Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

Management of non-alcoholic fatty liver disease:Lifestyle changes

In this editorial,we commented on a recently released manuscript by Zeng et al in the World Journal of Gastroenterology.We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease(NAFLD).NAFLD is a hepatic manifestation of the metabolic syndrome,which ultimately leads to advanced hepatic fibrosis,cirrhosis,and hepatocellular carcinoma and affects more than 25%of the population globally.Existing therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection,anti-inflammation,and regulating disease-related metabolic disorder symptoms.Although several drugs are in late-stage development,potent drugs against the diseases are lacking.Additionally,existing surgical approaches such as bariatric surgery are not routinely used to treat NAFLD.Intervening in patients’unhealthy lifestyles,such as weight loss through dietary changes and exercises to ameliorate patientassociated metabolic disorders and metabolic syndrome,is the first-line treatment for patients with NAFLD.With sufficient intrinsic motivation and adherence,the management of unhealthy lifestyles can reduce the severity of the disease,improve the quality of life,and increase the survival expectancy of patients with NAFLD.

Scale offers the possibility of identifying adherence to lifestyle interventions in patients with non-alcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disorder,and dietary and lifestyle interventions remain the mainstays of NAFLD therapy.Zeng et al established a prediction system to evaluate adherence to lifestyle interventions in patients with NAFLD and choose optimal management.Here,we discuss the application scenarios of the scale and the areas warranting further attention,aiming to provide a possible reference for clinical recommend-ations.

Validation of adherence prediction system for lifestyle interventions in nonalcoholic fatty liver disease

This editorial delves into the research article by Zeng et al published in the latest issue of World Journal of Gastroenterology.The manuscript contributes significantly to addressing the global health issue of nonalcoholic fatty liver disease(NAFLD)by introducing and validating the Exercise and Diet Adherence Scale(EDAS).The article effectively conveys the importance of the study,highlighting the prevalence of NAFLD,the lack of approved drugs for its treatment,and the crucial role of lifestyle correction.The use of the Delphi method for scale development and the subsequent evaluation of its reliability add scientific rigor to the methodology.The results demonstrate that the scale is correlated with key lifestyle indicators,which makes it a promising tool for assessing patient adherence to interventions.The identification of specific score thresholds for predicting adherence to daily calorie intake and exercise adds practical value to the scale.The differentiation among scores indicative of good,average,and poor adherence enhances its clinical applicability.In conclusion,the manuscript introduces EDAS,a valuable instrument that can contribute substantially to the field of NAFLD research and clinical practice.

Exploring multifaceted factors in chronic kidney disease risk: A comprehensive analysis of biochemistry, lifestyle, and inflammation in elderly Chinese individuals

This letter praises a recent article in the World Journal of Clinical Cases(Roles of biochemistry data,lifestyle,and inflammation in identifying abnormal renal function in old Chinese),examining factors affecting abnormal renal function in elderly Chinese using advanced machine learning.It highlights the importance of uric acid,age,hemoglobin,body mass index,sport hours,and systolic blood pressure.The study's holistic approach,integrating lifestyle and inflammation,offers a nuanced understanding of chronic kidney disease risk factors.The letter suggests exploring mechanistic pathways of hyperuricemia,the link between anemia and renal function,and the connection between body mass index and estimated glomerular filtration rate.It advocates investigating physical activity's impact on renal health and the independent effects of blood pressure.The study significantly contributes to chronic kidney disease understanding,proposing avenues for further exploration and interventions.Commendations are extended to the authors and the journal.

An Analysis of the Lifestyle and Mental Health Status of Adult People Living in Dhaka City: A Cross-Sectional Study in Post COVID-19 Era

Introduction: The Novel Coronavirus or COVID-19 affected all the megacities of the world and made the mental health and lifestyle of people paralyzed. According to different studies, such difficulties were different in scale in different cities depending on the demographic attributes of the people. This phenomenon has created the essence of the current study to examine the health conditions in terms of their mental health, lifestyle, and demographic attributes during and immediate past of the COVID-19 era. Method: It was a cross-sectional study covering the people of Dhaka City Corporation. For this purpose, a multistage sampling method was applied, under which the respondents were selected randomly and a self-administered structured questionnaire was used to collect data. The questionnaire was developed based on the DASS 21, as it was suitable to measure the components of mental health in the form of depression, anxiety, and stress. Descriptive analysis and cross-tabulation were applied to find out the association between dependent and independent variables, whereas, a chi-square test was performed to examine the hypothesis. Finally, multivariate analysis was done to find out the risk factors. Three logistic regression models were developed for three dependent variables. Result: The findings of the analysis revealed that the lifestyle of people had severely influenced the components of their mental health conditions during and immediate past of COVID-19 in the Dhaka City Corporation, which varies to some extent depending on the demographic attributes of those. Conclusion: The above findings are statistically significant enough to conclude about the essence of taking preventive measures regarding mental health issues in the future. However, the limitations of this study-keeping it within the urban areas and the educated people, have also created the venue for future researchers to move with their research endeavors in the rural areas nationwide and thus generalize the results.

