BACKGROUND Research exploring the influence of healthier lifestyle modification(LSM)on the risk of hepatocellular carcinoma(HCC)in patients with chronic hepatitis B(CHB)is limited.AIM To emulate a target trial to dete...BACKGROUND Research exploring the influence of healthier lifestyle modification(LSM)on the risk of hepatocellular carcinoma(HCC)in patients with chronic hepatitis B(CHB)is limited.AIM To emulate a target trial to determine the effect of LSM on HCC incidence and mortality among patients with CHB by large-scale population-based observational data.METHODS Among the patients with CHB enrolled in the Korean National Health Insurance Service between January 1,2009,and December 31,2017,those aged≥20 years who drank alcohol,smoked cigarettes,and were sedentary were analyzed.Exposure included at least one LSM,including alcohol abstinence,smoking cessation,and regular exercise.The primary outcome was HCC development,and the secondary outcome was liver-related mortality.We used 2:1 propensity score matching to account for covariates.RESULTS With 48766 patients in the LSM group and 103560 in the control group,the adjusted hazard ratio(HR)for incident HCC and liver-related mortality was 0.92[95%confidence interval(CI):0.87-0.96]and 0.92(95%CI:0.86-0.99)in the LSM group,respectively,compared with the control group.Among the LSM group,the adjusted HR(95%CI)for incident HCC was 0.84(0.76-0.94),0.87(0.81-0.94),and 1.08(1.00-1.16)for alcohol abstinence,smoking cessation,and regular exercise,respectively.The adjusted HR(95%CI)for liver-related mortality was 0.92(0.80-1.06),0.81(0.72-0.91),and 1.15(1.04-1.27)for alcohol abstinence,smoking cessation,and regular exercise,respectively.CONCLUSION LSM lowered the risk of HCC and mortality in patients with CHB.Thus,active LSM,particularly alcohol abstinence and smoking cessation,should be encouraged in patients with CHB.展开更多
Type 2 diabetes mellitus(T2DM)is a lifelong condition and a grave threat to human health.Innovative efforts to relieve its detrimental effects are acutely needed.The sine qua non in T2DM management is consistent adher...Type 2 diabetes mellitus(T2DM)is a lifelong condition and a grave threat to human health.Innovative efforts to relieve its detrimental effects are acutely needed.The sine qua non in T2DM management is consistent adherence to a prudent lifestyle and nutrition,combined with aerobic and resistance exercise regimens,together repeatedly shown to lead to complete reversal and even longterm remission.Non-adherence to the above lifestyle adjustments condemns any treatment effort and ultimately the patient to a grim fate.It is thus imperative that every study evaluating the effects of innovative interventions in T2DM objectively compares the novel treatment modality to lifestyle modifications,preferably through double-blind controlled randomization,before claiming efficacy.展开更多
Background and Objectives:To compare the effectiveness of silymarin or its combination with lifestyle modi fications,Mediterranean hypocaloric diets,and medications for improving nonalcoholic fatty liver disease(NAFLD...Background and Objectives:To compare the effectiveness of silymarin or its combination with lifestyle modi fications,Mediterranean hypocaloric diets,and medications for improving nonalcoholic fatty liver disease(NAFLD).Methods and Study Design:PubMed,Embase,Cochrane Library,Web of Science,and Clinical Trails.gov were used to identify relevant studies.The treatment arm was silymarin or its combination with Medi terranean hypocaloric diets,medications,or lifestyle modifications.The comparators were placebo,Mediterrane an hypocaloric diets,medications,and lifestyle modifications.Results:This meta-analysis included 25 studies with 2283 patients.Total cholesterol levels were reduced by silymarin+Mediterranean hypocaloric diets(SMD:-0.39(-0.81,0.03),p=0.072)or medications[SMD:-1.12(-1.67,-0.58),p<0.001].Triglyceride levels were de creased by silymarin combined with the medication[SMD:-0.92(-1.98,0.14),p=0.080].Low-density lipoprotein cholesterol levels were reduced by silymarin alone[SMD:-0.25(-0.48,-0.03),p=0.027].The combination of si lymarin with Mediterranean hypocaloric diets[SMD:-0.47(-0.90,-0.04),p=0.031]or lifestyle modifications[SMD:-0.88(-1.09,-0.66),p<0.0001]decreased alanine aminotransferase levels.Aspartate aminotransferase lev els were reduced by a combination of silymarin and lifestyle modifications[SMD:-0.72(-1.49,0.05),p=0.061]or medications[SMD:-1.41(-2.24,-0.59),p=0.005].Silymarin(2.5 times)or silymarin plus lifestyle modifica tions(39%)reduced the hepatic steatosis rate in patients with NAFLD.The silymarin use increased the rate of pa tients with adverse effects[RR:1.98(1.11,3.54)];gastrointestinal problems were the most common adverse ef fects.Conclusions:Despite the overall advantages of therapies,different interventions showed different effects on markers in patients with NAFLD.These results highlight the need for more research to fully comprehend the features of the intervention.展开更多
Background:According to the Independent High-level Commission on Non-communicable Diseases(NCD)of the World Health Organization(WHO),global reduction in lung cancer mortality has been achieved since the year 2000,alth...Background:According to the Independent High-level Commission on Non-communicable Diseases(NCD)of the World Health Organization(WHO),global reduction in lung cancer mortality has been achieved since the year 2000,although this effect is not sufficient to reach the 30%reduction of mortality from NCDs by the year 2030,as stipulated by the United Nations Sustainable Development Goal 3.4.The objective of this study was to analyze whether the lifestyle changes implemented by the WHO at country level could have an impact on mortality from this form of cancer.Methods:WHO statistics,based on the unified mortality and causes-of-death reports of Member-State countries,were used to evaluate global lung cancer mortality trends and make comparisons and assessments of different types of community-based,country-wide interventions.Results:The lung cancer mortality decline was associated with the anti-tobacco campaign initiated by the WHO in the last 15 to 20 years.Comprehensive tobacco control remained the major and most successful lifestyle modification measure.In countries with declining lung cancer mortality,91%of countries had decreasing tobacco prevalence in males and 82%in females.Country-wide measures to increase physical activity had a strong tendency to be better implemented in countries with declining lung cancer mortality(t=1.79,P>0.05).Other WHO"best-buy"lifestyle modification campaigns(diet and alcohol)had been carried out for shorter periods,and their associations with lung cancer were less strong than tobacco.There was no significant difference between countries with declining and increasing lung cancer mortality in the measures for reduction of harmful alcohol use(t=0.92,P>0.05)and unhealthy diet reduction measures(t=0.84,P>0.05).Conclusion:Following WHO"best-buys"should facilitate to move countries towards the NCD including lung cancer mortality reduction targets.Governments and communities must embrace these targets with coordinated effective action for better health.展开更多
