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GE-Portuguese Journal of Gastroenterology
Print version ISSN 2341-4545
Abstract
POLICARPO, Sara Raquel Osório; MACHADO, Mariana V.; BARREIRA, David and CORTEZ-PINTO, Helena. NAFLD Nutritional Management: Results from a Multidisciplinary Approach. GE Port J Gastroenterol [online]. 2022, vol.29, n.6, pp.31-38. Epub Jan 02, 2023. ISSN 2341-4545. https://doi.org/10.1159/000520529.
Introduction:
Lifestyle changes are the mainstay treatment of nonalcoholic fatty liver disease (NAFLD). We aimed to assess the magnitude of weight loss in a group of NAFLD patients followed on a combined lifestyle intervention by a multidisciplinary team.
Methods:
Patients were assessed before and after a 12-month dietary intervention (Mediterranean diet aiming at weight loss). Patients who received a structured dietary plan along with general lifestyle recommendations were designated as the multidisciplinary treatment (MdT) group. Patients who declined follow-up still received general lifestyle recommendations and were designated as the conventional treatment group, being used as a control group.
Results:
From the 77 patients with documented NAFLD, 31.2% of patients were overweight and 55.8% obese; 66 patients constituted the MdT group and 11 the conventional treatment group. After 3 months, 89% of patients lost weight; at 6 months, 75.4% maintained the weight lost. At 12 months, 65% of patients still decreased their weight, with 92.2% of patients in the MdT group still maintaining a lower weight than baseline versus just 50% in the conventional group (p = 0.008). Only patients in the MdT group presented a weight loss higher than 10% (9.6%; n = 6). At 12 months patients in the MdT group presented an average reduction of 4.2 kg versus a reduction of just 0.6 kg in the conventional treatment group (p = 0.016). The MdT group, but not the conventional group, presented significant differences in liver enzymes at 12 months compared to baseline.
Conclusion:
Adherence to a multidisciplinary approach, compared to management solely by a hepatologist, in NAFLD patients, is effective with greater weight loss after a 12-month follow-up and a lower rate of weight gain recurrence.
Keywords : Dietary intervention; Mediterranean diet; Nonalcoholic fatty liver disease; Multidisciplinary team; Weight loss.