JMIR Publications

ABSTRACT

Background:

Cardiovascular disease is the most common cause of death among people with non-alcoholic fatty liver disease (NAFLD) and lifestyle changes can improve health outcomes.

Objective:

To explore the acceptability of a digital health program in addition to exploring changes in clinical outcomes, such as weight, cardiometabolic risk factors, and health related quality of life

Methods:

A prospective open-label, single-arm, 12-week study including individuals with either BMI>30, metabolic syndrome or type 2 diabetes mellitus and NAFLD, screened by FibroScan. A digital health program focused on disease education, low carbohydrate diet, increasing activity levels, reducing stress and healthy lifestyle coaching was offered to participants. The primary outcome was feasibility and acceptability; secondary outcomes included liver fat changes, body composition and other clinical parameters at baseline and 12 weeks.

Results:

Thirty-eight individuals were included; median age 59.5 years, 60.5% female, 34 (89%) completed the program, 29 (76%) were active during the study. Median satisfaction score (MAUQ): 6.3 /7. Mean weight loss (SD): 3.5 (3.7) kg (p<0.001) or 3.2% (3.4), with 2.2 (2.7) kg reduction in fat mass (p<0.001). Relative liver fat reduction (SD): 19.4% (23.9). Systolic blood pressure (SD) reduced by 6.0 (13.5) mmHg (p=0.009), triglyceride levels by median (IQR) of 0.14 (0–0.47) mmol/L (p=0.003), s-insulin levels by 3.2 (0.0–5.4) µU/ml (p=0.003) and HbA1c levels by 0.5 (-0.7–3.8) mmol/mol (p=0.033).

Conclusions:

The digital health program was feasible for individuals with NAFLD and improved liver-specific and cardiometabolic health. This could provide a new tool to improve health outcomes in people with NAFLD. Clinical Trial: The study was registered at clinicaltrials.gov under the trial identifier NCT05426382.