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

In this editorial we comment on the article titled “Establishment and validation
of an adherence prediction system for lifestyle interventions in non-alcoholic
fatty liver disease” by Zeng et al published in a recent issue of the World
Journal of Gastroenterology. Non-alcoholic fatty liver disease (NAFLD)
represents one of the current challenges in hepatology and public health, due to
its continuous growing prevalence and the rising incidence of NAFLD-related
fibrosis, non-alcoholic steatohepatitis and cirrhosis. The only effective
therapeutic strategy for this disease is represented by encouraging patients to
improve their lifestyle through the modification of dietary intake and increased
physical exercise, but the effective application of such modifications is often
limited by various factors such as lack of information, psychological barriers
or poor social support. While poor adherence to a healthy lifestyle can be
decisive in determining the clinical outcome, in daily practice there is a lack
of quantitative instruments aimed at identifying patients with the lowest
adherence to lifestyle changes and higher risk of disease progression in the
course of follow-up. In this article, Zeng et al propose a quantitative scale to
assess the grade of adherence of patients with NAFLD to healthy lifestyle
intervention, called the Exercise and Diet Adherence Scale (EDAS). This scale,
consisting of 33 items divided into 6 dimensions which relates to six subjective
aspects in the self-management of NAFLD, has shown a good correlation with the
identification of the sub-cohort of patients with the highest reduction in
caloric intake, increase in physical exercise, probability of a reduction in
liver stiffness measurement and alanine aminotransferase levels. The correlation
among clinical outcomes and specific dimensions of this scale also highlights
the pivotal role of a good and confidential doctor-patient relationship and of
an effective communication. There is an urgent need for practical and effective
instruments to assess the grade of self-management of NAFLD patients, together
with the development of multidisciplinary teams with the aim of applying
structured behavioral interventions.

©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights
reserved.

DOI: 10.3748/wjg.v30.i25.3143
PMCID: PMC11238672
PMID: 39006382 [Indexed for MEDLINE]

Conflict of interest statement: Conflict-of-interest statement: The authors have
no conflicts of interest to disclose regarding this paper.