The Impact of Lifestyle Factors on Migraine Frequency and Severity in Neurology

Objective: This systematic review examines the impact of lifestyle factors on migraine frequency and severity through a comprehensive analysis of lifestyle factors such as diet, physical activity, sleep patterns, stress, mental health, and environmental influences. Methods: We thoroughly searched Google Scholar, PUBMED, Scopus, and Web of Science databases using keywords related to migraines and lifestyle factors. Keywords incorporated the Boolean operator “and” to narrow search results. Following the PRISMA guidelines, we identified, screened, and evaluated studies for inclusion, resulting in nine studies meeting the eligibility criteria. Results: A total of 4917 records were initially identified from Scopus (2786), PubMed (854), and Web of Science (1277). Following deduplication, 3657 records underwent title screening, with 382 additionally screened by abstract. Ultimately, 88 full-text articles were assessed, resulting in 9 studies meeting eligibility for qualitative synthesis: 7 prospective and 2 retrospective studies. Our findings highlight the multifaceted role of lifestyle factors in migraine pathophysiology and management. Dietary habits, such as high-calorie, high-fat, and gluten-containing diets were linked to migraine triggers. Moderate physical activity showed beneficial effects on migraine management, while intense exercise could exacerbate symptoms. Poor sleep hygiene and insomnia were strongly associated with increased migraine frequency and severity. Chronic stress and poor mental health significantly contributed to migraine exacerbation, with stress management techniques proving beneficial. Environmental factors, including light, sound, weather changes, and allergens, were also identified as significant migraine triggers. Conclusions: Personalized lifestyle modifications, tailored to individual patient profiles, are crucial in managing migraines. Evidence-based recommendations include balanced diets, moderate physical activity, improved sleep hygiene, stress management techniques, and environmental adaptations.

A Study on the Relationship Between Skin Sensitivity and Lifestyle, Skin Conditions

Investigate the self-assessment of the skin sensitivity degree of Chinese cosmetic consumers,and explore the differences in lifestyle and skin conditions among consumers with different degrees of skin sensitivity.The study selected 716 female participants from different cities,and collected relevant data through questionnaire surveys,instrument tests,and other methods.The results found that the participants who self-assessed as having sensitive skin had a lower average age,frequency of skin care,frequency of makeup,and years of makeup.The proportion of choosing medical cosmetology and staying up late was higher,the skin was more elastic,the skin tone was more biased towards red,there were more red areas,and the skin texture was better(p<0.05).The research results can be used to guide the development of cosmetics to meet the needs of consumers with different degrees of skin sensitivity.

Health awareness and lifestyle toward healthcare-seeking behavior among students in Universitas Advent Indonesia

Objective:Healthcare-seeking behavior(HSB)would affect the prevalence of morbidity and mortality.There are various factors that affect one's HSB.This study aimed to determine if health awareness and lifestyle might relate to HSB.Methods:A cross-sectional study was applied by using three questionnaires to determine par ticipants'health awareness,lifestyle,and HSB.This study took place in Universitas Advent Indonesia and the students were recruited to be par ticipants.Results:There were 39 par ticipants joined in this study.Most of the par ticipants were females,third-year students,and from Accounting major.Almost all participants were aware of their low risk of health issues,had a fine lifestyle,and had moderate HSB.Conclusions:One's urge to seek health care facilities was not related to their health awareness and lifestyle.There was no fur ther study to contradict with this finding at this moment.

Analysis of the Relationship between Eating and Swallowing Function and Lifestyle of the Elderly Living in the Community-A Secondary Publication

Objectives:The relationship between eating and swallowing function,and lifestyle among community-dwelling elderly people has not been extensively studied.This study aimed to analyze the characteristics of eating and swallowing function and their association with the lifestyle among the elderly.Methods:A self-administered questionnaire survey was conducted on 419 elderly people who participated in the oral function improvement project operated by the Community Comprehensive Support Center.A total of 288 valid responses(58 males,230 females,average age 73.6 years)were analyzed.The survey items included basic demographics,health status,lifestyle,and eating and swallowing functions.The chi-square(χ2)test was used to compare for a difference in the risk of dysphagia.Results:72 patients(25.0%)were judged to be at risk for dysphagia,and 216(75.0%)were judged to be not at risk for dysphagia using the revised dysphagia risk assessment scale.The mean score for oral preparatory dysphagia was the highest,while the mean score for pharyngeal dysphagia was the lowest.The group at risk of dysphagia had significant difficulty in chewing and had bad sleep quality as compared to the group that was not at risk.Conclusion:Concerning the risk of dysphagia,there is a need to maintain and improve masticatory function.In addition,improving the swallowing function of the elderly may prevent insomnia and improve sleep quality.

