Evidence mapPaperPMID 39167567Full record

ReviewHepatology (Baltimore, Md.)2026

A narrative review of lifestyle management guidelines for metabolic dysfunction-associated steatotic liver disease.

Dana Ivancovsky Wajcman, Christopher J Byrne, John F Dillon, Paul N Brennan, Marcela Villota-Rivas, Zobair M Younossi, Alina M Allen, Javier Crespo, Lynn H Gerber, Jeffrey V Lazarus

Abstract readReview
In one paragraph

Review in Hepatology (Baltimore, Md.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

  1. How to Identify and Treat MetALD.Gastroenterology & hepatology · 2026
    Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Food Insecurity Is Highly Prevalent Amongst Patients With Chronic Liver Disease in Northern England: A Cross-Sectional Analysis.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025
    Article
  9. Article
  10. Article
  11. Obesity and its management in primary care setting.Journal of diabetes and its complications · 2025
    Review
  12. Review
  13. Liver diseases: epidemiology, causes, trends and predictions.Signal transduction and targeted therapy · 2025
    Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Dana Ivancovsky WajcmanBarcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.ORCID 0000-0002-6238-3938
Christopher J ByrneDivision of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.ORCID 0000-0002-7586-7712
John F DillonDivision of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.ORCID 0000-0002-2164-4476
Paul N BrennanThe Global NASH Council, Washington, District of Columbia, USA.ORCID 0000-0001-8368-1478
Marcela Villota-RivasBarcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.ORCID 0000-0002-7332-735
Zobair M YounossiThe Global NASH Council, Washington, District of Columbia, USA.ORCID 0000-0001-9313-577
Alina M AllenDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0002-8393-8410
Javier CrespoLiver Unit, Digestive Disease Department, Marqués de Valdecilla University Hospital, Santander, Cantabria University, Spain.ORCID 0000-0001-8248-0172
Lynn H GerberThe Global NASH Council, Washington, District of Columbia, USA.ORCID 0000-0001-7525-680
Jeffrey V LazarusBarcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.ORCID 0000-0001-9618-2299

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsMetabolic dysfunction-associated steatotic liver disease management guidelines have been published worldwide; we aimed to summarize, categorize, and compare their lifestyle intervention recommendations. APPROACH AND

resultsWe searched metabolic dysfunction-associated steatotic liver disease/NAFLD management guidelines published between January 1, 2013, and June 31, 2024, through databases including PubMed/MEDLINE, Cochrane, and CINAHL. In total, 35 qualifying guidelines were included in the final analysis. Guideline recommendations were categorized into 5 domains (ie, weight reduction goals, physical activity, nutrition, alcohol, and tobacco smoking) and were ranked based on how frequently they appeared. A recommendation was defined as widely adopted if recommended in ≥24 (≥66.6%) of the guidelines. These included increasing physical activity; reducing body weight by 7%-10% to improve steatohepatitis and/or fibrosis; restricting caloric intake; undertaking 150-300 or 75-150 minutes/week of moderate or vigorous-intensity physical activity, respectively; and decreasing consumption of commercially produced fructose. The least mentioned topics, in ≤9 of the guidelines, evaluated environmental determinants of health, mental health, referring patients for psychological or cognitive behavioral therapy, using digital health interventions, and assessing patients' social determinants of health.

conclusionsMost guidelines recommend weight reduction through physical activity and improving nutrition, as these have proven positive effects on health outcomes when sustained. However, gaps regarding mental health and the social and environmental determinants of metabolic dysfunction-associated steatotic liver disease were found. To optimize behavioral modifications and treatment, we recommend carrying out studies that will provide further evidence on social support, environmental factors, and mental health, as well as further exploring digital health interventions.

Indexed as

Life StyleNon-alcoholic Fatty Liver DiseasePractice Guidelines as TopicExerciseHumans

Identifiers

PMID39167567
PMCPMC13089823

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.