Integrative proteomic-transcriptomic analysis revealed the lifestyles of Lactobacillus paracasei H4-11 and Kluyveromyces marxianus L1-1 under co-cultivation conditions

Compared with the rice-acid soup inoculated with single starter,the synergistically intensifi ed rice-acid soup inoculated with Lactobacillus paracasei H4-11(L.paracasei H4-11)and Kluyveromyces marxianus L1-1(K.marxianus L1-1)contained more fl avor compounds.Organic acids mainly included L-lactic acid and the main volatile fl avor component was ethyl acetate.Moreover,the signal intensity of astringency and bitterness and the total concentration of volatile sulfur compounds were reduced.The combined analysis results of RNA sequencing(RNA-seq)technology and 4D label-free quantitative(4D LFQ)proteomics explained the fl avor formation pathways in rice-acid soup inoculated with L.paracasei H4-11 and K.marxianus L1-1.In L.paracasei H4-11,L-lactate dehydrogenase,phosphoglucomutase,acetate kinase,alcohol dehydrogenase and acetyl-CoA were up-regulated and D-lactate dehydrogenase and N-Acetyltransferase were down-regulated.In K.marxianus L1-1,Acetyl-CoA,acetaldehyde dehydrogenase,acyl-coenzyme A,N-acetyltransferase,and L-lactate dehydrogenase were up-regulated and hexokinase,alcohol dehydrogenase,and alcohol O-acetyltransferase were down-regulated.The above up-regulation and down-regulation synergistically promoted the formation of characteristic fl avor compounds(mainly L-lactic acid and ethyl acetate).Enzyme-linked immunoassay(ELISA)and parallel reaction monitoring(PRM)quantitative analysis respectively verifi ed that 5 key metabolic enzymes and 27 proteins in L.paracasei H4-11 and K.marxianus L1-1 were associated with the characteristic fl avor of rice-acid soup,as confi rmed by the quantitative results of 4D LFQ.

Study on establishing hypertension animal models by adverse lifestyles and the antihypertensive effect of traditional Chinese medicine

OBJECTIVE Nowadays,with the living habits and diet structure changes,the morbidity and mortality of hypertension has been rising yearly,which induced by adverse lifestyles,excessive alcohol and poor diet.However,the animal models of hypertension resulted from adverse lifestyles have rarely been reported.It is essential to set up some more systematic models to study the characters of hypertension and evaluate the efficacy of traditional Chinese medicine(TCM).METHODS To build the rat model of human lifehabitual hypertension,SD rats had free access to alcohol with high-sucrose-fat diet(AHSFD),alcohol with high-fat diet(AHFD),high-sucrose-fat diet(HSFD),high-fat diet(HFD)and alcohol etc.Various of indicators were detected systematically to explore the features of hypertension models which included blood pressure(BP),liver and kidney functions,the lipid profiles and indexes quantifying TCM symptoms.Then we choose one of the stable and sustained animal models,studying the effects of RPA.E(which extracted from a TCM)on modulating the level of hypertension and the preliminary mechanism in this abstract.RESULTS ①The BP level,serum TC,TG,LDL-C of AHSFD-induced and AHFD-induced rats increased significantly,while the HDL-C reduced in the 4th week.② The BP level HSFD-induced rats increased significantly in the 6th week,serum TC,TG increased in 10 th week.③ The BP level of alcohol-induced rats increased significantly in the 9th week,serum TC,TG increased in 24 th week.④ The level of serum ALT,AST,UA and Cr of all model rats increased significantly after 12 weeks.Meanwhile the microcirculation increased significantly after8 weeks.⑤ After 4-week administration,RPA.E could significantly reduce BP of AHFD-induced hypertensive rats,and could reduce the serum TC,LDL-C,HDL-C,ALT,AST level after 8-week.CONCLUSION The rats induced by AHSFD,AHFD,HSFD and alcohol can raise BP obviously with underlying hepatic and kidney damage,the lipid profiles disorder and TCM symptoms change,while the AH(S)FD-induced hypertension models are earlier and more stable.RPA.E could mildly reduce BP level,and improve the lipid profiles disorders,hepatic damage,which reflects the characteristics of TCM on antihypertensive effects.The above models have their own characteristics,can be used to study the causes and pathogenesis of hypertension complicating metabolic disorder and the related treatment drug screening.

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.?

