How to motivate liver disease candidates to make lifestyle changes
Scientists supported in part by the EU-funded LiverScreen project have found that when people are screened for liver fibrosis, they are more motivated to make improvements in their alcohol intake, diet, exercise and weight. This suggests that a screening programme could serve as a tool for the prevention, early detection and treatment of advanced fibrosis. As part of the study, researchers investigated 4 796 people living in Denmark at risk of alcohol-related or non-alcoholic fatty liver disease. They found that participation in a liver fibrosis screening programme leads to sustained improvements in lifestyle among individuals at risk for these diseases. Of the 4 796 participants, 1 850 were at risk for alcohol-related liver disease (ALD) and 2 946 for metabolic dysfunction-associated steatotic liver disease (MASLD). A total of 383 individuals – 10 % of the ALD group and 7 % of the MASLD group – screened positive for fibrosis. Having received lifestyle advice, participants completed questionnaires evaluating lifestyle changes at 1 week and 6 months, and a subgroup was re-examined at 2 years.
Drinking less
In the ALD group, excessive drinking decreased from 46 % to 32 % at the 6-month mark. Only a small percentage – 15 % – reported increased drinking, without any differences between individuals who screened positive and those who screened negative. For participants with a high-risk alcohol use at baseline, a positive screening test predicted abstinence or decreased alcohol use after 6 months. After 2 years, excessive drinking dropped from 52 % to 41 % in a subgroup of 752 individuals and a positive screening test again predicted abstinence or decreased alcohol use.
Eating better, exercising more
MASLD participants showed similar improvements in lifestyle at 6 months. An estimated 35 % improved their diet, 22 % exercised more, and 13 % reported a weight loss of 5 % or greater. Improvements in the MASLD group were most pronounced in participants who had screened positive. “This is to our knowledge the first study investigating global lifestyle changes after targeted, population-based screening for liver fibrosis across the spectrum of steatotic liver disease. Our study is unique, because we investigated 4796 at-risk individuals from the general population, have an 84% response rate, evaluate both short- and long-term changes, and assessed lifestyle risk factors …,” report the authors in their paper. “Our results indicate that screening for liver disease may act as an added motivation for patients to achieve better health,” the study authors supported by LiverScreen (Screening for liver fibrosis - population-based study across European countries) conclude. “The act of attending a screening program for liver fibrosis can therefore be seen as a catalyst for behavioural change, boosting existing motivation for lifestyle improvements.” For more information, please see: LiverScreen project website
Keywords
LiverScreen, liver, fibrosis, liver disease, alcohol-related liver disease, metabolic dysfunction-associated steatotic liver disease, alcohol, lifestyle changes