Background and aims:Non-alcoholic fatty liver disease(NAFLD)is remarkably increasing in developing countries like India,in parallel with the increasing incidence of obesity.Lifestyle modification is a recommended trea...Background and aims:Non-alcoholic fatty liver disease(NAFLD)is remarkably increasing in developing countries like India,in parallel with the increasing incidence of obesity.Lifestyle modification is a recommended treatment for NAFLD.In most of the previous studies,improvement after lifestyle modification was assessed by liver fibrosis through liver biopsy,but we cannot do a serial liver biopsy in every NAFLD patient.Liver fibrosis can also be assessed by fibroscan non-invasively in NAFLD.This study was designed to evaluate the effect of lifestyle modification on liver enzymes and Fibroscan values in a population with NAFLD.Methods:Initially,50 NAFLD patients were included in this prospective follow-up study;however,after 6 months of lifestyle modification,only 39 participants were studied.During both the first and second consultations,Fibroscan was carried out.All participants underwent a careful interview,anthropometry measurements and radiological and biochemical tests during every consultation.Results:After 6 months of lifestyle modification,Fibroscan values improved significantly(8.3160.11kPa vs 7.8760.12kPa,p¼0.009).Alanine aminotransferase(ALT)values also showed improvement during the second consultation(97.2562.62 U/L vs 66.6963.95 U/L,p<0.001).Conclusion:Measured by Fibroscan and liver enzymes,it has been found that lifestyle modification is an effective therapy to downgrade hepatic injury in NAFLD patients.Serial Fibroscan can be used to assess the treatment response in NAFLD patients due to its non-invasive nature.展开更多
Background: Adherence to recommended lifestyle modification regarding hypertension control remains a serious problem in Malawi, leading to poor blood pressure control. Objective: This study examined factors that facil...Background: Adherence to recommended lifestyle modification regarding hypertension control remains a serious problem in Malawi, leading to poor blood pressure control. Objective: This study examined factors that facilitate adherence to recommended lifestyle modification among hypertensive clients’ at Malamulo hospital in Thyolo Malawi. Methods: A descriptive cross-sectional quantitative study was conducted with 108 clients who were recruited through a systematic sampling method. Data were collected through face-to-face interviews using a pre-tested structured questionnaire. Using statistical Packages for Social Sciences (SPSS) version 22, Chi-Square (x2) test was applied to test each predictor variable for statistical significance. The significant predictors were entered into the logistic regression model to determine the independent predictors of recommended lifestyle modifications amongst clients. Odds ratio (OR) at 95% Confidence Interval (CI) was used to declare the independent effect of each variable on the outcome variable. Results: 108 respondents were enrolled in the study, the majority of who were women (60.2%). Findings demonstrated that clients had adequate knowledge of lifestyle modification with an overall knowledge rate of 92% though the overall adherence rate was poor at 53.8%. Having family support (OR = 4.587, 95% CI: 1.625, 12.947, p = 0.004) and support groups (OR = 4.043, 95% CI: 1.496, 10.926, p = 0.006) are more likely to facilitate adherence to recommended lifestyle modification unlike situations of non-involvement of family and lack of support groups. Conclusion: Clients demonstrated adequate knowledge of recommended lifestyle modifications with poor adherence to them. The presence of support groups and a strong family support system are important factors for fostering adherence to the recommended lifestyle modifications regarding hypertension control.展开更多
In this article,we discuss the recently published article by Soni et al.This study explores the effectiveness of a comprehensive digital health program,RESET care,which integrates personalized dietary plans,structured...In this article,we discuss the recently published article by Soni et al.This study explores the effectiveness of a comprehensive digital health program,RESET care,which integrates personalized dietary plans,structured exercise,and cognitive behavioral therapy delivered through a mobile app equipped with Internet of Things devices such as body composition analyzers and smartwatches.Metabolic dysfunction-associated liver disease(MASLD),a global health burden affecting approximately 25%of the population,demands sustainable lifestyle modifications as its primary management strategy.The study reports that 100%of participants in the comprehensive intervention group(diet+exercise+cognitive behavioral therapy)achieved a weight reduction≥7%(6.99±2.98 kg,7.00%±3.39%;P=0.002),a clinically significant threshold for MASLD improvement.In addition,participants showed a mean weight reduction of 6.99 kg(101.10±17.85 vs 94.11±17.38,P<0.001)and a body mass index reduction of 2.18 kg/m²(32.90±3.02 vs 30.72±3.41,P<0.001).These results underscore the potential of digital health platforms to provide scalable,evidence-based solutions for the treatment of MASLD.While these results highlight the potential of digital platforms in the scalable and personalized management of MASLD,the small study sample size and short duration of follow-up limit the generalizability of the results.Future large-scale,long-term trials are needed to confirm sustained benefits,cost-effectiveness,and broader applicability.This letter contextualizes the study within the evolving landscape of MASLD management and emphasizes the clinical implications of integrating digital technologies into standard care.