representative samples and to determine if mHealth lifestyle intervention programs can lead to sustained, long-term weight loss in patients with NASH.

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Section: Introductionmentioning

confidence: 99%

Mobile health lifestyle intervention program leads to clinically significant loss of body weight in patients with NASH

Stine

Rivas

Hummer

et al. 2023

Hepatology Communications

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“…Additionally, there were advantages for patients in terms of cost savings, as they could avoid visiting onsite healthcare facilities [ 28 , 32 ]. This demonstrates that telemedicine is both feasible and acceptable for monitoring patients with MAFLD, primarily via the use of mobile applications [ 33 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, patients in the intermediate and high-risk stages of disease progression will be referred to tertiary healthcare for monitoring and therapy. Additionally, they will receive lifestyle modification guidance from primary healthcare providers using telemedicine [ 23 , 33 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Telemedicine as an Option for Monitoring Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Patients Facing the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Akbar,

Choirida,

Muttaqin

et al. 2024

JPM

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Healthcare visits were reduced during the COVID-19 pandemic, causing disturbances in sustainable MAFLD monitoring. Telemedicine acts to maintain connectivity between patients and healthcare professionals. This review aimed to assess the role of telemedicine in monitoring MAFLD during the pandemic. Databases searched included l PubMed Central and ScienceDirect from 2020 to 2023. Assessment with The Cochrane Risk of Bias for randomized controlled trials (RCTs) and the Newcastle-Ottawa scale for non-RCTs systematic reviews. Meta-analyses employing a random-effect model were performed to determine the pooled mean difference (MD) and p-value. The results showed three RCT and two non-RCT (n = 239) with 56.9% males and a mean age of 51.3 years. The median intervention duration was 5.5 months. The parameters assessed included body weight (BW), body mass index (BMI), waist circumference, liver function (AST/ALT), lipid profile, HbA1c, and others. Meta-analysis revealed that telemedicine had a significant effect on improving outcomes for BW (MD −2.81: 95% CI, −4.11, −1.51, p < 0.0001) and BMI (MD −1.01: 95% CI, −1.47, −0.55, p < 0.0001) compared to standard care, while the AST/ALT levels were not significantly reduced. Some biochemical markers decreased based on the systematic reviews. In conclusion, telemedicine using mobile-based applications could be an option for monitoring lifestyle modification in MAFLD patients facing the COVID-19 pandemic.

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“…An exercise dose of 750 MET-min•wk −1 , which is the equivalent of 150 min•wk −1 of moderate-intensity activity or 75 min•wk −1 of vigorous intensity activity, appears sufficient to improve clinical outcomes in patients with NASH (64). In addition, although the majority of the published literature uses direct, in-person supervision of exercise, emerging evidence suggests that remote monitoring with telehealth or unsupervised mobile health-delivered lifestyle intervention programs may be equally feasible, safe, acceptable, and possibly as efficacious as traditional, supervised in-person exercise training (110)(111)(112)(113)(114).…”

Section: Continued Next Pagementioning

confidence: 99%

Physical Activity and Nonalcoholic Fatty Liver Disease: A Roundtable Statement from the American College of Sports Medicine

Stine

Long

Corey

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Although physical activity (PA) is crucial in the prevention and clinical management of nonalcoholic fatty liver disease, most individuals with this chronic disease are inactive and do not achieve recommended amounts of PA. There is a robust and consistent body of evidence highlighting the benefit of participating in regular PA, including a reduction in liver fat and improvement in body composition, cardiorespiratory fitness, vascular biology, and health-related quality of life. Importantly, the benefits of regular PA can be seen without clinically significant weight loss. At least 150 min of moderate or 75 min of vigorous intensity PA are recommended weekly for all patients with nonalcoholic fatty liver disease, including those with compensated cirrhosis. If a formal exercise training program is prescribed, aerobic exercise with the addition of resistance training is preferred. In this roundtable document, the benefits of PA are discussed, along with recommendations for 1) PA assessment and screening; 2) how best to advise, counsel, and prescribe regular PA; and 3) when to refer to an exercise specialist.

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Time to Step It Up: Mobile Health Intervention for Lifestyle Modification in Patients with Nonalcoholic Fatty Liver Disease

Cited by 6 publications

References 11 publications

Mobile health lifestyle intervention program leads to clinically significant loss of body weight in patients with NASH

Mobile health lifestyle intervention program leads to clinically significant loss of body weight in patients with NASH

Telemedicine as an Option for Monitoring Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Patients Facing the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Physical Activity and Nonalcoholic Fatty Liver Disease: A Roundtable Statement from the American College of Sports Medicine

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