Importance must be attached to correcting unhealthy lifestyles in prevention and control of hypertension

On the macro level,the ‘2018 Chinese Guidelines for Prevention and Treatment of Hypertension’[1] provides a detailed overview on the population strategies for hypertension prevention as well as the principles and methods of community standardized management for hypertension control,with particular emphasis on the significance of correcting unhealthy lifestyles for the prevention and control of hypertension and its complications.?

Comparison of Public Health Nurse’s Lifestyle Counseling Skills for Clients with Different Readiness of Behavior Changes in Primary Care Settings

Purpose: Public health nurses (PHNs) are required to assess the readiness of the clients and provide lifestyle counseling accordingly. The purpose of this study was to compare the lifestyle counseling provided for clients with different levels of readiness based on self-evaluations and independent assessment. Methods: Participants were PHNs with 10 years’ experience or less. Lifestyle counseling skills were measured through a simulated counseling session in a primary setting lasting up to 30 minutes, followed by a review session, where the participant provided self-evaluations, and the simulated client provided others-evaluations, of the session. The simulated clients played the role of clients at either the pre-contemplation or contemplation stage of preparedness as per the stages of behavior change theory. Results: The self-evaluation results showed that the mean scores for five of the six skill categories, are lower in the precontemplation-stage client cases than in the contemplation-stage client cases, and significantly so for two skill categories. The others-evaluations showed significantly lower mean scores for all skill categories in the precontemplation cases than in the contemplation cases. Conclusion: The PHNs and simulated clients agreed that lifestyle counseling skills were inadequate for the precontemplation cases, as compared with the contemplation cases. The lifestyle counseling skills of PHNs with less experience may not be well-adjusted to the readiness of the client, indicating difficulties in supporting less prepared clients.

译林版初中英语7A Unit 6 Food & Lifestyle教学设计

一、教学背景 本堂课为笔者在江苏省南通市初中英语优课评比活动中的一堂公开课,指导教师为南通市学科带头人、南通市如东县教师发展中心孙志斌老师。授课时间为45分钟。本堂课在此次活动中获一等奖。

Effect of lifestyle intervention on non-alcoholic fatty liver disease in Chinese obese children

AIM: To investigate the effect of lifestyle intervention on non-alcoholic fatty liver disease (NAFLD) in Chinese obese children. METHODS: Seventy-six obese children aged from 10 to 17 years with NAFLD were enrolled for a one-month intervention and divided randomly into three groups. Group1, consisting of 38 obese children, was an untreated control group without any intervention. Group 2, consisting of 19 obese children in summer camp, was strictly controlled only by life style intervention. Group 3, consisting of 19 obese children, received oral vitamin E therapy at a dose of 100 mg/d. The height, weight, fasting blood glucose (FBG), fasting serum insulin (FINS), plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), total cholesterol (TCHO) and homeostasis model assent- insulin resistance (HOMA-IR) were measured at baseline and after one month. All patients were underwent to an ultrasonographic study of the liver performed by one operator who was blinded to the groups. RESULTS: The monitor indices of BMI, ALT, AST, TG, TCHO and HOMA-IR were successfully improved except in group 1. BMI and ALT in group 2 were reduced more significantly than in group 3 (2.44 ± 0.82 vs 1.45 ± 0.80, P = 0.001; 88.58 ± 39.99 vs 63.69 ± 27.05, P = 0.040, respectively).CONCLUSION: Both a short-term lifestyle intervention and vitamin E therapy have an effect on NAFLD in obese children. Compared with vitamin E, lifestyle intervention is more effective. Therefore, lifestyle intervention should represent the first step in the management of children with NAFLD.

