Shira Zelber-Sagi, PhD, RD, is a professor and head of the School of Public Health at the University of Haifa, Israel.
If you were to name the 3 most important recent advances in the management of nonalcoholic fatty liver disease (NAFLD) that are relevant for everyday practice, what would they be?
First of all, I would recommend the screening for NAFLD in primary care clinics. I think that we have very good screening tools nowadays, like the FIB-4 [index], and it’s only a matter of using them. They are there to be used and it’s a matter of increasing awareness and using these tools to screen for patients with high risk of advanced fibrosis.
The second thing is to increase the awareness of the importance of diet and physical activity. Patients and physicians need to understand that NAFLD is a lifestyle-oriented liver disease and it is completely reversible by lifestyle modification. This is a very strong message to bring to the patient.
The third thing is creating motivation. We know that physicians are the most important people to increase the motivation of patients to do diet. So, for each patient in the clinic, please remember to advise patients about their diet, to ask them about their diet and physical activity, to ask them about alcohol consumption and smoking. If you keep asking them, you will increase their awareness and motivation towards lifestyle change.