scholarly journals EVALUATION OF REST ENERGY EXPENDITURE IN PATIENTS WITH NON ALCOHOLIC FATTY LIVER DISEASE

2021 ◽  
Author(s):  
Andressa OLIVEIRA ◽  
Sabrina Alves FERNANDES ◽  
Randhall Bruce CARTERI ◽  
Cristiane Valle TOVO
Keyword(s):  
Physical Activity ◽  
Liver Disease ◽  
Energy Expenditure ◽  
Indirect Calorimetry ◽  
Fatty Liver Disease ◽  
World Health ◽  
Alcoholic Fatty Liver ◽  
Health Organization ◽  
Predictive Formulas ◽  
Alcoholic Fatty Liver Disease

ABSTRACT BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is currently considered a global public health problem, with changes in lifestyle being the effective way to treat the disease. To date, there is no recommended standard of assessment to determine the resting energy expenditure (REE) of patients with NAFLD, so that dietary therapy can be properly guided. OBJECTIVE: To evaluate the REE of patients with NAFLD through indirect calorimetry and compare with different predictive formulas of REE and with REE by electrical bioimpedance analysis (BIA). Assess body composition through BIA, with NAFLD staging and the presence of comorbidities. METHODS: They were evaluated in patients with NAFLD over 18 years of age treated at the Gastroenterology outpatient clinic of a tertiary level hospital in southern Brazil. NAFLD staging was performed using liver biopsy or a non-invasive method. Weight, height and body mass index (BMI) were determined in all patients. The short version of the International Physical Activity Questionnaire was used to assess physical activity. Comorbidities as arterial hypertension, diabetes mellitus and dyslipidemia were evaluated. To estimate energy expenditure at rest, Harris-Benedict, Jeor Mifflin-St, World Health Organization and Schofield formulas were used. BIA was used to assess resting metabolic rate (RMR) and body mass, and to measure RMR, indirect calorimetry was also used. Associations between categorical variables were tested with Pearson’s χ2 test and between groups with McNemar’s test. The level of significance assumed was 5%. The degree of agreement between the REE measurement methods was assessed using the Blan-Altman test. RESULTS: A total of 67 patients were evaluated, 70.5% male, with a mean age of 59 years and a mean BMI of 33.08 kg/m2 ±5.13. The average RMR per CI was 1,753 kcal ±614.58. When comparing the RMR estimate by different formulas with indirect calorimetry, only the Jeor Mifflin-St formula showed a statistically significant difference (P=0.0001), with a difference of +318.49 kcal. BIA and Harris Benedict’s formula presented values closer to CI, 1,658 and 1,845 kcal respectively. CONCLUSION: We suggest that the Jeor Mifflin-St formula should not be used to estimate the RMR in patients with NAFLD. In the absence of indirect calorimetry, some alternatives can be used safely in this population, such as BIA and the predictive formulas of Harris Benedict, Schofield and the World Health Organization.

Modern approaches to pharmacotherapy of non-alcoholic fatty liver disease

2021 ◽  
pp. 48-64
Author(s):  
Maksim Leonidovich Maksimov ◽  
Albina Airatovna Zvegintseva ◽  
Tatyana Sergeevna Shindina
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Intestinal Microflora ◽  
World Health ◽  
Alcoholic Fatty Liver ◽  
Reduce Body Weight ◽  
Body Weight Increase ◽  
Health Organization ◽  
Alcoholic Fatty Liver Disease

According to the forecasts of the World Health Organization, non-alcoholic fatty liver disease (NAFLD) will rank first in the structure of liver diseases by 2020. The article presents the current provisions on the pathogenesis of NAFLD, as well as existing and promising directions in the treatment of non-alcoholic fatty liver disease. A review of the recommendations of the leading hepatological associations for the treatment of non-alcoholic fatty liver disease is carried out. The main directions in the pharmacological treatment of NAFLD are the prescription of drugs that reduce body weight, increase the sensitivity of tissues to insulin, affect oxidative stress, normalize the levels of lipids and blood transaminases, and correct intestinal microflora.

Higher Healthy Lifestyle Score is associated with lower presence of non-alcoholic fatty liver disease in middle-aged and older Chinese adults: a community-based cross-sectional study

2021 ◽  
pp. 1-9
Author(s):  
Yun-yang Deng ◽  
Qing-wei Zhong ◽  
Hai-li Zhong ◽  
Feng Xiong ◽  
Yue-bin Ke ◽  
...  
Keyword(s):  
Physical Activity ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Healthy Lifestyle ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Abstract Objective: Previous studies have reported inverse associations between certain healthy lifestyle factors and non-alcoholic fatty liver disease (NAFLD), but limited evidence showed the synergistic effect of those lifestyles. This study examined the relationship of a combination of lifestyles, expressed as Healthy Lifestyle Score (HLS), with NAFLD. Design: A community-based cross-sectional study. Questionnaires and body assessments were used to collect data on the six-item HLS (ranging from 0 to 6, where higher scores indicate better health). The HLS consists of non-smoking (no active or passive smoking), normal BMI (18·5–23·9 kg/m2), physical activity (moderate or vigorous physical activity ≥ 150 min/week), healthy diet pattern, good sleep (no insomnia or <6 months) and no anxiety (Self-rating Anxiety Scale < 50), one point each. NAFLD was diagnosed by ultrasonography. Setting: Guangzhou, China. Participants: Two thousand nine hundred and eighty-one participants aged 40–75 years. Results: The overall prevalence of NAFLD was 50·8 %. After adjusting for potential covariates, HLS was associated with lower presence of NAFLD. The OR of NAFLD for subjects with higher HLS (3, 4, 5–6 v. 0–1 points) were 0·68 (95 % CI 0·51, 0·91), 0·58 (95 % CI 0·43, 0·78) and 0·35 (95 % CI 0·25, 0·51), respectively (P-values < 0·05). Among the six items, BMI and physical activity were the strongest contributors. Sensitivity analyses showed that the association was more significant after weighting the HLS. The beneficial association remained after excluding any one of the six components or replacing BMI with waist circumference. Conclusions: Higher HLS was associated with lower presence of NAFLD, suggesting that a healthy lifestyle pattern might be beneficial to liver health.

