title: A pilot trial of body weight reduction for nonalcoholic fatty liver disease with a home-based lifestyle modification intervention delivered in collaboration with interdisciplinary medical staff.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome. The aim of this study was to evaluate a 6-month home-based lifestyle modification intervention delivered in collaboration with physicians, hygienists, registered dietitians, and nurses.
  
  
  METHODS
  Outpatients with NAFLD diagnosed by abdominal ultrasonography were eligible for this study. Abdominal computed tomography (CT) scan evaluated liver fat deposition by the liver-spleen ratio (L/S ratio) and visceral fat accumulation as the visceral fat area (VFA; cm(2)). During the 6-month home-based lifestyle modification intervention, each patient was examined by physicians, nurses, hygienists, and registered dietitians, who provided individualized advice to the patients. Patients recorded their daily weight for self-control of weight with recommended diet and exercise regimens.
  
  
  RESULTS
  Sixty-seven NAFLD patients were enrolled in this study and 22 patients (32.8%) completed the 6-month intervention. Nineteen of the 22 patients achieved significant improvements in body weight, body mass index (BMI), waist circumference, VFA, L/S ratio, and systolic blood pressure, with improved laboratory data. Overall, 39 patients withdrew from the intervention. The mean age of the patients who withdrew was 50.0 +/- 11.0 years, which was significantly younger than that of the patients who were followed up (60.1 +/- 10.1 years; P < 0.01).
  
  
  CONCLUSIONS
  The reduction in body weight achieved by NAFLD patients during the 6-month intervention was associated with improved fat deposition and liver function. This intervention offers a practical approach for treating a large number of NAFLD patients with lifestyle modification therapy.
authors.affiliation: Department of Internal Medicine, Saga Medical School, Nabeshima, Saga, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Oza
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.forename: Eriko
authors.initials: E
authors.lastname: Ishibashi
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Kitajima
authors.forename: Hiroko
authors.initials: H
authors.lastname: Horie
authors.forename: Michiko
authors.initials: M
authors.lastname: Ushirogawa
authors.forename: Takeko
authors.initials: T
authors.lastname: Tsuzura
authors.forename: Shunya
authors.initials: S
authors.lastname: Nakashita
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Oda
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Iwata
authors.initials: I
authors.lastname: Ozaki
authors.forename: Takahisa
authors.initials: T
authors.lastname: Eguchi
authors.forename: Naofumi
authors.initials: N
authors.lastname: Ono
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000328:Adult; D000368:Aged; D003299:Cooperative Behavior; D004038:Diet, Reducing / Q000379:methods*; D015444:Exercise; D005234:Fatty Liver / Q000178:diet therapy / Q000628:therapy*; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010865:Pilot Projects; D040242:Risk Reduction Behavior; D015431:Weight Loss