Changes in dietary patterns and body composition within 12 months of liver transplantation
- Authors: McCoy, Simone , Campbell, Katrina , Lassemillante, Annie-Claude , Wallen, Matthew , Fawcett, Jonathon , Jarrett, Maree , Macdonald, Graeme , Hickman, Ingrid
- Date: 2016
- Type: Text , Journal article
- Relation: Hepatobiliary Surgery and Nutrition Vol.6 , no.5 (2017), p. 317-326
- Full Text: false
- Reviewed:
- Description: Background: Cardiometabolic risk factors are increasing in liver transplant recipients (LTR). Influencing dietary factors have not been assessed. The aim of this observational study was to assess changes in weight, metabolic function, dietary intake and eating behaviours in the first year after orthotopic liver transplantation (OLT). Methods: Consecutive recruitment of 17 patients (14 males) awaiting OLT at a single tertiary hospital. Dietary intake, food behaviours and anthropometry were recorded at baseline, and 6 and 12 months posttransplant. Results: By 12 months, patients had gained on average 7.3% of body weight. The prevalence of overweight or obesity increased from baseline 53% to 77% (P=0.001). By 6 months, 65% (n=11/17) of patients had altered glucose metabolism. Dietary intake was consistent with a Western-style dietary pattern with high saturated fat. Over half of the patients (69%, n=11/16) reported low to no depressive feelings and rated their self-esteem as good (53%, n=9/16). The Power of Food Scale increased between pre and post-transplant, indicating a stronger appetitive drive. Conclusions: Weight gain occurs early post-transplant, with significant metabolic dysfunction present within 6 months, however is not associated with significant psychological distress. Early dietary intervention designed to limit weight gain and target cardiometabolic health is recommended for this unique patient population.
High-intensity interval training for the management of nonalcoholic steatohepatitis : participant experiences and perspectives
- Authors: Keating, Shelley , Croci, Ilaria , Wallen, Matthew , Cox, Emily , Coombes, Jeff , Burton, Nicola , Macdonald, Graeme , Hickman, Ingrid
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Clinical and Translational Hepatology Vol. 11, no. 5 (2023), p. 1050-1060
- Full Text:
- Reviewed:
- Description: Background and Aims: High-intensity interval training (HIIT) is a therapeutic option for people with nonalcoholic steatohepatitis (NASH). However, the perspectives and experiences of HIIT for people with NASH are unknown, limiting translation of research. We explored the experiences and perspectives of both professionally supervised and self-directed HIIT in people with NASH and evaluated participant-reported knowledge, barriers, and enablers to commencing and sus-taining HIIT. Methods: Twelve participants with NASH un-derwent 12 weeks of supervised HIIT (3 days/week, 4×4 minutes at 85–95% maximal heart rate, interspersed with 3 minutes active recovery), followed by 12-weeks of self-directed (unsupervised) HIIT. One-on-one, semistructured participant interviews were conducted by exercise staff prior to HIIT and following both supervised and self-directed HIIT to explore prior knowledge, barriers, enablers, and outcomes at each stage. Interviews were audio-recorded, transcribed, coded, and thematically analyzed by two independent re-searchers. Results: Four dominant themes were identified: (1) no awareness of/experience with HIIT and ambivalence about exercise capabilities; (2) multiple medical and social barriers to commencing and continuing HIIT; (3) exercise specialist support was a highly valued enabler, and (4) HIIT was enjoyed and provided holistic benefits. Conclusions: People with NASH may lack knowledge of and confidence for HIIT, and experience multiple complex barriers to commencing and continuing HIIT. Exercise specialist support is a key enabler to sustained engagement. These factors need to be addressed in future clinical programs to augment the uptake and long-term sustainability of HIIT by people with NASH so they can experience the range of related benefits. © 2023 The Author(s).
