Clinical Gastroenterology Vol.32 No.5(3-2)

Theme The Impact of Sarcopenia and Nutrition on Liver Diseases
Title Effect of Long—term Lifestyle Intervention by a Clinical Nutrition Manager in NAFLD/NASH Patients
Publish Date 2017/05
Author Satoshi Abe Department of Gastroenterology, Saiseikai Niigata Daini Hospital / Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
Author Naoko Fukasawa Department of Nutrition, Saiseikai Niigata Daini Hospital
Author Michitaka Imai Department of Gastroenterology, Saiseikai Niigata Daini Hospital
Author Toshiaki Yoshida Department of Gastroenterology, Saiseikai Niigata Daini Hospital
Author Shuji Terai Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
Author Toru Ishikawa Department of Gastroenterology, Saiseikai Niigata Daini Hospital
[ Summary ] The importance of lifestyle intervention for patients with non‒alcoholic fatty liver disease (NAFLD) patients is clear, but it has several problems, the effect is not fully obtained, and the patients relapse after intervention. The long‒term intervention by the clinical nutrition manager results in continuous improvement and suppresses relapse due to inappropriate lifestyle. In our experience, 36 patients who were previously diagnosed with NAFLD received lifestyle intervention for 30 months. The alanine aminotransferase (ALT) level gradually improved throughout the entire period, while body mass index, aspartate aminotransferase, and glycated hemoglobin levels were improved in the first 3 months and maintained thereafter. In 24 patients who had an ALT > 30 IU/l before intervention, 19 had decreased ALT levels, three had unchanged levels, and two had increased levels in first 3 months. In the five patients who did not demonstrate decreased levels in the first 3 months, ALT improvement was obtained by subsequent intervention. ALT level relapse was observed in only one case, and the other cases were maintained throughout the entire period. The problem of lifestyle behavior of NAFLD patients is diverse. In planning nutritional interventions, we must understand individual lifestyle problems and set feasible stepwise goals. As a result, continuous improvement in liver injuries and metabolic disorders are obtained, leading to improved prognosis.
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