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integ...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integrated personalized diet,exercise,and cognitive behavior therapy,delivered via MyTatva’s digital health application enabled through a body composition analyzer(BCA)and smartwatch.AIM To evaluates the effectiveness of the comprehensive program delivered via My-Tatva’s digital health app enabled through internet of thing devices.METHODS This retrospective observational study analyzed deidentified data from 22 par-ticipants enrolled in the MyTatva RESET care program.Participants were divided into three groups:Group A,diet plan;Group B,diet+exercise plan;and Group C,diet+exercise+cognitive behavioral therapy plan.Participants were provided with a BCA and smartwatch for continuous monitoring of anthropometric para-meters.Statistical analysis,including one-way ANOVA and post-hoc Tukey’s Honest Significant Difference test,was conducted to compare mean changes in anthropometric parameters across the groups.INTRODUCTION Non-alcoholic fatty liver disease(NAFLD)has emerged as a global health burden,affecting approximately 1 in 4 in-dividuals worldwide.NAFLD ranges from simple steatosis(fat accumulation)to non-alcoholic steatohepatitis(NASH),and its global prevalence in the general population is estimated between 6.3%and 33%,with NASH affecting 3-5%[1,2].Obesity is a major risk factor of NAFLD,with studies showing that the likelihood of developing NAFLD increases 5-fold at a body mass index(BMI)of 30-32.5 kg/m²and up to 14-fold at BMI of 37.5-40 kg/m²compared to a BMI of 20-22.5 kg/m²[3,4].Effective NAFLD management requires both dietary and physical activity modifications.Healthy weight loss with sustained muscle mass plays a pivotal role,with a reduction of 3%-5%decreasing hepatic steatosis,5%-7%improving NASH conditions,and 10%or more needed to reverse hepatic fibrosis[5].Management also normalizes elevated liver enzymes(aspartate aminotransferase and alanine aminotransferase),enhances insulin sensitivity,and thereby reduces cardiovascular risk by improving endothelial function and increasing cardiorespiratory fitness[6].However,diet or exercise alone is often not as effective as a combined approach.Integrating both balanced dietary changes and increased physical activity yields more sustainable improvements in NAFLD and overall metabolic health[1,7].Traditional intervention methods usually involve in-person consultations,which often lack real-time and continuous patient monitoring.The recommendation of drastic changes in diet and exercise can also be overwhelming for patients,leading to low adherence rates.Many patients struggle to maintain these changes in the long-term due to a lack of con-tinuous motivational support[8,9].In recent years,the health ecosystem has witnessed a significant shift toward digital health platforms,which complement pharmacological treatments in chronic disease management,and increase scala-bility.These platforms provide continuous monitoring and personalized support,helping to bridge the gap between health care setups and patients[10].Recent digital advances enable internet of things(IoT)devices to be integrated into such management plans to track health metrics,to address the limitations of traditional methods[11,12].The MyTatva digital health application offers the RESET plan,a novel comprehensive approach for NAFLD mana-gement by integrating personalized support from nutrition,physiotherapy,and cognitive behavioral therapy(CBT)coaches.We aimed to evaluate the effectiveness of the RESET plan by analyzing the reduction in anthropometric para-meters across three different digital intervention groups.展开更多
Irritable bowel syndrome (IBS) is the commonest cause of recurrent abdominal pain (RAP) in children in both more developed and developing parts of the world. It is defined by the Rome III criteria for functional gastr...Irritable bowel syndrome (IBS) is the commonest cause of recurrent abdominal pain (RAP) in children in both more developed and developing parts of the world. It is defined by the Rome III criteria for functional gastrointestinal disorders. It is characterized by abdominal pain that is improved by defecation and whose onset is associated with a change in stool form and or frequency and is not explained by structural or biochemical abnormalities. It is estimated that 10%-15% of older children and adolescents suffer from IBS. IBS can be considered to be a brain-gut disorder possibly due to complex interaction between environmental and hereditary factors. The diagnosis of IBS is made based on the Rome III criteria together with ruling out organic causes of RAP in children such as inflammatory bowel disease and celiac disease. Once the diagnosis of IBS is made, it is important to explain to the parents (and children) that there is no serious underlying disease. This reassurance may be effective treatment in a large number of cases. Lifestyle modifications, stress management, dietary interventions and probiotics may be beneficial in some cases. Although there is limited evidence for efficacy of pharmacological therapies such as antispasmodics and antidiarrheals; these have a role in severe cases. Biopsychosocial therapies have shown encouraging results in initial trials but are beset by limited availability. Further research is necessary to understand the pathophysiology and provide specific focused therapies.展开更多
OBJECTIVE:To assess the lipid-lowering activity and safety of a dietary supplement containing monacolin Kβ-hydroxy acid form(MKA),Heye(Folium Nelumbinis),and Cangzhu(Rhizoma Atractylodis Lanceae),compared to lifestyl...OBJECTIVE:To assess the lipid-lowering activity and safety of a dietary supplement containing monacolin Kβ-hydroxy acid form(MKA),Heye(Folium Nelumbinis),and Cangzhu(Rhizoma Atractylodis Lanceae),compared to lifestyle modifications.METHODS:Totally 117 subjects with moderate to severe dyslipidemia(according to Chinese guidelines)and low CV risk were randomly assigned into three treatment groups:lifestyle modification(LM),LM plus a low dosage of MKA,LM plus a high dosage of MKA,and treated for 60 d.The primary endpoint was the reduction of low density lipoprotein cholesterol(LDL-C)and total cholesterol(TC).Safeties along with Traditional Chinese Medicine Syndromes were assessed through the study.RESULTS:A low dosage of MKA along with lifestyle modifications caused a significant decrease in LDL-C by 15.6%on average(95%CI,9.6%to 21%)with,a decrease in TC by 15.3%on average(95%CI,9.26%to 21.4%),and a decrease in non-HDL-C by 35.4%(95%CI,25.76%to 41.34%).Weak evidence of a reduction of triglycerides but an increment of HDL-C was observed in patients with severe hyperlipidemia.No severe adverse events occurred during the study.CONCLUSION:Our results confirm the LDL-C and TC lowering properties of MKA is clinically meaningful.It also produces a significant reduction of non-HDL-C,and slightly effects on TG and HDL-C as well.展开更多
