Community-based lifestyle modification programme for non-alcoholic fatty liver disease: a randomized controlled trial.

Abstract

BACKGROUND & AIMS:

Healthy lifestyle is the most important management of non-alcoholic fatty liver disease (NAFLD). This study aimed at assessing the efficacy of a community-based lifestyle modification programme in the remission of NAFLD.

METHODS:

This was a parallel group, superiority, randomized controlled trial. 154 adults with NAFLD identified during population screening were randomized to participate in a dietitian-led lifestyle modification programme at 2 community centres or receive usual care for 12 months. The primary outcome was remission of NAFLD at month 12 as evidenced by intrahepatic triglyceride content (IHTG) of less than 5% by proton-magnetic resonance spectroscopy.

RESULTS:

74 patients in the intervention group and 71 patients in the control group completed all study assessments. In an intention-to-treat analysis of all 154 patients, 64% of the patients in the intervention group and 20% in the control group achieved remission of NAFLD (difference between groups 44%; 95% CI 30-58%; p<0.001). The mean (SD) changes in IHTG from baseline to month 12 were -6.7% (6.1%) in the intervention group and -2.1% (6.4%) in the control group (p<0.001). Body weight decreased by 5.6 (4.4) kg and 0.6 (2.5) kg in the two groups, respectively (p<0.001). While 97% of patients with weight loss of more than 10% had remission of NAFLD, 41% of those with weight loss of 3.0-4.9% could also achieve the primary outcome.

CONCLUSIONS:

The community-based lifestyle modification programme is effective in reducing and normalizing liver fat in NAFLD patients.

• Authors: Vincent Wai-Sun Wong, Ruth Suk-Mei Chan, Grace Lai-Hung Wong, Bernice Ho-Ki Cheung, Winnie Chiu-Wing Chu, David Ka-Wai Yeung, Angel Mei-Ling Chim, Jennifer Wing-Yan Lai, Liz Sin Li, Mandy Man-Mei Sea, Francis Ka-Leung Chan, Joseph Jao-Yiu Sung, Jean Woo, Henry Lik-Yuen Chan
• Journal: Journal of hepatology (J Hepatol) Vol. 59 Issue 3 Pg. 536-42 (Sep 2013) ISSN: 1600-0641 [Electronic] Netherlands
• PMID: 23623998 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Chemical References

• Triglycerides

Topics

• Adult
• Community Health Centers
• Exercise Therapy
• Fatty Liver (diet therapy, metabolism, therapy)
• Female
• Humans
• Life Style
• Liver (metabolism)
• Magnetic Resonance Spectroscopy
• Male
• Middle Aged
• Non-alcoholic Fatty Liver Disease
• Remission Induction (methods)
• Single-Blind Method
• Triglycerides (metabolism)