In a cohort of patients with non-alcoholic fatty liver disease (NAFLD), an online lifestyle modification-focused intervention was similarly effective to a group-based program in achieving weight loss and liver enzyme normalization, according to data from an Italian study recently presented at The International Liver Congress in Paris.

“Lifestyle changes are mandatory for patients with NAFLD, but these are very difficult to achieve in busy clinical units,” Giulio Marchesini, a professor at the University of Bologna, Italy, who presented the findings, said in a statement. “We wanted to develop a web-based program to help them achieve these changes, and to compare its effects with a structured, face-to-face program involving a multidisciplinary team. The participation of patients with NAFLD in structured lifestyle programs may be jeopardized by job and other time constraints, and a web-based intervention may be better suited to young, busy patients.”

In the study, Marchesini and colleagues recruited 716 patients with NAFLD to either attend a 5-week intensive group-based lifestyle modification program focused on healthy dieting and physical activity (n = 438), or participate in another online intervention (n = 278). This experimental program included five modules with interactive games, questionnaires, and offline contact with the study center.

The researchers’ primary outcome of interest was the percentage of patients within a study group who achieved 10 percent weight loss, with additional markers of disease severity evaluated after six, 12, and 24 months beyond each program’s conclusion.

Both of the study groups saw a body mass index decrease of nearly two points, Marchesini said, with the study’s weight loss goal achieved by 12 percent and 15 percent of the patients in the web-based arm and group-based arm, respectively.

Liver enzymes also decreased across both of the groups, although those in the web-based study group were significantly more likely to demonstrate a normal alanine aminotransferase (ALT) level at the six month and 12 month follow-up points. Other surrogate markers of fibrosis decreased significantly from baseline in both of the study groups.

Taken together, these findings suggest that web-based intervention could be an ideal option for NAFLD patients in need of lifestyle interventions, Marchesini suggested.

“We were impressed that more than one in 10 patients in both intervention groups achieved a weight loss target of 10 percent,” Marchesini said. “Our study has shown that a web-based lifestyle modification program is a feasible and practical way of achieving a clinically meaningful level of weight loss in our NAFLD patients. … Ideally, we would now like to roll out the intervention to other liver units.”