Polycystic ovary syndrome(PCOS)is the most common endocrine and metabolic disease in women of reproductive age.PCOS is characterized by ovulatory disruption,which can lead to infertility.Patients with PCOS are also mo...Polycystic ovary syndrome(PCOS)is the most common endocrine and metabolic disease in women of reproductive age.PCOS is characterized by ovulatory disruption,which can lead to infertility.Patients with PCOS are also more likely to have poor pregnancy outcomes.For obese women,lifestyle interventions are recommended first,which have general health benefits.For women who have difficulty changing their lifestyle,drugs for the treatment of obesity or bariatric surgery could be considered.Clomiphene citrate is the first-line medication after weight loss that has been utilized in the past.Letrozole is supplanting clomiphene as the best option for ovulation induction for now,particularly in patients with PCOS.Metformin can improve ovulation and pregnancy rates;however,it has minimal effects in terms of raising live birth rates.Second-line therapies include gonadotropins and laparoscopic ovary drilling.In vitro fertilization can be utilized as a third-line treatment for patients with PCOS who have failed ovulation induction therapy or have other infertility factors.In summary,to achieve fertility,patients with PCOS require standardized individualized therapy.展开更多
Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quas...Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.展开更多
BACKGROUND Tinnitus affects 10%-30%of the population.Recent evidence suggests that tinnitus is associated with spleen deficiency.However,compared with kidney deficiency-related tinnitus,less research has been conducte...BACKGROUND Tinnitus affects 10%-30%of the population.Recent evidence suggests that tinnitus is associated with spleen deficiency.However,compared with kidney deficiency-related tinnitus,less research has been conducted on the impact of spleen defi-ciency-related tinnitus.AIM To investigate the clinical efficacy of using Guipi Wan and dietary and lifestyle modification based on traditional Chinese medicine for treatment of patients with spleen and stomach deficiency-related tinnitus.METHODS We enrolled 110 patients with spleen and stomach deficiency-related tinnitus who were distributed into treatment(58 cases)and control(52 cases)groups.Tinnitus severity,sleep quality and emotional state were assessed by questionnaires[Tinnitus Evaluation Questionnaire(TEQ);Pittsburgh Sleep Quality Index(PSQI);Depression-Anxiety-Stress Scale-21(DASS-21)]that were used for analysis in the two groups during the initial and intervention and after.In the treatment group,patients were treated with oral administration of Guipi Wan and consulted for healthy dietary and lifestyle modification.In the control group,patients were only assessed and not treated.RESULTS At the end of the 6-months,TEQ scores decreased significantly in the treatment group(P=0.021)but not in the Control group.Significant effects in the treatment group were noted for PSQI total score(P=0.043)and several PSQI component scores in the treatment group(P<0.05).After treatment,the DASS-21 scores were significantly reduced in the treatment group(P<0.05).CONCLUSION Guipi Wan combined with dietary and lifestyle modification based on regulating the spleen and stomach can be considered core to the treatment of tinnitus related to spleen and stomach deficiency.展开更多
Naturopathy is a traditional health care science having its own concepts of health and healing rooting through nature.It is a non-pharmacological system of health care which derives its disease causing and health keep...Naturopathy is a traditional health care science having its own concepts of health and healing rooting through nature.It is a non-pharmacological system of health care which derives its disease causing and health keeping principles from fundamental natural elements(Panchamahabhutas)viz.Prithvi,Jala,Vayu,Agni,and Akash.The imbalance among these five elements individually or in respect to others creates disease and in turn also forms the basis of healing if such imbalances are corrected.This paper reviews the simple concepts of naturopathy referring to health and disease and contextualises them to the on-going pandemic which has affected the entire world.An extensive manual and digital search of the relevant literature was done related to naturopathy in order to compile the review.This review is important from the perspectives that in the current pandemic the cure is still not evident from any corner of the world and from any system of medicine.Therefore such simple health keeping strategies from naturopathy seem to be of much relevance.展开更多
Lifestyle factors play a critical role in promoting healthy aging and extending life expectancy Lifestyle factors(Zhao et al.2023,2022;Ofori-Asenso et al.2019).However,the biological mechanisms through which lifestyle...Lifestyle factors play a critical role in promoting healthy aging and extending life expectancy Lifestyle factors(Zhao et al.2023,2022;Ofori-Asenso et al.2019).However,the biological mechanisms through which lifestyle modifications mitigate adverse health outcomes have not yet been fully elucidated.展开更多
To the Editor:Heart failure(HF)is a major health problem with high mortality rates despite advances in major therapeutic strategies.Cardiometabolic markers such as insulin sensitivity and resistance contribute to the ...To the Editor:Heart failure(HF)is a major health problem with high mortality rates despite advances in major therapeutic strategies.Cardiometabolic markers such as insulin sensitivity and resistance contribute to the occurrence and less favorable prognosis of HF,despite the availability of advanced therapies.Adherence to healthy lifestyle behaviors has been shown to significantly improve cardiometabolic markers and reduce the risk of HF.Recent guidelines recommended lifestyle modifications such as increased physical activity(PA),healthy diet,weight loss,and smoking cessation as primary strategies for preventing HF and reducing mortality in individuals with HF.展开更多
