Abstract:
Non Alcoholic Fatty Liver Disease can be considered as spectrum of hepatic diseases related to metabolic and cardiovascular diseases including obesity, insulin resistance (IR), hypertension, dyslipidemia and Type 2 diabetes (T2D). It is characterized increased liver fat content with a threshold of >5% in absence of significant alcohol consumption. It can further progress to liver fibrosis cirrhosis and liver cancer due to a steatosis-inflammatory-fibrosis response, causing a dramatic burden to patients and society. This trend will have substantial implications for public health, including increased healthcare costs and an escalating demand for liver transplantation, as NAFLD and its subtype, non-alcoholic steatohepatitis (NASH), are poised to become the most common indications for this procedure. Patients with NAFLD who exhibit evidence of non-alcoholic steatohepatitis and advanced fibrosis are at a markedly elevated risk of adverse outcomes, including overall mortality and liver-specific morbidity and mortality. Considering the nutritional limitations in cited researches clinicians are recommended to suggest patients with Body mass index ≥ 25 kg/m2 to intensive multicomponent behavioural intervention and this is the main focus of our research. Fat accumulation happens because of excess energy consumption and unmatched energy expenditure. Thus in our research we targeted weight management, modification of dietary macronutrient composition with special emphasis on Mediterranean diet, physical activity and behavioural therapy. Initially systematic approach was adapted to evaluate lifestyle using a tailored KAP tool. A 12-week multicomponent intervention plan integrating dietary modifications, physical activity, and behavioural interventions to support subjects in reducing liver fat, improving metabolic health, and fostering long-term healthy habits was designed and implemented. One educational talk of 45 minutes duration was organised each time using developed IEC materials. Educational Sessions were conducted on weekly basis in both offline and online mode (Google meet, Zoom, what’s app and phone calls) which include key topics such as Introduction to NAFLD and the role of nutrition, Benefits of Mediterranean diet, understanding macronutrients and their impact on liver health, Reading food labels and meal planning, Mindful eating and portion control, Importance of physical activity etc. A comprehensive Dietary Manual will be provided to participants, containing personalized dietary advice for NAFLD subjects. After completion of 90 days of intervention the impact assessment of the package will be done using the same Survey Instrument which was used earlier and for assessing improvement in nutrition status, and improvement in the knowledge, attitude and practice. The entire data will be finally be tabulated and statistically analysed using appropriate statistical tests.