Family and women decide child nutrition—The role of human development, capabilities and lifestyles

In this article, capacities and freedom approach, as well as lifestyles are explored taking into account child nutrition, and other relevant dimensions of human life more than just economic and other elementary resources, and also social, cultural, psychological, values and freedom dimensions. Nourishment, health and survival are considered some of the elementary capabilities, and the concept of malnutrition, including under and over-nutrition, is discussed, based upon the comparison of data on food production and distribution from the macro level context, as well as from the family and individual levels included anthropometrical measurements. The advantages and limits of different kinds of measurements are discussed, suggesting more complex approaches, based also upon family and gender equality. The double burden of malnutrition, under and over-nourishment of children is highlighted as a public health issue to be resolved by adequate policies and considering the role of female empowerment, nutrition-knowledge and education as relevant keys to achieve equality in family food and resource distribution, healthy lifestyles and human development.

Teaching about Different Lifestyles in Second Language Learning

Cultural learning is an indispensible part in both first and second language learning.One cannot learn a language without learning the culture where it operates.This literature review aims to clarify the relationship between language and culture and arouse language teachers' consciousness of the benefits of integrating cultural teaching into language learning in second language classrooms by addressing the question:What are the benefits of combining language teaching and cultural teaching? Consequently it explains the nature of different lifestyles in different cultures and the process of second language learning.Also,it explores the significance of cultural awareness in second language learning and teaching and the strategies to incorporate lifestyles into second language teaching.The findings of this literature review strongly suggest the importance for second language teachers to incorporate culture into classroom teaching.Learning a second language cannot be separated from learning the target culture which facilitates successful language learning and reduces prejudice,misunderstanding and stereotyped notions towards the target language group.

NRN1 and CAT Gene Polymorphisms, Complex Noise, and Lifestyles interactively Affect the Risk of Noise-induced Hearing Loss

Objective The effects of interactions between genetic and environmental factors on the noise-induced hearing loss(NIHL)are still unclear.This study aimed to assess interactions among gene polymorphisms,noise metrics,and lifestyles on the risk of NIHL.Methods A case-control study was conducted using 307 patients with NIHL and 307 matched healthy individuals from five manufacturing industries.General demographic data,lifestyle details,and noise exposure levels were recorded.The Kompetitive allele-specific polymerase chain reaction(KASP)was used to analyze the genotypes of 18 SNPs.Results GMDR model demonstrated a relevant interaction between NRN1 rs3805789 and CAT rs7943316(P=0.0107).Subjects with T allele of rs3805789 or T allele of rs7943316 had higher risks of NIHL than those with the SNP pair of rs3805789-CC and rs7943316-AA(P<0.05).There was an interaction among rs3805789,rs7943316,and kurtosis(P=0.0010).Subjects exposed to complex noise and carrying both rs3805789-CT and rs7943316-TT or rs3805789-CT/TT and rs7943316-AA had higher risks of NIHL than those exposed to steady noise and carrying both rs3805789-CC and rs7943316-AA(P<0.05).The best six-locus model involving NRN1 rs3805789,CAT rs7943316,smoking,video volume,physical exercise,and working pressure for the risk of NIHL was found to be the interaction(P=0.0010).An interaction was also found among smoking,video volume,physical exercise,working pressure,and kurtosis(P=0.0107).Conclusion Concurrence of NRN1 and CAT constitutes a genetic risk factor for NIHL.Complex noise exposure significantly increases the risk of NIHL in subjects with a high genetic risk score.Interactions between genes and lifestyles as well as noise metrics and lifestyles affect the risk of NIHL.

Environments favorable to healthy lifestyles:A systematic review of initiatives in Canada

Background: In recent years, a number of initiatives aimed at promoting healthy lifestyles in health-friendly environments have been implemented.The purpose of this review is to synthesize initiatives conducted in Canada and documented in publications for the period 1995–2015 in order to gain a better understanding of their objectives and impacts.Methods: A systematic review of Canadian initiatives published over the past 20 years was conducted from multiple databases(i.e., Scopus,SPORTDiscus, Pub Med, Academic search complete, Reseausante.com, Cairn, and Erudit). In total, 264 publications were identified and retained for the final analysis based on 5 criteria:(1) publication between 1995 and 2015,(2) online availability,(3) research conducted in Canada,(4) main topic related to environments favorable to healthy lifestyles(EFHL), and(5) publication in French or English.Results: A sharp increase in the number of studies on EFHL was observed between 2010 and 2015(57%). Two major lifestyle components—physical activity and nutrition—and 2 environmental aspects—neighborhood and built environment—were the elements most frequently examined regarding adults(48%), young people(34%), and seniors(9%), using quantitative(60%) and qualitative(18%) methods. Furthermore, the analysis reveals a greater focus on the municipal(53%) than the national or provincial levels(31%).Conclusion: This work is a first map of Canadian studies related to EFHL. It clarifies the definition of EFHL and classifies its components. As well,it documents the issues raised, the research methods employed, and the role of stakeholders, while outlining a new research agenda that includes dimensions of EFHL formerly neglected by researchers, namely, political and sociocultural spheres of action.? 2018 Production and hosting by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).