Estimates suggest that by 2035,overweight and obesity will affect 54%of the global adult population,totaling 3.3 billion individuals(1).In the U.S.,over 70%of adults are currently affected by overweight and obesity,wi...Estimates suggest that by 2035,overweight and obesity will affect 54%of the global adult population,totaling 3.3 billion individuals(1).In the U.S.,over 70%of adults are currently affected by overweight and obesity,with prevalence projected to exceed 80%by 2050,with obesity increasing at a faster rate than overweight(2).Considering that obesity is a chronic disease characterized by excessive adipose accumulation or distribution that presents a health risk and requires lifelong care,the Journal of the Academy of Nutrition and Dietetics published the“Position of the Academy of Nutrition and Dietetics:Medical Nutrition Therapy Behavioral Interventions Provided by Dietitians for Adults with Overweight or Obesity,2024”(3,4).展开更多
Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exer...Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exercise plays a critical role in NAFLD management. In terms of dietary modification, Mediterranean diet is the most studied dietary pattern and is recommended in many guidelines, however, it may not be feasible and affordable for many patients. Recently, a ketogenic diet and intermittent fasting have gained public attention and have been studied in the role of weight management. This article reviews specifically whether these trendy dietary patterns have an effect on NAFLD outcomes regarding intrahepatic fat content, fibrosis, and liver enzymes, the scientific rationales behind these particular dietary patterns, as well as the safety concerns in some certain patient groups.展开更多
文摘BACKGROUND Research exploring the influence of healthier lifestyle modification(LSM)on the risk of hepatocellular carcinoma(HCC)in patients with chronic hepatitis B(CHB)is limited.AIM To emulate a target trial to determine the effect of LSM on HCC incidence and mortality among patients with CHB by large-scale population-based observational data.METHODS Among the patients with CHB enrolled in the Korean National Health Insurance Service between January 1,2009,and December 31,2017,those aged≥20 years who drank alcohol,smoked cigarettes,and were sedentary were analyzed.Exposure included at least one LSM,including alcohol abstinence,smoking cessation,and regular exercise.The primary outcome was HCC development,and the secondary outcome was liver-related mortality.We used 2:1 propensity score matching to account for covariates.RESULTS With 48766 patients in the LSM group and 103560 in the control group,the adjusted hazard ratio(HR)for incident HCC and liver-related mortality was 0.92[95%confidence interval(CI):0.87-0.96]and 0.92(95%CI:0.86-0.99)in the LSM group,respectively,compared with the control group.Among the LSM group,the adjusted HR(95%CI)for incident HCC was 0.84(0.76-0.94),0.87(0.81-0.94),and 1.08(1.00-1.16)for alcohol abstinence,smoking cessation,and regular exercise,respectively.The adjusted HR(95%CI)for liver-related mortality was 0.92(0.80-1.06),0.81(0.72-0.91),and 1.15(1.04-1.27)for alcohol abstinence,smoking cessation,and regular exercise,respectively.CONCLUSION LSM lowered the risk of HCC and mortality in patients with CHB.Thus,active LSM,particularly alcohol abstinence and smoking cessation,should be encouraged in patients with CHB.
文摘Type 2 diabetes mellitus(T2DM)is a lifelong condition and a grave threat to human health.Innovative efforts to relieve its detrimental effects are acutely needed.The sine qua non in T2DM management is consistent adherence to a prudent lifestyle and nutrition,combined with aerobic and resistance exercise regimens,together repeatedly shown to lead to complete reversal and even longterm remission.Non-adherence to the above lifestyle adjustments condemns any treatment effort and ultimately the patient to a grim fate.It is thus imperative that every study evaluating the effects of innovative interventions in T2DM objectively compares the novel treatment modality to lifestyle modifications,preferably through double-blind controlled randomization,before claiming efficacy.
文摘Background and Objectives:To compare the effectiveness of silymarin or its combination with lifestyle modi fications,Mediterranean hypocaloric diets,and medications for improving nonalcoholic fatty liver disease(NAFLD).Methods and Study Design:PubMed,Embase,Cochrane Library,Web of Science,and Clinical Trails.gov were used to identify relevant studies.The treatment arm was silymarin or its combination with Medi terranean hypocaloric diets,medications,or lifestyle modifications.The comparators were placebo,Mediterrane an hypocaloric diets,medications,and lifestyle modifications.Results:This meta-analysis included 25 studies with 2283 patients.Total cholesterol levels were reduced by silymarin+Mediterranean hypocaloric diets(SMD:-0.39(-0.81,0.03),p=0.072)or medications[SMD:-1.12(-1.67,-0.58),p<0.001].Triglyceride levels were de creased by silymarin combined with the medication[SMD:-0.92(-1.98,0.14),p=0.080].Low-density lipoprotein cholesterol levels were reduced by silymarin alone[SMD:-0.25(-0.48,-0.03),p=0.027].The combination of si lymarin with Mediterranean hypocaloric diets[SMD:-0.47(-0.90,-0.04),p=0.031]or lifestyle modifications[SMD:-0.88(-1.09,-0.66),p<0.0001]decreased alanine aminotransferase levels.Aspartate aminotransferase lev els were reduced by a combination of silymarin and lifestyle modifications[SMD:-0.72(-1.49,0.05),p=0.061]or medications[SMD:-1.41(-2.24,-0.59),p=0.005].Silymarin(2.5 times)or silymarin plus lifestyle modifica tions(39%)reduced the hepatic steatosis rate in patients with NAFLD.The silymarin use increased the rate of pa tients with adverse effects[RR:1.98(1.11,3.54)];gastrointestinal problems were the most common adverse ef fects.Conclusions:Despite the overall advantages of therapies,different interventions showed different effects on markers in patients with NAFLD.These results highlight the need for more research to fully comprehend the features of the intervention.
