Effects of a lifestyle intervention in patients with Non-Alcoholic Fatty Liver Disease or Hepatitis C

The lifestyle intervention was conducted at Westmead Hospital, Australia from 2004 to 2007 in patients diagnosed with non-alcoholic fatty liver disease. Subjects were randomised at baseline to one of 3 intervention arms (Group A, B or C) or a control group. Group A was a low-intensity intervention consisting of 3 consultations over four weeks (Baseline, 2 and 4 weeks). Group B was a moderate-intensity 10 week consisting of 6 fortnightly consultations (baseline, Weeks 2, 4, 6, 8 and 10). Group C had an identical intervention as Group B in the first 3 months and then received a telephone-based maintenance program through to 12 months to assess whether such a program would result in an improved level of sustained change. Telephone calls were made to participants in Group C at 4, 5, 6, 8 and 10 months from baseline. The intervention developed for this study was based on behavioural theory and consisted of strategies aimed at affecting mediators and addressing specific determinants of behaviours was based on elements derived from Social Cognitive Theory, the Transtheoretical Model, the Theory of Self-Determination and Motivational Interviewing. The intervention consisted of individual face to face counselling sessions delivered by dietitians/exercise physiologists. The initial session was 1 hour and the review sessions were 45 -60 minutes. The counselling aimed to assist participants in making positive changes to physical activity and dietary behaviours. Participants were encouraged to increase both planned and incidental moderate-intensity physical activity to achieve at least 150 minutes per week for general health and 200 minutes or more per week for weight loss. They were encouraged to aim for a diet low in saturated fats and processed food and a reduction in daily energy intake for weight loss. The counselling sessions included discussion of the participant’s and the Intervention Goals, reflection on current diet and physical activity habits, Goal Setting, review of participants, self-efficacy and motivation for change, discussion of barriers to change, information and education to support dietary and physical activity changes along with review and discussion of progress. Databases were developed to collect data on participant attendance and record implementation of telephone consultations.