Lifestyle interventions in nonalcoholic fatty liver disease

Zobair M. Younossi, Shira Zelber-Sagi, Linda Henry, Lynn H. Gerber

Research output: Contribution to journalReview articlepeer-review


Nonalcoholic fatty liver disease (NAFLD) is a dynamic chronic liver disease that develops in close association with metabolic irregularities. Between 2016 and 2019, the global prevalence among adults was reported as 38% and among children and adolescents it was about 10%. NAFLD can be progressive and is associated with increased mortality from cardiovascular disease, extrahepatic cancers and liver complications. Despite these numerous adverse outcomes, no pharmacological treatments currently exist to treat nonalcoholic steatohepatitis, the progressive form of NAFLD. Therefore, the main treatment is the pursuit of a healthy lifestyle for both children and adults, which includes a diet rich in fruits, nuts, seeds, whole grains, fish and chicken and avoiding overconsumption of ultra-processed food, red meat, sugar-sweetened beverages and foods cooked at high heat. Physical activity at a level where one can talk but not sing is also recommended, including leisure-time activities and structured exercise. Avoidance of smoking and alcohol is also recommended. Policy-makers, community and school leaders need to work together to make their environments healthy by developing walkable and safe spaces with food stores stocked with culturally appropriate and healthy food items at affordable prices as well as providing age-appropriate and safe play areas in both schools and neighbourhoods.

Original languageEnglish
Pages (from-to)708-722
Number of pages15
JournalNature Reviews Gastroenterology and Hepatology
Issue number11
StatePublished - Nov 2023

Bibliographical note

Publisher Copyright:
© 2023, Springer Nature Limited.

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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