文摘Background:According to the Independent High-level Commission on Non-communicable Diseases(NCD)of the World Health Organization(WHO),global reduction in lung cancer mortality has been achieved since the year 2000,although this effect is not sufficient to reach the 30%reduction of mortality from NCDs by the year 2030,as stipulated by the United Nations Sustainable Development Goal 3.4.The objective of this study was to analyze whether the lifestyle changes implemented by the WHO at country level could have an impact on mortality from this form of cancer.Methods:WHO statistics,based on the unified mortality and causes-of-death reports of Member-State countries,were used to evaluate global lung cancer mortality trends and make comparisons and assessments of different types of community-based,country-wide interventions.Results:The lung cancer mortality decline was associated with the anti-tobacco campaign initiated by the WHO in the last 15 to 20 years.Comprehensive tobacco control remained the major and most successful lifestyle modification measure.In countries with declining lung cancer mortality,91%of countries had decreasing tobacco prevalence in males and 82%in females.Country-wide measures to increase physical activity had a strong tendency to be better implemented in countries with declining lung cancer mortality(t=1.79,P>0.05).Other WHO"best-buy"lifestyle modification campaigns(diet and alcohol)had been carried out for shorter periods,and their associations with lung cancer were less strong than tobacco.There was no significant difference between countries with declining and increasing lung cancer mortality in the measures for reduction of harmful alcohol use(t=0.92,P>0.05)and unhealthy diet reduction measures(t=0.84,P>0.05).Conclusion:Following WHO"best-buys"should facilitate to move countries towards the NCD including lung cancer mortality reduction targets.Governments and communities must embrace these targets with coordinated effective action for better health.
文摘Background and aims:Non-alcoholic fatty liver disease(NAFLD)is remarkably increasing in developing countries like India,in parallel with the increasing incidence of obesity.Lifestyle modification is a recommended treatment for NAFLD.In most of the previous studies,improvement after lifestyle modification was assessed by liver fibrosis through liver biopsy,but we cannot do a serial liver biopsy in every NAFLD patient.Liver fibrosis can also be assessed by fibroscan non-invasively in NAFLD.This study was designed to evaluate the effect of lifestyle modification on liver enzymes and Fibroscan values in a population with NAFLD.Methods:Initially,50 NAFLD patients were included in this prospective follow-up study;however,after 6 months of lifestyle modification,only 39 participants were studied.During both the first and second consultations,Fibroscan was carried out.All participants underwent a careful interview,anthropometry measurements and radiological and biochemical tests during every consultation.Results:After 6 months of lifestyle modification,Fibroscan values improved significantly(8.3160.11kPa vs 7.8760.12kPa,p¼0.009).Alanine aminotransferase(ALT)values also showed improvement during the second consultation(97.2562.62 U/L vs 66.6963.95 U/L,p<0.001).Conclusion:Measured by Fibroscan and liver enzymes,it has been found that lifestyle modification is an effective therapy to downgrade hepatic injury in NAFLD patients.Serial Fibroscan can be used to assess the treatment response in NAFLD patients due to its non-invasive nature.
文摘Background: Adherence to recommended lifestyle modification regarding hypertension control remains a serious problem in Malawi, leading to poor blood pressure control. Objective: This study examined factors that facilitate adherence to recommended lifestyle modification among hypertensive clients’ at Malamulo hospital in Thyolo Malawi. Methods: A descriptive cross-sectional quantitative study was conducted with 108 clients who were recruited through a systematic sampling method. Data were collected through face-to-face interviews using a pre-tested structured questionnaire. Using statistical Packages for Social Sciences (SPSS) version 22, Chi-Square (x2) test was applied to test each predictor variable for statistical significance. The significant predictors were entered into the logistic regression model to determine the independent predictors of recommended lifestyle modifications amongst clients. Odds ratio (OR) at 95% Confidence Interval (CI) was used to declare the independent effect of each variable on the outcome variable. Results: 108 respondents were enrolled in the study, the majority of who were women (60.2%). Findings demonstrated that clients had adequate knowledge of lifestyle modification with an overall knowledge rate of 92% though the overall adherence rate was poor at 53.8%. Having family support (OR = 4.587, 95% CI: 1.625, 12.947, p = 0.004) and support groups (OR = 4.043, 95% CI: 1.496, 10.926, p = 0.006) are more likely to facilitate adherence to recommended lifestyle modification unlike situations of non-involvement of family and lack of support groups. Conclusion: Clients demonstrated adequate knowledge of recommended lifestyle modifications with poor adherence to them. The presence of support groups and a strong family support system are important factors for fostering adherence to the recommended lifestyle modifications regarding hypertension control.
文摘In this article,we discuss the recently published article by Soni et al.This study explores the effectiveness of a comprehensive digital health program,RESET care,which integrates personalized dietary plans,structured exercise,and cognitive behavioral therapy delivered through a mobile app equipped with Internet of Things devices such as body composition analyzers and smartwatches.Metabolic dysfunction-associated liver disease(MASLD),a global health burden affecting approximately 25%of the population,demands sustainable lifestyle modifications as its primary management strategy.The study reports that 100%of participants in the comprehensive intervention group(diet+exercise+cognitive behavioral therapy)achieved a weight reduction≥7%(6.99±2.98 kg,7.00%±3.39%;P=0.002),a clinically significant threshold for MASLD improvement.In addition,participants showed a mean weight reduction of 6.99 kg(101.10±17.85 vs 94.11±17.38,P<0.001)and a body mass index reduction of 2.18 kg/m²(32.90±3.02 vs 30.72±3.41,P<0.001).These results underscore the potential of digital health platforms to provide scalable,evidence-based solutions for the treatment of MASLD.While these results highlight the potential of digital platforms in the scalable and personalized management of MASLD,the small study sample size and short duration of follow-up limit the generalizability of the results.Future large-scale,long-term trials are needed to confirm sustained benefits,cost-effectiveness,and broader applicability.This letter contextualizes the study within the evolving landscape of MASLD management and emphasizes the clinical implications of integrating digital technologies into standard care.