Lifestyle-related disease in Crohn’s disease: Relapse prevention by a semi-vegetarian diet

AIM: To investigate whether semi-vegetarian diet (SVD) has a preventive effect against relapse of Crohn’s disease (CD) in patients who have achieved remission,who are a high-risk group for relapse.METHODS: A prospective,single center,2-year clinical trial was conducted.Twenty-two adult CD patients who achieved clinical remission either medically (n = 17) or surgically (n = 5) and consumed an SVD during hospitalization were advised to continue with an SVD and avoid known high-risk foods for inflammatory bowel disease.The primary endpoint was clinical relapse defi ned as the appearance of active symptoms of CD.Kaplan-Meier survival analysis was used to calculate the cumulative proportion of patients who had a relapse.A 2-year analysis of relapse rates of patients who followed an SVD and those who did not (an omnivorous diet group) was undertaken.RESULTS: SVD was continued by 16 patients (compliance 73%).Remission was maintained in 15 of 16 patients (94%) in the SVD group vs two of six (33%)in the omnivorous group.Remission rate with SVD was 100% at 1 year and 92% at 2 years.SVD showed signif icant prevention in the time to relapse compared to that in the omnivorous group (P = 0.0003,log rank test).The concentration of C-reactive protein was normal at the f inal visit in more than half of the patients in remission who were taking an SVD,who maintained remission during the study (9/15;60%),who terminated follow-up (8/12;67%),and who completed 2 years follow-up (7/10;70%).There was no untoward effect of SVD.CONCLUSION: SVD was highly effective in preventing relapse in CD.

The Prevalence of Nonalcoholic Fatty Liver Disease and its Association with Lifestyle/dietary Habits among University Faculty and Staff in Chengdu

Objective To investigate the prevalence of nonalcoholic fatty liver disease （NAFLD） in different university categories and its association with lifestyle/dietary habits. Methods A cross-sectional study was carried out on 9 378 faculty members and staff who participated in an annual health checkup at three universities selected by random cluster sampling. Demographic, anthropometric, biochemical indices and abdominal ultrasound measurements were collected. A nested case-control study was conducted with 200 NAFLD cases and 200 controls matched by gender, age （±3 years）, and university. Results The overall prevalence of NAFLD was 10.3% （13.7% in males and 6.8% in females）. The prevalence was significantly higher in the science and engineering university {22.1%） than in the comprehensive universities with （6.4%） and without （10.9%） medical colleges. Obesity/overweight, hyperlipidemia, diabetes mellitus, and family history of NAFLD were independently associated with higher risk of NAFLD, as were frequent consumption of desserts and salty/spicy foods. Using nutritional supplements was a protective factor against NAFLD. Intake of coarse cereals, potatoes, vegetables, fruits, and milk was significantly lower, and intake of red meat, viscera, candies and pastries, cooking oil, and total energy was significantly higher in participants with NAFLD than in controls. Conclusion Science and engineering university faculty and staff are key targets for NAFLD prevention. NAFLD is closely associated with age, gender, university type, metabolic diseases, and lifestyle/dietary habits.

Nutritional status in relation to lifestyle in patients with compensated viral cirrhosis

AIM:To assess the nourishment status and lifestyle of non-hospitalized patients with compensated cirrhosis by using noninvasive methods.METHODS:The subjects for this study consisted of 27 healthy volunteers,59 patients with chronic viral hepatitis,and 74 patients with viral cirrhosis,from urban areas.We assessed the biochemical blood tests,anthropometric parameters,diet,lifestyle and physical activity of the patients.A homeostasis model assessment-insulin resistance(HOMA-IR) value of ≥ 2.5 was considered to indicate insulin resistance.We measured height,weight,waist circumference,arm circumference,triceps skin-fold thickness,and handgrip strength,and calculated body mass index,arm muscle circumference(AMC),and arm muscle area(AMA).We interviewed the subjects about their dietary habits and lifestyle using health assessment computer software.We surveyed daily physical activity using a pedometer.Univariate and multivariate logistic regression modeling were used to identify the relevant factors for insulin resistance.RESULTS:The rate of patients with HOMA-IR ≥ 2.5(which was considered to indicate insulin resistance) was 14(35.9%) in the chronic hepatitis and 17(37.8%) in the cirrhotic patients.AMC(%)(control vs chronic hepatitis,111.9% ± 10.5% vs 104.9% ± 10.7%,P = 0.021;control vs cirrhosis,111.9% ± 10.5% vs 102.7% ± 10.8%,P = 0.001) and AMA(%)(control vs chronic hepatitis,128.2% ± 25.1% vs 112.2% ± 22.9%,P = 0.013;control vs cirrhosis,128.2% ± 25.1% vs 107.5% ± 22.5%,P = 0.001) in patients with chronic hepatitis and liver cirrhosis were significantly lower than in the control subjects.Handgrip strength(%) in the cirrhosis group was significantly lower than in the controls(control vs cirrhosis,92.1% ± 16.2% vs 66.9% ± 17.6%,P < 0.001).The results might reflect a decrease in muscle mass.The total nutrition intake and amounts of carbohydrates,protein and fat were not significantly different amongst the groups.Physical activity levels(kcal/d)(control vs cirrhosis,210 ± 113 kcal/d vs 125 ± 74 kcal/d,P = 0.001),number of steps(step/d)(control vs cirrhosis,8070 ±3027 step/d vs 5789 ± 3368 step/d,P = 0.011),and exercise(Ex)(Ex/wk)(control vs cirrhosis,12.4 ± 9.3 Ex/wk vs 7.0 ± 7.7 Ex/wk,P = 0.013) in the cirrhosis group was significantly lower than the control group.The results indicate that the physical activity level of the chronic hepatitis and cirrhosis groups were low.Univariate and multivariate logistic regression modeling suggested that Ex was associated with insulin resistance(odds ratio,6.809;95% CI,1.288-36.001;P = 0.024).The results seem to point towards decreased physical activity being a relevant factor for insulin resistance.CONCLUSION:Non-hospitalized cirrhotic patients may need to maintain an adequate dietary intake and receive lifestyle guidance to increase their physical activity levels.

