Energy balance
Lifestyle interventions achieving 7-10% body weight loss are effective in resolving nonalcoholic steatohepatitis (NASH) and regressing fibrosis in patients with metabolic-associated fatty liver disease (MAFLD).
To reverse liver inflammation and fibrosis, you need to lose 7-10% of your body weight through diet and exercise. Losing more than 10% can even reverse scarring (fibrosis). The hardest part is sticking with it, as most people fail to reach these targets. Combine a calorie-restricted diet (like the Mediterranean diet) with 150-300 minutes of moderate exercise per week.
The resolution of NASH in a proportion of cases with improved liver inflammation has been observed with 7%-10% weight reduction. Further, fibrosis regression has been observed in those losing > 10% body weight by lifestyle changes
Why this rating
Supported by multiple clinical trials and guidelines, though adherence is noted as a challenge.
Source
Management of metabolic-associated fatty liver disease: The diabetology perspective
Mohammad Sadiq Jeeyavudeen et al. · World Journal of Gastroenterology · 2023
DOI 10.3748/wjg.v29.i1.126
More from this paper
- GLP-1 receptor agonists (GLP-1RAs) significantly improve liver enzymes (AST, ALT, GGT) and reduce fibrosis scores in patients with MAFLD and T2DM, though they are not recommended as a primary treatment for NASH histology in the absence of diabetes.Good
- Pioglitazone improves NASH histology without worsening fibrosis in patients with T2DM and MAFLD, but its use is limited by side effects including weight gain, fluid retention, and potential bladder cancer risk.Good
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