Association of Health-related Quality of Life with Health Examination and Lifestyles of Government Managers in China

In order to study the association of each item of a health examination and lifestyles with health-related quality of life (HRQoL), a cross-sectional survey by a self-administered questionnaire using the 12-Item Short Form Health Survey (SF-12, version 1) was conducted on 145 government managers that took health examinations in Tongji Hospital, Wuhan, China during 2005. The results showed that the determinations of organic functions including BMI, hemoglobin, blood platelet count, urine protein, urine WBC and lipid metabolism (LDL) were associated with HRQoL. The lifestyle items including age, sex, life satisfaction, drinking alcohol and kind of alcohol drunk, drinking tea, sleep quality and adhering to bedtime, working overtime, work stress were associated with HRQoL in the multiple regression models. Sex, age and life satisfaction were the lifestyle items most closely associated with HRQoL, while LDL, hemoglobin and urine protein were the health examination items most closely associated HRQoL. This study revealed that both lifestyle and health examination items were associated with HRQoL.

Child Care Providers’ Perceptions of Children’s Lifestyles and Risk Factors for Obesity: A Focus Group Study

Objective: This study attempts to understand child care providers’ perceptions of remarkable children’s lifestyles and discusses potentially successful strategies of cooperation among child care providers, parents, and health professionals for health promotion and the prevention of obesity in preschool children. Methods: We conducted 6 focus group discussions consisting of 34 child care providers employed by private and public child care centers, and a public kindergarten in Yamanashi Prefecture, Japan. Systematic thematic analysis was conducted to generate themes to address the study questions. Results: What the focus group participants discussed with felt mainly into the 3 different kinds of points: “Concerns of Child Care Providers Regarding Parental Attitudes about Nutrition and Nurture,” “Tensions between Parents and Child Care Providers,” and “Current Obesity Prevention Activities and the Role of Child Care Professionals.” Conclusions: Childcare providers had many concerns that fell into 5 main issues of the possible detrimental effects on children’s health due to parents’ nurturing methods and lifestyles. Participants described possible strategies for the prevention of childhood obesity in childcare settings as well as barriers to effective intervention. Childcare providers felt that a system to demand helps from public health nurses in guiding parents would be effective in preventing childhood obesity.

Health related quality of life of university students in Lebanon: Lifestyles behaviors and socio-demographic predictors

Measuring and monitoring health related quality of life (HRQoL) in youth are important for both researchers and decision makers. During the time that young people are at university, many will encounter a number of academic, as well as social, emotional and psychological difficulties. The aims of this study are to: 1) assess the health related quality of life of youths using SF-36 questionnaire and its factor determinants, and 2) provide an objective basis for a health promotion structure. Methods: This is a cross-sectional study in South Lebanon, in a population of 282 young university students attending a public university which is the largest and most widespread institution of higher education in Lebanon. Socioeconomic and lifestyle behaviors data were collected. Students’ HRQoL was measured using the SF-36 Health Survey. Results: The mean age of the respondents was 18.7 years (SD = 1.16), 80.1% were women, 64.5% were living in rural area. The proportion of current smokers was significantly greater among men than women (26.8% vs. 11.5%, p < 0.01). Water pipe was the main type of smoking. Education of the fathers had negatively influenced HRQoL. Younger age scored higher in Social Functioning and Role-Emotional;the area of residence had no influences on SF-36 scales scores. Females had poorer HRQoL than males especially in mental health scales. Smokers had low Vitality and Mental Health scores. Sedentary lifestyle was linked to a lower score of Physical Functioning (β = -5.16, 95% CI = -7.67 -2.65), and Vitality ( β= -5.85, 95% CI = -10.24 -1.45). The HRQoL of the students studying business and economics was higher than those studying health. Conclusion: Youths’ HRQoL is affected by socio-demographic and behavioral characteristics. Effective health-promoting actions, social support, and counseling services should be implemented in the campus and are a necessary step towards the main goal of improving the overall HRQoL of the university young students in Lebanon.

Using Individual, ApoE Genotype-Based Dietary and Physical Activity Advice to Promote Healthy Lifestyles in Finland—Impacts on Cardiovascular Risk Markers

Aim: There is increasing demand for individualized health advice. The aim of this study was to assess the effects on cardiovascular risk markers of receiving personal genetic health information, using apoE genotypes as a tool for promoting lifestyle changes. ApoE was chosen because it had a significant impact on lipid metabolism and cholesterol absorption, all factors for CVD. Methods: This study was a one-year explanatory intervention study for healthy adults, aged between 20 - 67 years old (n = 106). Their clinical markers (serum lipids, blood glucose, blood pressure, Body Mass Index, body fat percentage and waist circumference) were measured three times during the intervention. The clinical effects were assessed for three groups: a high risk group (ε 4+, n = 16);a low-risk group (&#949?4-, n = 35);and a control group (n = 55). Results: The triglyceride values and waist circumference lowered more in &#949?4+ compared with the control group (p < 0.05;alpha value 0.005) during the intervention. Conclusion: The personal genetic information, based on apoE, may have positive effects on cardiovascular risk markers (e.g., improvement in triglyceride values). The individual health information, based on genotyping could be a potential option in the prevention of CVD. More research is required on how to utilize genotype-based health information in the prevention of lifestyle-related diseases.

