Journal of clinical and experimental hepatology
July 28, 2026 · via Europe PMC
Efficacy of Structured Lifestyle Intervention in Normal Body Mass Index Non-alcoholic Fatty Liver Disease.
Sharanabasava, Sharma PN, Maharshi S, Sharma KK, Tak V, Pokharna R, Nijhawan S, Sharma SS.
AI summary — for doctors, generated from the abstract only
In a non-randomized controlled study of patients with normal-BMI NAFLD, a structured lifestyle intervention (diet counseling, prescribed exercise, weekly follow-up) was associated with greater improvement in liver enzymes and liver stiffness at 6 months compared with standard advice, independent of weight loss.
What was studied
A prospective, controlled, non-randomized (preference-based) interventional study of 120 patients with normal-BMI, ultrasound-detected NAFLD and elevated liver enzymes, comparing a structured 6-month lifestyle intervention (dietary counseling, prescribed aerobic exercise 150-200 min/week, weekly telephonic follow-up, n=60) versus standard verbal advice (control, n=60), assessing changes in liver stiffness and liver enzymes (SGOT, SGPT) at 1, 3, and 6 months.
Key findings
- Retention was excellent (100% intervention, 95% control) and baseline characteristics were comparable between groups.
- At 6 months, the intervention group showed a greater reduction in SGPT (alanine aminotransferase) levels (-23.1 U/L, a 27% decrease) compared with controls, with a between-group difference of -18.7 U/L.
- The abstract text is truncated regarding exact statistical significance values and liver stiffness change figures, but the authors conclude that structured lifestyle modification was associated with significant improvements in liver biochemistry and stiffness, independent of weight loss.
Clinical relevance
The findings suggest that structured, intensive lifestyle intervention programs may improve liver enzymes and stiffness in normal-BMI NAFLD patients even without significant weight loss, which may be relevant given that lean NAFLD management is less well studied; however, the authors caution that the non-randomized, preference-based design and high motivation of participants should be considered when interpreting results.
Who should care
Limitations
The authors explicitly state that the preference-based (non-randomized) design and high motivation of participants should be considered when interpreting these results, limiting causal conclusions.
A structured lifestyle program improved liver enzymes and stiffness in normal-BMI NAFLD patients independent of weight loss, but the non-randomized design and highly motivated participants limit how strongly this can be generalized.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background and aims
Lifestyle modification remains the cornerstone of non-alcoholic fatty liver disease (NAFLD) management, but its efficacy in lean or normal-Body Mass Index (BMI) patients is inadequately studied. We evaluated the effect of structured lifestyle intervention on liver biochemistry and stiffness in patients with normal-BMI NAFLD.
Methods
This prospective, controlled interventional study enrolled 120 consecutive patients with ultrasound-detected hepatic steatosis, elevated liver enzymes, and BMI 2. Participants were allocated to intervention (n = 60) or control (n = 60) groups using a non-randomized, preference-based approach based on willingness for intensive counseling. The intervention comprised structured dietary counseling, prescribed aerobic exercise (150-200 min/week), and weekly telephonic follow-up for 6 months. Controls received standard verbal advice. Changes in liver stiffness and serum levels of aspartate aminotransferase (SGOT) and alanine aminotransferase (SGPT) were assessed at 1,3 and 6 months.
Results
Baseline characteristics were comparable between groups and retention was excellent (100% intervention, 95% controls). At 6 months, the intervention group showed greater reduction in SGPT levels (-23.1 U/L, 27% decrease, P P = 0.147), with between-group difference of -18.7 U/L (P P P P P P < 0.001; NNT = 2.6). Benefits were consistent across diabetes status, steatosis grade, and age subgroups. BMI showed a modest non-significant reduction in the intervention group while remaining within the normal range.
Conclusions
In this non-randomized preference-based study, structured lifestyle modification with dietary counseling, prescribed exercise, and systematic follow-up was associated with significant improvements in liver biochemistry and stiffness in normal-BMI NAFLD patients, independent of weight loss. The preference-based design and high motivation of participants should be considered when interpreting these results.
DOI
10.1016/j.jceh.2026.103632
PMID
42751023
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
Want more like this?
Browse more from the feed. A free account unlocks the full feed, saving and communities.
Back to the research feed