Energy balance
Weight loss of 5-10% achieved through caloric restriction and/or increased physical activity is the first-line, evidence-based treatment for NAFLD, with specific thresholds required for steatosis reduction (≥5%), inflammation improvement (7-10%), and fibrosis improvement (≥10%).
Aim for a 5-10% reduction in body weight through a caloric deficit. You do not need to follow a specific 'liver diet' like Keto or Low-Fat; choose a sustainable healthy pattern (like Mediterranean) that you can maintain. Combine this with at least 150 minutes of moderate exercise per week. Even if you are normal weight, losing 3-5% of your body weight can improve liver fat.
Weight reduction achieved by caloric restriction, either with or without increased physical activity, leads to improvements in multiple NAFLD biomarkers... A seminal interventional trial with histological end points suggested that body weight reduction of ≥5% is required to reduce liver fat, 7–10% to improve liver inflammation, and ≥10% to improve fibrosis/scarring.
Why this rating
Supported by multiple RCTs, meta-analyses, and histological end-point trials cited in the text.
Source
Practical Lifestyle Management of Nonalcoholic Fatty Liver Disease for Busy Clinicians
Shira Zelber‐Sagi et al. · Diabetes Spectrum · 2024
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