title: Effects of therapeutic lifestyle program on ultrasound-diagnosed nonalcoholic fatty liver disease.
abstract: BACKGROUND
  To investigate the effects of varied therapeutic lifestyle programs on patients with ultrasound-diagnosed nonalcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  A prospective, case-controlled study was conducted. A total of 54 subjects with NAFLD were subdivided into 3 groups: (1) diet plus exercise group (DPE group, n = 16); (2) exercise group (E group, n = 23); and (3) control group (C group, n = 15). The DPE group received a low-calorie balanced diet and regular high-intensity stationary bicycle exercise program for 10 weeks, while the E group received the same exercise protocol as the DPE group but without any changes in diet. Anthropometric indices, biochemical data, physical fitness data and liver ultrasound findings were recorded. A generalized estimating equation method was used to determine the differences among groups.
  
  
  RESULTS
  Compared with the C group, the DPE group demonstrated significant improvements in anthropometric indices, total cholesterol, insulin sensitivity, liver biochemistry, ultrasound finding and physical fitness, while the E group showed significant improvements in anthropometric indices, insulin sensitivity status, ultrasound finding and physical fitness but not liver biochemistry. Compared with the E group, the DPE group showed greater reduction in anthropometric indices (body mass index, body weight, abdominal circumference, hip circumference), total cholesterol, alanine aminotransferase, and gamma-glutamyltransferase.
  
  
  CONCLUSIONS
  Our data suggest that both 10-week diet-plus-exercise and exercise-only therapeutic lifestyle programs are effective for improving anthropometric indices, insulin sensitivity, ultrasound findings and physical fitness in ultrasound-diagnosed NAFLD patients. However, the range of improvement in patients on the diet-plus-exercise program is more obvious than that in patients on the exercise-only program. Moreover, the diet-plus-exercise program resulted in significant improvement in liver biochemistry, but the exercise-only program did not. In summary, diet plus exercise is more efficacious than exercise alone in the lifestyle modification treatment of NAFLD.
authors.affiliation: Department of Obstetrics and Gynecology, Taiwan Adventist Hospital Taipei, Taiwan, Republic of China.
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Chen
authors.forename: Chieh-Yu
authors.initials: CY
authors.lastname: Liu
authors.forename: Shian-Rei
authors.initials: SR
authors.lastname: Li
authors.forename: Hui-Ting
authors.initials: HT
authors.lastname: Huang
authors.forename: Ching-Yen
authors.initials: CY
authors.lastname: Tsai
authors.forename: Hei-Jen
authors.initials: HJ
authors.lastname: Jou
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005081:Exercise Therapy; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D011446:Prospective Studies; D014463:Ultrasonography