Role of diet and lifestyle changes in nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD)has becomeone of the most common causes of liver disease worldwide and has been recognized as a major health burden.The prevalence of NAFLD has grown proportionallywith the rise in obesity,sedentary lifestyle,unhealthydietary pattern,and metabolic syndrome.Currently,there is no drug therapy that can be formulated fortreating NAFLD.A combination of dietary modificationsand increased physical activity remains the mainstayof NAFLD management.It is hard to maintain thismode of management;however,it seems to havesignificant long-term benefits.Furthermore,NAFLDpatients,whether obese or not,should be educatedthat a healthy diet and physical activity have benefitsbeyond weight reduction.Further large controlled randomized trials are needed in order to identify the bestdietary regimen and physical activity in the management of NAFLD patients.This review highlights the roleof diet and lifestyle modifications in the managementof NAFLD,and focuses on human studies regarding dietary modifications and physical activity.

Dietary habits, lifestyle factors and neurodegenerative diseases

Worldwide stroke is increasing in parallel with modernization,changes in lifestyle,and the growing elderly population.Our review is focused on the link between diet,as part of‘modern lifestyle’,and health in the context of genetic predisposition of individuals to‘unhealthy’metabolic pathway activity.It is concluded that lifestyle including high sugar diets,alcohol and tobacco addiction or high fat diets as well as ageing,brain injury,oxidative stress and neuroinflammation,negatively influence the onset,severity and duration of neurodegenerative diseases.Fortunately,there are several healthy dietary components such as polyunsaturated fatty acids and the anti-oxidants curcumin,resveratrol,blueberry polyphenols,sulphoraphane,salvionic acid as well as caloric restriction and physical activity,which may counteract ageing and associated neurodegenerative diseases via increased autophagy or increased neurogenesis in the adult brain.

Pediatric non-alcoholic fatty liver disease:Preventive and therapeutic value of lifestyle intervention

Nonalcoholic fatty liver disease(NAFLD),ranging from simple steatosis to nonalcoholic steatohepatitis(NASH),and eventually cirrhosis and liver failure,is seen to be increasing amongst Western children.NAFLD rates are rising in parallel with the epidemic of childhood obesity,and in particular,fatty liver evolves more easily in NASH when poor dietary habits and sedentary lifestyle are combined.In fact,its general prevalence in the child population varies between 2.6% and 10%,but increases up to 80% in obese children.Since NASH is expected to become the most common cause of pediatric chronic liver disease in the near future,there is broad interest amongst clinical researchers to move forward,both in diagnosis and treatment.Unfortunately,to date,the expensive and invasive procedure of liver biopsy is seen as the gold standard for NASH diagnosis and few noninvasive diagnostic methods can be applied successfully.Moreover,there are still no approved pharmacological interventions for NAFLD/NASH.Therefore,current management paradigms are based upon the presence of associated risk factors and aims to improve an individual's quality of life,thus reducing NAFLD-associated morbidity and mortality.Today,lifestyle intervention(diet and exercise) is the treatment of choice for NAFLD/ NASH.Thus far,no study has evaluated the potential preventive effect of lifestyle intervention on children at risk of NAFLD/NASH.Future studies will be required in this area with the perspective of developing a national program to promote nutrition education and increase physical activity as means of preventing the disease in individuals at risk.Here,we outline the clinical course,pathogenesis and management of NAFLD in children,highlighting the preventive and therapeutic value of lifestyle intervention.