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.

Therapeutic Lifestyle Changes (TLCs) Improve the Quality of Life in the Elderly with Hypertension

Hypertension was one of the most serious diseases that affect many people in Indonesia in the age group of 18 years old and above. Hypertension can affect the quality of life, especially for the elderly, so the quality of life for the elderly will be disrupted and the life expectancy of elderly people will also decrease. Elderly people who have a good quality of life will have inner satisfaction, which can be judged from the physical, psychological and social aspects. This study only measured the quality of life of physical dimensions, especially blood pressure (systolic and diastolic). Improved quality of life of people with hypertension can be pursued with behavioral changes that increase blood pressure. One way can be given is the Therapeutic Lifestyle Changes (TLCs). The aim of this study was to determine the effect of the Therapeutic Lifestyle Changes (TLCs) on improving the quality of life of the elderly with hypertension in Puskesmas Pasirkaliki Bandung. This research is a quasi-experimental design with two group pre-post tests with control group. The statistical test used Wilcoxon test and Mann Whitney with a standard error of 5% or α = 0.05, because the data distribution was not normal. In the total sample, there were 52 respondents who had hypertension. Therapeutic Lifestyle Changes (TLCs) was done once a week for 4 weeks. The results prove that there is a statistically significant difference in systolic and diastolic blood pressure (quality of life) (Z = -4.415;Z = -4.208 p < 0.05). It is advisable for people with hypertension to expect to remain consistent in the Therapeutic Lifestyle Changes (TLCs) in their activity of daily life.

Remission of type 2 diabetes depends on prompt comprehensive lifestyle changes upon diagnosis: How can this“Road to Damascus” experience be supported?

Theoretically, a new diagnosis of type 2 diabetes mellitus(T2DM) requires a dramatic change in an individual’s way of life. Weight loss and physical activity can lead to remission of diabetes, which has been associated with a lower risk of developing complications. Today, the importance of a healthy lifestyle is further highlighted by data showing that obesity and diabetes increase the risk of severe complications from coronavirus disease 2019. However, remission rarely occurs in reality, probably due to the inability of people with T2DM to adhere to the intensive lifestyle interventions that are necessary. The complexity of contributing factors may explain why making these changes is so challenging and underscore the fact that there is no magical solution for T2DM. Instead, hard work from both patients and health care providers is needed for the conversion to be achieved. This article calls for more research on the underlying reasons why adhering to a healthy way of life is so difficult for people with diabetes and obesity. Clearly defining these barriers would facilitate the planning of effective policies to promote the adoption of appropriate lifestyle changes early in the course of the disease.

Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis

BACKGROUND Non-alcoholic steatohepatitis(NASH) has become one of the leading causes of liver disease in the western world. In obese patients weight reduction is recommended. Up to now there are no specific guidelines for weight loss in order to reduce hepatic fat content.AIM To investigate the effects of a 24-wk guided lifestyle intervention program compared to a meal replacement regimen based on soy protein.METHODS Twenty-six subjects with NASH participated in a randomized single-center study. They were randomly assigned to either meal replacement group(MR-G)with soy-yogurt-honey preparation or to guided lifestyle change group(LC-G)with endurance activity and nutrition counselling. Serum alanine transaminase(ALT), aspartate transaminase(AST), lipid parameters, and adipokines were measured. Liver fat content and lipid composition were determined by magnetic resonance imaging and magnetic resonance spectroscopy. Body fat mass and lean body mass were assessed using Bod Pod? device. Pre-and post-intervention monitoring of parameters was performed. Statistical analyses were conducted with SPSS software, results were expressed as median(interquartile range).RESULTS Twenty-two subjects(MR-G, n = 11 and LC-G, n = 11) completed the study(9 women, 13 men; age 52.1(15.0) years, body mass index(BMI) 32.3(3.3) kg/m^2).In both groups a significant weight loss was achieved(MR-G:-6.4(3.6) kg, P <0.01; LC-G:-9.1(10.4) kg, P < 0.01). BMI dropped in both groups(MR-G:-2.3(1.5)kg/m^2, P = 0.003; LC-G:-3.0(3.4) kg/m^2, P = 0.006). Internal fat and hepatic lipid content were markedly reduced in both groups in comparable amount. There was a strong correlation between reduction in liver fat and decrease in ALT.Likewise, both groups showed an improvement in glycemic control and lipid profile. Changes in adipokines, particularly in adiponectin and leptin were closely related to intrahepatic lipid changes.CONCLUSION Comprehensive lifestyle intervention and meal replacement regimen have comparable effects on body and liver fat, as well as decrease in markers of hepatic inflammation among NASH patients.

