Skip to main content Accessibility help
×
Home
Hostname: page-component-cf9d5c678-7bjf6 Total loading time: 0.247 Render date: 2021-07-27T00:29:21.714Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review

Published online by Cambridge University Press:  17 July 2017

J.B. Moore
Affiliation:
Department of Nutritional Sciences, University of Surrey, Guildford, GU2 7XH, UK School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, LS2 9JT, UK
S Kenneally
Affiliation:
Department of Nutritional Sciences, University of Surrey, Guildford, GU2 7XH, UK
J.H. Sier
Affiliation:
School of Food Science and Nutrition, University of Leeds, Leeds, West Yorkshire, LS2 9JT, UK
Rights & Permissions[Opens in a new window]

Abstract

Type
Abstract
Copyright
Copyright © The Authors 2017 

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide with prevalence above 30% in many adult populations( Reference Blachier, Leleu and Peck-Radosavljevic 1 ). Strongly associated with obesity, weight loss through diet and physical activity change is the mainstay of its management. This can be difficult to achieve however, and uncertainty exists as to what type of lifestyle changes are most effective( Reference Hannah and Harrison 2 ). Therefore the aim of this work was to systematically evaluate randomised controlled trials assessing diet, exercise or combination interventions aimed at reducing steatosis or markers of NAFLD activity.

The review was conducted by independent reviewers in accordance with PRISMA guidelines and is registered at Prospero (CRD42016032764). Medline, Scopus and Cochrane databases were searched from January 1st 1980 through to July 31st 2016, for intervention trials assessing the effects of diet, weight loss, exercise or any combination thereof, on NAFLD disease markers in human adults. Risk of publication bias and study quality was assessed using the American Dietetic Association Quality Criteria Checklist.

From a total of 1710 identified records, 24 articles met the inclusion and exclusion criteria; 6 assessed weight loss using dietary restriction, 10 assessed exercise and 8 were combination interventions. Overall, 13 of the 24 studies were rated as high quality trials and those rated as neutral did have a number of positive points. While, all of the trials demonstrated significant reduction in steatosis and/or markers of NAFLD activity, combination interventions appear to be the most effective at improving NAFLD. Results suggest that 5–10% weight loss using a modestly hypocaloric diet of 500kcal less per day than calculated energy requirement, in combination with 30–60 minutes exercise on 3–5 days per week should be recommended. The evidence from these interventions show dietary composition is probably less important than total energy intake, and while aerobic and resistance exercise both appear to be equally effective in improving NAFLD, the effect is less so than for weight loss.

We conclude this amount of weight loss is achievable in the trial setting but is challenging in the clinical environment. High intensity, multidisciplinary intervention in specialist clinics is likely to be required in order to manage NAFLD by lifestyle modification alone.

Fig. 1. Flow diagram showing identification and selection of relevant studies for inclusion.

References

1. Blachier, M, Leleu, H, Peck-Radosavljevic, M et al. (2013) J Hepatol. 58, 593608.CrossRefGoogle Scholar
2. Hannah, WN & Harrison, SA (2016) Dig Dis Sci. 61, 1365–74.CrossRefGoogle Scholar
You have Access
3
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *