Nonalcoholic Fatty Liver Disease: Lifestyle Modification

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease. The prevalence of NAFLD is growing gradually worldwide with increases in obesity, sedentary lifestyles, and an unbalanced diet. NAFLD ranges from simple steatosis without inflammation to steatohepatitis that can progress to cirrhosis. There is no single effective treatment that has widespread effects in NAFLD. The cornerstone of treatment is lifestyle modification, including weight reduction, diet, and physical activity. An approximately 7-10% weight reduction via diet or physical activity can improve the liver histopathology. Risk factors for NAFLD include a high-calorie diet, high-lipid diet, high-carbohydrate diet, saturated fatty acids, trans fatty acids, cholesterol, high fructose intake, and low-choline diet. Factors that protect against NAFLD include a low-calorie diet, low-carbohydrate diet, low-lipid diet, monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), dietary fiber, coffee, green tea, and light alcohol consumption. Physical activity also helps to manage NAFLD with or without weight reduction. Recent reports found that resistance training is as effective as aerobic training. Lifestyle modification has very low compliance. To maintain a treatment program, a multidisciplinary team approach is required that includes physicians, dietitians, physical trainers, and psychologists. (Korean J Med 2014;86:416-424)