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)management requires sustainable lifestyle modifications.This study aimed to evaluate the effectiveness of the RESET care plan,a comprehensive program that is an integrated personalized diet,exercise,and cognitive behavior therapy,delivered via MyTatva’s digital health application enabled through a body composition analyzer(BCA)and smartwatch.AIM To evaluates the effectiveness of the comprehensive program delivered via My-Tatva’s digital health app enabled through internet of thing devices.METHODS This retrospective observational study analyzed deidentified data from 22 par-ticipants enrolled in the MyTatva RESET care program.Participants were divided into three groups:Group A,diet plan;Group B,diet+exercise plan;and Group C,diet+exercise+cognitive behavioral therapy plan.Participants were provided with a BCA and smartwatch for continuous monitoring of anthropometric para-meters.Statistical analysis,including one-way ANOVA and post-hoc Tukey’s Honest Significant Difference test,was conducted to compare mean changes in anthropometric parameters across the groups.INTRODUCTION Non-alcoholic fatty liver disease(NAFLD)has emerged as a global health burden,affecting approximately 1 in 4 in-dividuals worldwide.NAFLD ranges from simple steatosis(fat accumulation)to non-alcoholic steatohepatitis(NASH),and its global prevalence in the general population is estimated between 6.3%and 33%,with NASH affecting 3-5%[1,2].Obesity is a major risk factor of NAFLD,with studies showing that the likelihood of developing NAFLD increases 5-fold at a body mass index(BMI)of 30-32.5 kg/m²and up to 14-fold at BMI of 37.5-40 kg/m²compared to a BMI of 20-22.5 kg/m²[3,4].Effective NAFLD management requires both dietary and physical activity modifications.Healthy weight loss with sustained muscle mass plays a pivotal role,with a reduction of 3%-5%decreasing hepatic steatosis,5%-7%improving NASH conditions,and 10%or more needed to reverse hepatic fibrosis[5].Management also normalizes elevated liver enzymes(aspartate aminotransferase and alanine aminotransferase),enhances insulin sensitivity,and thereby reduces cardiovascular risk by improving endothelial function and increasing cardiorespiratory fitness[6].However,diet or exercise alone is often not as effective as a combined approach.Integrating both balanced dietary changes and increased physical activity yields more sustainable improvements in NAFLD and overall metabolic health[1,7].Traditional intervention methods usually involve in-person consultations,which often lack real-time and continuous patient monitoring.The recommendation of drastic changes in diet and exercise can also be overwhelming for patients,leading to low adherence rates.Many patients struggle to maintain these changes in the long-term due to a lack of con-tinuous motivational support[8,9].In recent years,the health ecosystem has witnessed a significant shift toward digital health platforms,which complement pharmacological treatments in chronic disease management,and increase scala-bility.These platforms provide continuous monitoring and personalized support,helping to bridge the gap between health care setups and patients[10].Recent digital advances enable internet of things(IoT)devices to be integrated into such management plans to track health metrics,to address the limitations of traditional methods[11,12].The MyTatva digital health application offers the RESET plan,a novel comprehensive approach for NAFLD mana-gement by integrating personalized support from nutrition,physiotherapy,and cognitive behavioral therapy(CBT)coaches.We aimed to evaluate the effectiveness of the RESET plan by analyzing the reduction in anthropometric para-meters across three different digital intervention groups.
文摘Irritable bowel syndrome (IBS) is the commonest cause of recurrent abdominal pain (RAP) in children in both more developed and developing parts of the world. It is defined by the Rome III criteria for functional gastrointestinal disorders. It is characterized by abdominal pain that is improved by defecation and whose onset is associated with a change in stool form and or frequency and is not explained by structural or biochemical abnormalities. It is estimated that 10%-15% of older children and adolescents suffer from IBS. IBS can be considered to be a brain-gut disorder possibly due to complex interaction between environmental and hereditary factors. The diagnosis of IBS is made based on the Rome III criteria together with ruling out organic causes of RAP in children such as inflammatory bowel disease and celiac disease. Once the diagnosis of IBS is made, it is important to explain to the parents (and children) that there is no serious underlying disease. This reassurance may be effective treatment in a large number of cases. Lifestyle modifications, stress management, dietary interventions and probiotics may be beneficial in some cases. Although there is limited evidence for efficacy of pharmacological therapies such as antispasmodics and antidiarrheals; these have a role in severe cases. Biopsychosocial therapies have shown encouraging results in initial trials but are beset by limited availability. Further research is necessary to understand the pathophysiology and provide specific focused therapies.
基金Supported by Guangzhou Science and Technology Plan project(No.201710010107)Joint Innovation Specific Project in Key areas from Guangdong Branch Institute of China Academy of Chinese Medical Sciences(No.ZZ0908065)Project of Administration of Traditional Chinese Medicine of Guangdong Province of China(No.201811389)。
文摘OBJECTIVE:To assess the lipid-lowering activity and safety of a dietary supplement containing monacolin Kβ-hydroxy acid form(MKA),Heye(Folium Nelumbinis),and Cangzhu(Rhizoma Atractylodis Lanceae),compared to lifestyle modifications.METHODS:Totally 117 subjects with moderate to severe dyslipidemia(according to Chinese guidelines)and low CV risk were randomly assigned into three treatment groups:lifestyle modification(LM),LM plus a low dosage of MKA,LM plus a high dosage of MKA,and treated for 60 d.The primary endpoint was the reduction of low density lipoprotein cholesterol(LDL-C)and total cholesterol(TC).Safeties along with Traditional Chinese Medicine Syndromes were assessed through the study.RESULTS:A low dosage of MKA along with lifestyle modifications caused a significant decrease in LDL-C by 15.6%on average(95%CI,9.6%to 21%)with,a decrease in TC by 15.3%on average(95%CI,9.26%to 21.4%),and a decrease in non-HDL-C by 35.4%(95%CI,25.76%to 41.34%).Weak evidence of a reduction of triglycerides but an increment of HDL-C was observed in patients with severe hyperlipidemia.No severe adverse events occurred during the study.CONCLUSION:Our results confirm the LDL-C and TC lowering properties of MKA is clinically meaningful.It also produces a significant reduction of non-HDL-C,and slightly effects on TG and HDL-C as well.
基金supported by Beijing Municipal Administration of Hospitals'Ascent Plan(No.DFL20181401)of China.
