title: Community-based lifestyle modification programme for non-alcoholic fatty liver disease: a randomized controlled trial.
abstract: OBJECTIVE
  Healthy lifestyle is the most important management of non-alcoholic fatty liver disease (NAFLD). This study aimed at assessing the efficacy of a community-based lifestyle modification programme in the remission of NAFLD.
  
  
  METHODS
  This was a parallel group, superiority, randomized controlled trial. 154 adults with NAFLD identified during population screening were randomized to participate in a dietitian-led lifestyle modification programme at 2 community centres or receive usual care for 12 months. The primary outcome was remission of NAFLD at month 12 as evidenced by intrahepatic triglyceride content (IHTG) of less than 5% by proton-magnetic resonance spectroscopy.
  
  
  RESULTS
  74 patients in the intervention group and 71 patients in the control group completed all study assessments. In an intention-to-treat analysis of all 154 patients, 64% of the patients in the intervention group and 20% in the control group achieved remission of NAFLD (difference between groups 44%; 95% CI 30-58%; p<0.001). The mean (SD) changes in IHTG from baseline to month 12 were -6.7% (6.1%) in the intervention group and -2.1% (6.4%) in the control group (p<0.001). Body weight decreased by 5.6 (4.4) kg and 0.6 (2.5) kg in the two groups, respectively (p<0.001). While 97% of patients with weight loss of more than 10% had remission of NAFLD, 41% of those with weight loss of 3.0-4.9% could also achieve the primary outcome.
  
  
  CONCLUSIONS
  The community-based lifestyle modification programme is effective in reducing and normalizing liver fat in NAFLD patients.
authors.affiliation: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Vincent Wai-Sun
authors.initials: VW
authors.lastname: Wong
authors.forename: Ruth Suk-Mei
authors.initials: RS
authors.lastname: Chan
authors.forename: Grace Lai-Hung
authors.initials: GL
authors.lastname: Wong
authors.forename: Bernice Ho-Ki
authors.initials: BH
authors.lastname: Cheung
authors.forename: Winnie Chiu-Wing
authors.initials: WC
authors.lastname: Chu
authors.forename: David Ka-Wai
authors.initials: DK
authors.lastname: Yeung
authors.forename: Angel Mei-Ling
authors.initials: AM
authors.lastname: Chim
authors.forename: Jennifer Wing-Yan
authors.initials: JW
authors.lastname: Lai
authors.forename: Liz Sin
authors.initials: LS
authors.lastname: Li
authors.forename: Mandy Man-Mei
authors.initials: MM
authors.lastname: Sea
authors.forename: Francis Ka-Leung
authors.initials: FK
authors.lastname: Chan
authors.forename: Joseph Jao-Yiu
authors.initials: JJ
authors.lastname: Sung
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
authors.forename: Henry Lik-Yuen
authors.initials: HL
authors.lastname: Chan
mesh_terms: D000328:Adult; D003151:Community Health Centers; D005081:Exercise Therapy; D005234:Fatty Liver / Q000178:diet therapy / Q000378:metabolism / Q000628:therapy*; D005260:Female; D006801:Humans; D008019:Life Style; D008099:Liver / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012074:Remission Induction / Q000379:methods; D016037:Single-Blind Method; D014280:Triglycerides / Q000378:metabolism
chemical_list: D014280:Triglycerides
keywords: (1)H-MRS; ALT; AST; BMI; GI; HDL; IHTG; LDL; Magnetic resonance spectroscopy; NAFLD; Non-alcoholic steatohepatitis; Obesity; Transient elastography; Weight loss; alanine aminotransferase; aspartate aminotransferase; body mass index; glycaemic index; high density lipoprotein; intrahepatic triglyceride content; low density lipoprotein; non-alcoholic fatty liver disease; proton-magnetic resonance spectroscopy