Determinants of Physical Activity Engagement in Patients With Nonalcoholic Fatty Liver Disease: The Need for an Individualized Approach to Lifestyle Interventions

2020 ◽  
Author(s):  
Philip O’Gorman ◽  
Ann Monaghan ◽  
Marie McGrath ◽  
Sara Naimimohasses ◽  
John Gormley ◽  
...  
Keyword(s):  
Physical Activity ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Binary Logistic Regression ◽  
World Health Organisation ◽  
World Health ◽  
Published Data ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver

Abstract Objectives Physical activity (PA) is an important non-pharmacological treatment for non-alcoholic fatty liver disease (NAFLD). This study investigated the determinants of PA engagement and awareness of the World Health Organisation (WHO) PA guidelines in patients with NAFLD. Methods Study participants were 101 patients with NAFLD (median age: 54 [IQR = 15] y; 53 women and 48 men) who completed 4 questionnaires: (1) a PA guideline awareness questionnaire; (2) a PA questionnaire assessing PA levels; and (3) 2 questionnaires assessing perceived barriers and motivators for engaging in PA. Binary logistic regression was performed to assess predictors of PA levels. Results Twenty-four percent of participants correctly identified the recommended WHO weekly PA guidelines, and 39% adhered to the guidelines. Lack of willpower, time and energy were the most frequently cited barrier domains. Scores for lack of willpower (odds ratio [OR] = 1.45, 95% CI = 1.088–1.919) and lack of resources (OR = 1.378, 95% CI = 1.003–1.893), and reporting 3 or more ‘significant’ barrier domains (OR = 5.48, 95% CI = 1.792–15.873) were significant predictors of PA levels. Maintaining health and fitness was the most cited motivator domain and was a significant predictor (OR = 2.551, 95% CI = 1.253–5.208) of PA levels. Conclusions This study highlights) the lack of awareness of the WHO PA guidelines and the key determinants of PA participation in patients with NAFLD. Determinants of PA should be identified at the individual level to create a personalized approach for PA maintenance for people with NAFLD to promote lifelong participation in PA. Impact This study closes a gap in the published data on the determinants of PA engagement in patients with NAFLD.

scholarly journals Association of physical activity with risk of hepatobiliary diseases in China: a prospective cohort study of 0.5 million people

2020 ◽  
pp. bjsports-2020-102174 ◽  
Author(s):  
Yuanjie Pang ◽  
Jun Lv ◽  
Christiana Kartsonaki ◽  
Canqing Yu ◽  
Yu Guo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Leisure Time ◽  
Gallstone Disease ◽  
Total Physical Activity ◽  
Occupational Physical Activity ◽  
Alcoholic Fatty Liver ◽  
Hepatobiliary Diseases ◽  
Alcoholic Fatty Liver Disease

ObjectiveThere is limited prospective evidence on the association of physical activity with hepatobiliary cancer subtypes and other major hepatobiliary diseases, especially in China. We aimed to quantify the associations with risk of these diseases.MethodsThe study population involved 460 937 participants of the prospective China Kadoorie Biobank aged 30–79 years from 10 diverse areas in China without history of cancer or hepatobiliary disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for each disease associated with self-reported total and domain-specific physical activity (occupational and non-occupational, ie, leisure time, household and commuting).ResultsDuring ~10 years of follow-up, 22 012 incident cases of hepatobiliary diseases were recorded. The overall mean (SD) total physical activity was 21.2 (13.9) metabolic equivalent of task (MET)-hours/day, with 62% from occupational activity. Total physical activity was inversely associated with hospitalised non-alcoholic fatty liver disease (HR comparing top vs bottom quintile: 0.62, 95% confidence interval (CI) 0.53 to 0.72), viral hepatitis (0.73, 95% CI 0.62 to 0.87), cirrhosis (0.76, 95% CI 0.66 to 0.88) and liver cancer (0.81, 95% CI 0.71 to 0.93), as well as gallstone disease (0.86, 95% CI 0.81 to 0.90), gallbladder cancer (0.51, 95% CI 0.32 to 0.80) and biliary tract cancer (0.55, 95% CI 0.38 to 0.78). The associations for occupational physical activity were similar to those for total physical activity, but for non-occupational physical activity they differed by disease subtype. For leisure-time physical activity, there was an inverse association with liver cancer and an inverse trend for gallstone disease (HR comparing ≥7.5 MET-hours/day with none: 0.83, 95% CI 0.75 to 0.91 and 0.82, 95% CI 0.66 to 1.01).ConclusionAmong Chinese adults, high total physical activity, particularly occupational physical activity, was inversely associated with risk of major hepatobiliary cancers and diseases, including non-alcoholic fatty liver disease, cirrhosis and certain types of cancer.

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