文摘Polycystic ovary syndrome(PCOS)is the most common endocrine and metabolic disease in women of reproductive age.PCOS is characterized by ovulatory disruption,which can lead to infertility.Patients with PCOS are also more likely to have poor pregnancy outcomes.For obese women,lifestyle interventions are recommended first,which have general health benefits.For women who have difficulty changing their lifestyle,drugs for the treatment of obesity or bariatric surgery could be considered.Clomiphene citrate is the first-line medication after weight loss that has been utilized in the past.Letrozole is supplanting clomiphene as the best option for ovulation induction for now,particularly in patients with PCOS.Metformin can improve ovulation and pregnancy rates;however,it has minimal effects in terms of raising live birth rates.Second-line therapies include gonadotropins and laparoscopic ovary drilling.In vitro fertilization can be utilized as a third-line treatment for patients with PCOS who have failed ovulation induction therapy or have other infertility factors.In summary,to achieve fertility,patients with PCOS require standardized individualized therapy.
文摘Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.
基金National Key Research Foundation Project,No.2020YFC2005202.
文摘BACKGROUND Tinnitus affects 10%-30%of the population.Recent evidence suggests that tinnitus is associated with spleen deficiency.However,compared with kidney deficiency-related tinnitus,less research has been conducted on the impact of spleen defi-ciency-related tinnitus.AIM To investigate the clinical efficacy of using Guipi Wan and dietary and lifestyle modification based on traditional Chinese medicine for treatment of patients with spleen and stomach deficiency-related tinnitus.METHODS We enrolled 110 patients with spleen and stomach deficiency-related tinnitus who were distributed into treatment(58 cases)and control(52 cases)groups.Tinnitus severity,sleep quality and emotional state were assessed by questionnaires[Tinnitus Evaluation Questionnaire(TEQ);Pittsburgh Sleep Quality Index(PSQI);Depression-Anxiety-Stress Scale-21(DASS-21)]that were used for analysis in the two groups during the initial and intervention and after.In the treatment group,patients were treated with oral administration of Guipi Wan and consulted for healthy dietary and lifestyle modification.In the control group,patients were only assessed and not treated.RESULTS At the end of the 6-months,TEQ scores decreased significantly in the treatment group(P=0.021)but not in the Control group.Significant effects in the treatment group were noted for PSQI total score(P=0.043)and several PSQI component scores in the treatment group(P<0.05).After treatment,the DASS-21 scores were significantly reduced in the treatment group(P<0.05).CONCLUSION Guipi Wan combined with dietary and lifestyle modification based on regulating the spleen and stomach can be considered core to the treatment of tinnitus related to spleen and stomach deficiency.
文摘Naturopathy is a traditional health care science having its own concepts of health and healing rooting through nature.It is a non-pharmacological system of health care which derives its disease causing and health keeping principles from fundamental natural elements(Panchamahabhutas)viz.Prithvi,Jala,Vayu,Agni,and Akash.The imbalance among these five elements individually or in respect to others creates disease and in turn also forms the basis of healing if such imbalances are corrected.This paper reviews the simple concepts of naturopathy referring to health and disease and contextualises them to the on-going pandemic which has affected the entire world.An extensive manual and digital search of the relevant literature was done related to naturopathy in order to compile the review.This review is important from the perspectives that in the current pandemic the cure is still not evident from any corner of the world and from any system of medicine.Therefore such simple health keeping strategies from naturopathy seem to be of much relevance.
基金supported by grants from the National Science Foundation of China(32200536,32288101)Shanghai Municipal Science and Technology Major Project(2023SHZDZX02,2017SHZDZX01)+1 种基金the Science and Technology Development Fund of Shanghai Pudong New Area(PKJ2023-Y04)the Key Specialty Construction Project of Pudong Health and Family Planning Commission of Shanghai(PWZxk2022-01).
文摘Lifestyle factors play a critical role in promoting healthy aging and extending life expectancy Lifestyle factors(Zhao et al.2023,2022;Ofori-Asenso et al.2019).However,the biological mechanisms through which lifestyle modifications mitigate adverse health outcomes have not yet been fully elucidated.
基金Dr.Z.Wu was supported by the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(No.20172004)Dr.X.Gao was supported by the key projects in the 3-year plan of Shanghai municipal public health system(2023-2025)(Nos.GWVI-4 and GWVI-11.1-42)the National Natural Science Foundation of China(No.82473622).
文摘To the Editor:Heart failure(HF)is a major health problem with high mortality rates despite advances in major therapeutic strategies.Cardiometabolic markers such as insulin sensitivity and resistance contribute to the occurrence and less favorable prognosis of HF,despite the availability of advanced therapies.Adherence to healthy lifestyle behaviors has been shown to significantly improve cardiometabolic markers and reduce the risk of HF.Recent guidelines recommended lifestyle modifications such as increased physical activity(PA),healthy diet,weight loss,and smoking cessation as primary strategies for preventing HF and reducing mortality in individuals with HF.
文摘Estimates suggest that by 2035,overweight and obesity will affect 54%of the global adult population,totaling 3.3 billion individuals(1).In the U.S.,over 70%of adults are currently affected by overweight and obesity,with prevalence projected to exceed 80%by 2050,with obesity increasing at a faster rate than overweight(2).Considering that obesity is a chronic disease characterized by excessive adipose accumulation or distribution that presents a health risk and requires lifelong care,the Journal of the Academy of Nutrition and Dietetics published the“Position of the Academy of Nutrition and Dietetics:Medical Nutrition Therapy Behavioral Interventions Provided by Dietitians for Adults with Overweight or Obesity,2024”(3,4).
文摘Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exercise plays a critical role in NAFLD management. In terms of dietary modification, Mediterranean diet is the most studied dietary pattern and is recommended in many guidelines, however, it may not be feasible and affordable for many patients. Recently, a ketogenic diet and intermittent fasting have gained public attention and have been studied in the role of weight management. This article reviews specifically whether these trendy dietary patterns have an effect on NAFLD outcomes regarding intrahepatic fat content, fibrosis, and liver enzymes, the scientific rationales behind these particular dietary patterns, as well as the safety concerns in some certain patient groups.
