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Lifestyle Interventions in NASH – Backbone, Therapy or Waste of Time?

The effects of lifestyle interventions as a baseline therapy for the treatment of NASH are well accepted. However, there is a high degree of frustration when it comes to recommending and implementing lifestyle changes. Large interventional studies in the field of metabolic disease are largely negative with regards to long-term outcomes.

In regards to NASH, both patients and physicians are frequently overestimating the degree of lifestyle changes that can be achieved or, more importantly, can be maintained. Clinical or personal resources in the general practice and specialised care of patients are limited and not sufficient to train or support patients in this phase of lifestyle changes. Therefore, effective and simplified lifestyle interventions need to be developed. These could include interventions that focus on a single nutrient, e.g. defined carbohydrates, to simplify the dietary restrictions or formula diets.

Furthermore, lifestyle changes need to be supported by feedback from peers or platforms that support dynamic monitoring to allow long-term adherence. In order to prevent frustration from unachievable goals, nutritionists and trainers will be required at an early point to develop an individualised combination strategy.

Because NASH is tied to obesity, poor diet, and inactivity, lifestyle changes are almost always going to be primary recommended goals for patients. However, physicians need to select the correct intervention approach and patients need to be supported to ensure long-term adherence.


Jörn Schattenberg is an Attending Physician at the University Medical Center Mainz. At the upcoming Global NASH Congress, Jörn will be presenting on potential interventions in NASH.

View the agenda for the Global NASH Congress.

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