High-intensity interval training is safe, feasible and efficacious in nonalcoholic steatohepatitis : a randomized controlled trial
- Authors: Keating, Shelley , Croci, Ilaria , Wallen, Matthew , Cox, Emily , Thuzar, Moe , Pham, Uyen , Mielke, Gregore , Coombes, Jeff , Macdonald, Graeme , Hickman, Ingrid
- Date: 2023
- Type: Text , Journal article
- Relation: Digestive Diseases and Sciences Vol. 68, no. 5 (2023), p. 2123-2139
- Full Text:
- Reviewed:
- Description: Background: High-Intensity Interval Training (HIIT) involves bursts of high-intensity exercise interspersed with lower-intensity exercise recovery. HIIT may benefit cardiometabolic health in people with nonalcoholic steatohepatitis (NASH). Aims: We aimed to examine the safety, feasibility, and efficacy of 12-weeks of supervised HIIT compared with a sham-exercise control (CON) for improving aerobic fitness and peripheral insulin sensitivity in biopsy-proven NASH. Methods: Participants based in the community [(n = 14, 56 ± 10 years, BMI 39.2 ± 6.7 kg/m2, 64% male), NAFLD Activity Score 5 (range 3–7)] were randomized to 12-weeks of supervised HIIT (n = 8, 4 × 4 min at 85–95% maximal heart rate, interspersed with 3 min active recovery; 3 days/week) or CON (n = 6, stretching; 3 days/week). Safety (adverse events) and feasibility determined as
NAFLD in clinical practice : Can simple blood and anthropometric markers be used to detect change in liver fat measured by 1H-MRS?
- Authors: Keating, Shelley , Parker, Helen , Hickman, Ingrid , Gomersall, Sjaan , Wallen, Matthew , Coombes, Jeff , Macdonald, Graeme , George, Jacob , Johnson, Nathan
- Date: 2017
- Type: Text , Journal article
- Relation: Liver International Vol. 37, no. 12 (2017), p.1907-1915
- Full Text: false
- Reviewed:
- Description: Background & Aims: Research in NAFLD management is commonly based on quantitative assessment of liver fat by proton-magnetic resonance spectroscopy (1H-MRS), and translation of this into clinical practice is currently limited by availability and expense. Novel steatosis biomarkers have been proposed for the prediction of liver fatness; however, whether these are suitable for detecting changes in liver fat is unknown. We aimed to determine the accuracy of these indices, and waist circumference (WC), in quantifying longitudinal change in 1H-MRS-quantified liver fat. Methods: We performed a secondary analysis using data from 97 overweight/obese adults (age: 39.7±11.5 years, body mass index: 30.7±4.4 kg/m2, liver fat: 6.0±4.8%, 65% male) who completed either an 8-week exercise or 12-week nutraceutical intervention, with varying degrees of change in liver fat. Baseline and post-intervention measures were liver fat (1H-MRS), NAFLD Liver Fat Score, Liver Fat Equation (LFE), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), the Visceral Adiposity Index (VAI) and WC. Results: Only the change in HSI, FLI and WC was associated with change in liver fat; however, correlations were weak to moderate. There was no agreement between the LFE and 1H-MRS for detecting liver fat change. Only change in WC significantly affected change in liver fat (P<.001), and WC AUROC for the presence of steatosis was 0.65 and 0.78 for men and women respectively.Conclusions: Novel indices are limited in their ability to detect longitudinal change in liver fat. Waist circumference may offer modest utility as a surrogate to infer liver fat change with lifestyle interventions.
- Description: Background & Aims: Research in NAFLD management is commonly based on quantitative assessment of liver fat by proton-magnetic resonance spectroscopy (1H-MRS), and translation of this into clinical practice is currently limited by availability and expense. Novel steatosis biomarkers have been proposed for the prediction of liver fatness; however, whether these are suitable for detecting changes in liver fat is unknown. We aimed to determine the accuracy of these indices, and waist circumference (WC), in quantifying longitudinal change in 1H-MRS-quantified liver fat. Methods: We performed a secondary analysis using data from 97 overweight/obese adults (age: 39.7±11.5 years, body mass index: 30.7±4.4 kg/m2, liver fat: 6.0±4.8%, 65% male) who completed either an 8-week exercise or 12-week nutraceutical intervention, with varying degrees of change in liver fat. Baseline and post-intervention measures were liver fat (1H-MRS), NAFLD Liver Fat Score, Liver Fat Equation (LFE), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), the Visceral Adiposity Index (VAI) and WC. Results: Only the change in HSI, FLI and WC was associated with change in liver fat; however, correlations were weak to moderate. There was no agreement between the LFE and 1H-MRS for detecting liver fat change. Only change in WC significantly affected change in liver fat (