From the Guidelines
The most effective management of Steatosis (Fatty Liver Disease) involves lifestyle modification using diet and exercise to achieve weight loss, with a goal of 5-10% reduction in total body weight, as recommended by the American Gastroenterological Association 1. This approach is supported by the latest evidence, which suggests that weight loss of 5% of total body weight can decrease hepatic steatosis, weight loss of 7% of total body weight can lead to nonalcoholic steatohepatitis resolution, and weight loss of 10% of total body weight can result in fibrosis regression or stability 1. Key components of this lifestyle modification include:
- A hypocaloric diet targeting 1200–1500 kcal/d or a reduction of 500–1000 kcal/d from baseline 1
- Following the Mediterranean diet, minimizing saturated fatty acid intake, and limiting or eliminating consumption of commercially produced fructose 1
- Regular physical activity, with a target of 150–300 minutes of moderate-intensity or 75–150 minutes of vigorous-intensity aerobic exercise per week 1
- Resistance training exercise as a complementary approach to aerobic exercise 1 Additionally, managing coexisting metabolic conditions, such as obesity, diabetes mellitus, hypertension, dyslipidemia, and cardiovascular disease, is crucial 1. Alcohol consumption should be restricted or eliminated from the diets of adults with NAFLD 1. Overall, this comprehensive approach to lifestyle modification can effectively reduce insulin resistance, decrease inflammation, and prevent progression to more severe liver damage, ultimately improving morbidity, mortality, and quality of life for patients with Steatosis (Fatty Liver Disease) 1.
From the Research
Lifestyle Modifications for Steatosis (Fatty Liver Disease) Management
The management of steatosis, also known as fatty liver disease, primarily involves lifestyle modifications. These modifications include:
- Weight loss: A weight loss of at least 7-10% is recommended to improve liver health and reduce the risk of cardiovascular disease and diabetes 2, 3, 4.
- Dietary changes: Following a Mediterranean diet, which is characterized by reduced carbohydrate intake and increased monounsaturated and omega-3 fatty acid intake, is recommended for patients with non-alcoholic fatty liver disease (NAFLD) 2, 4.
- Increased physical activity: Regular physical activity, including aerobic exercise and resistance training, can help reduce hepatic fat and improve liver health, even without weight loss 2, 5, 6, 4.
- Reduced sedentary behavior: Decreasing sedentary behavior, such as TV sitting, is also important for improving cardio-metabolic health and reducing the risk of NAFLD 2, 4.
Implementation of Lifestyle Modifications
The implementation of lifestyle modifications for steatosis management should be individualized and tailored to the patient's clinical characteristics, comorbidities, and fitness capacity. This may involve:
- A combination of physical exercise and calorie restriction dieting to achieve weight loss 3.
- Surgical or endoscopic surgery for weight loss in obese patients, depending on the degree of excess body weight and comorbidities 3.
- The use of established behavioral change models and techniques to support long-term maintenance of lifestyle modifications 2.
- Consideration of the patient's sociocultural preferences and adaptations to meet their needs 4.
Benefits of Lifestyle Modifications
Lifestyle modifications have been shown to have several benefits for patients with steatosis, including:
- Improvement in liver health and reduction in the risk of progressive liver disease 2, 5, 3, 6, 4.
- Reduction in cardiovascular and diabetes risk 2, 4.
- Improvement in cardio-metabolic health and reduction in the risk of NAFLD 2, 5, 6, 4.
- Prevention of the development of NAFLD and reduction in the public health burden 6.