Associations between parental adherence to healthy lifestyles and cognitive performance in offspring:A prospective cohort study in China

Background:Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood.This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods:We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies.A healthy parental lifestyle score(ranged 0-5)was constructed based on the following five modifiable lifestyle factors:Smoking,drinking,exercise,sleep,and diet.Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years(2012,2014,2016,and 2018).Results:Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence(multivariable-adjusted β=0.53,95%confidence interval[CI]:0.29-0.77)and overall crystallized intelligence(multivariable-adjusted β=0.35,95%CI:0.16-0.54)than those in the bottom tertile of parental healthy lifestyle scores.The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status.Additionally,maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance,with significant contribution observed for paternal never-smoking,weekly exercise,and diversified diet.When both parents and offspring adhered to a healthier lifestyle,we observed the highest level of the offspring’s overall crystallized intelligence.Conclusions:Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood,regardless of socioeconomic status.These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.

Lifestyles of Older Adults in Castilla-La Mancha(Spain):Influence of Sex,Age,and Habitat

This paper presents the quantitative research results of a comprehensive study titled“Current Profle of Older Adults in Castilla-La Mancha(Spain).”The study aims to understand and describe the characteristics of individuals aged 65 and above within this autonomous region,with a focus on the variables of sex,age,and habitat.A cross-sectional approach was employed,utilizing quantitative methods to collect data.To gather information,a customized questionnaire was developed to address the study objectives,covering various aspects such as sociodemographic factors,living conditions,leisure activities,social participation,and cultural interests.The survey was conducted via telephone,ensuring representation by employing gender quotas,age-group stratifcation,and considerations for habitat size.A representative sample of 1,065 participants was included in the study.The fndings reveal a degree of homogeneity in the lifestyles of older adults,with discernible variations infuenced by factors such as sex,habitat,and age.These results shed light on the diverse habits and experiences of older adults,emphasizing the signifcance of habitat conditions,social participation,and the aging process.

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.

Biological factors driving colorectal cancer metastasis

Approximately 20%of colorectal cancer(CRC)patients present with metastasis at diagnosis.Among Stage I-III CRC patients who undergo surgical resection,18%typically suffer from distal metastasis within the first three years following initial treatment.The median survival duration after the diagnosis of metastatic CRC(mCRC)is only 9 mo.mCRC is traditionally considered to be an advanced stage malignancy or is thought to be caused by incomplete resection of tumor tissue,allowing cancer cells to spread from primary to distant organs;however,increa-sing evidence suggests that the mCRC process can begin early in tumor development.CRC patients present with high heterogeneity and diverse cancer phenotypes that are classified on the basis of molecular and morphological alterations.Different genomic and nongenomic events can induce subclone diversity,which leads to cancer and metastasis.Throughout the course of mCRC,metastatic cascades are associated with invasive cancer cell migration through the circulatory system,extravasation,distal seeding,dormancy,and reactivation,with each step requiring specific molecular functions.However,cancer cells presenting neoantigens can be recognized and eliminated by the immune system.In this review,we explain the biological factors that drive CRC metastasis,namely,genomic instability,epigenetic instability,the metastatic cascade,the cancer-immunity cycle,and external lifestyle factors.Despite remarkable progress in CRC research,the role of molecular classification in therapeutic intervention remains unclear.This review shows the driving factors of mCRC which may help in identifying potential candidate biomarkers that can improve the diagnosis and early detection of mCRC cases.

Cardiovascular health awareness,risk perception,behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia

Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.

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.

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.

Effective roles of exercise and diet adherence in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is characterized by symptoms of excessive fat accumulation and steatosis in the liver without alcohol intake in patients.The associated pathogenic mechanism is not completely understood and there are no specific drugs for patients with NAFLD.Exercise and diet adherence are the best options for the management of NAFLD patients.Questionnaire associated analysis models of adherence to these interventions are used to assess their effectiveness in the management of NAFLD patients using specificity,sensitivity,and so on.Studies have indicated that the relative ratio of NAFLD can be reduced by physical activity with diet control.In the future,the pathogenesis of NAFLD should be clarified with stratified efforts to develop appropriate drugs,and both exercise and diet adherence should be optimized using better questionnaire design and evaluation models for patients with NAFLD.

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.