What About Change？ An Old Theory in a New Light

Change is a constant part of our life...It is almost a klise. It is everywhere, and we should know, how it can happen to us, and how to act it. This article is the first part of a year-long study, that aims to fmd, which factors can be a part of a successful lifestyle change, especially for conscious consumption. We consume ridiculously much, over the level, we need. Half of the world is hungry, and the other half is trying to lose some weight. If we can create a model, like an equation f.e. Double self confidence and one good family background are equal to 10 percent of success lifetime change, which is probable not, but if we can find something like that, it would change the theory of lifestyle changing in modem consumption society. This article shows our lifestyle changing model theory, and a study, which presents, its appearance in practise.

Cardiac Rehabilitation: Future of Heart Health in Saudi Arabia, a Perceptual View

Objective: Having a heart healthy life is one of the most rewarding gifts that you can own yourself in the modern lifestyle practices. Cardiac rehabilitation (CR) is the next step to recover and reverse the limitations experienced by patients who have undergone all the adverse pathophysiological and psychological consequences of cardiac events. Design: This is a review article. The need for cardiacrehabilitation: CR describes all the methods and measures used to prevent recurrent cardiac attaches and to return people with heart diseases to an active and a satisfying lifestyle. CR services should be offered by all health professionals who are in direct contact with the patient, like cardiac specialist, general practitioner, and other health care providers. The success rate of the CR program improves dramatically when it comes in parallel with limiting modifiable risk factors of cardiovascular diseases. The CR programs not only manage episodes of cardiac events, but also it is a comprehensive tool for preventing future heart problems and improving the patients’ life standard. Goals of Cardiacrehabilitation (CR): CR program has been evolved with a wide range of indications that aims to regain autonomy and maximize the physical, psychological and social activities. This makes people with cardiac diseases more confident and inspires behaviors that may minimize risk of further cardiac events. Thevision to improve CR in Saudi Arabia: This article will focus on the methods and parameters that will lead to an improvement in the CR services in the Kingdom of Saudi Arabia.

Lifestyle modifications and erectile dysfunction： Nhat can be expected？

Erectile dysfunction （ED） is a common medical disorder whose prevalence is increasing worldwide. Modifiable risk factors for ED include smoking, lack of physical activity, wrong diets, overweight or obesity, metabolic syndrome, and excessive alcohol consumption. Quite interestingly, all these metabolic conditions are strongly associated with a pro-inflammatory state that results in endothelial dysfunction by decreasing the availability of nitric oxide （NO）, which is the driving force of the blood genital flow. Lifestyle and nutrition have been recognized as central factors influencing both vascular NO production, testosterone levels, and erectile function. Moreover, it has also been suggested that lifestyle habits that decrease low-grade clinical inflammation may have a role in the improvement of erectile function. In clinical trials, lifestyle modifications were effective in ameliorating ED or restoring absent ED in people with obesity or metabolic syndrome. Therefore, promotion of healthful lifestyles would yield great benefits in reducing the burden of sexual dysfunction. Efforts, in order to implement educative strategies for healthy lifestyle, should be addressed.

Bioinformatics Analysis of the Relationship between Lifestyle and Prostate Cancer

In this study,we assessed the relationship between lifestyle and prostate cancer.We selected the Gene Expression Omnibus(GEO)dataset GSE10306 to analyze the expression levels of ataxin10(ATXN10),interferon related developmental regulator 1(IFRD1),formin-binding protein 1 like(FNBP1 L)and THO complex 2(THOC2)in prostate biopsies pre and post intensive nutrition and lifestyle intervention.Following a three-month intervention of nutrition and lifestyle,these genes showed a significant down-regulation.ONCOMINE database analysis showed that the four genes exhibited high expression in prostate cancer tissues compared with normal prostate tissues,which indicated that comprehensive lifestyle changes may modify the progression of prostate cancer mediated by altering the expression of ATXN10,FNBP1 L,THOC2 and IFRD1.Among the four genes,the high expression of IFRD1 was found to indicate a worse overall survival(OS)and disease-free survival(DFS).FNBP1 L and THOC2 were associated with CD8+T cell infiltration of prostate cancer.We also speculated a possible regulatory network for lifestyle to influence miRNA,subsequently influencing the expression of relevant genes.Our findings suggested that these genes may be used as potential target sites for the treatment of prostate cancer.