Healthy habits in terms of food intake and physical activity are first-line approach to prevention and treatment of nonalcoholic
fatty liver disease, but difficulties arise in turning attempts into practice. Independently of the specific role of individual nutrients, not
universally proven, overweight, obesity and diabetes are the specific conditions most frequently associated with hepatic fat accumulation.
Accordingly, weight loss is mandatory in the majority of patients; this can be achieved by dietary restriction, but is rarely maintained in
the long-term. Physical activity programs, both aerobic and resistance exercise may improve cardiorespiratory fitness, reduce the multiple
conditions associated with the metabolic syndrome and help weight loss maintenance. However, motivating sedentary individuals to
move is difficult and is favored by structured programs carried out along the lines of cognitive-behavior therapy. The role of behavior
therapy is now supported by pilot studies, observational studies and finally by a randomized controlled study with histological outcomes.
In the future, behavior interventions might be supported by important technological advances, such as smart phone technology and webbased
platforms to facilitate interactive engagement amongst patients and with their health care providers. Lifestyle programs must also
incorporate methods of overcoming barriers to accessing health service, engaging with workplace health programs and linking with
community attempts to improve public health.
Nonalcoholic fatty liver disease, metabolic syndrome, physical activity, cardiovascular disease, prevention, treatment, behavior
Principal Research Fellow Princess Alexandra Hospital Department of Nutrition and Dietetics Ground Floor, Building 15 Ipswich Road, Woolloongabba, QLD, 4102; Australia.