Perceptions of Weight Status and Energy Balance Behaviors Among Patients With Non-Alcoholic Fatty Liver Disease

Authors

Natalia I Heredia
Ruchi Gaba
Yan Liu
Shilpa Jain
Manasi Rungta
Manav Rungta
Hashem B El-Serag
Fasiha Kanwal
Aaron P Thrift
Maya Balakrishnan

Publication Date

4-5-2022

Journal

Scientific Reports

DOI

10.1038/s41598-022-09583-1

PMID

35383229

PMCID

PMC8983643

PubMedCentral® Posted Date

4-5-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Diet, Exercise, Female, Health Behavior, Humans, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Prospective Studies, Hepatology, Non-alcoholic fatty liver disease

Abstract

Weight loss through behavioral modification is central to treating non-alcoholic fatty liver disease (NAFLD). To achieve this, patients need to accurately self-perceive their health behaviors. We aimed to identify predictors of concordance between self-perception and objective measures of body weight, physical activity (PA) and dietary behaviors. We used data from the Harris County NAFLD Cohort, an ongoing prospective study in a regional safety-net healthcare system. Patients completed self-administered baseline questionnaires on demographics, diet, PA, and self-perceptions. We assessed concordance between actual and self-perceived body weight and energy-balance behaviors. Multivariable logistic regression identified predictors of concordance. Patients (n = 458; average age 46.5 years) were 90% Hispanic and 76% female. PA and fruit/vegetable intake guidelines were met among 37% and 9%, respectively. Most (89%) overweight/obese patients accurately perceived themselves as such. However, 41% of insufficiently-active and 34% of patients not meeting fruit/vegetable intake guidelines inaccurately self-perceived their behaviors as "just right". Women were 3 times more likely to accurately self-perceive weight status (adjusted odds ratio [AOR] 3.24; 95% CI 1.68-6.25) but 51% less likely to accurately self-perceive PA levels than men (AOR 0.49; 95% CI 0.29-0.81). Lower acculturation was associated with higher odds of accurate PA self-perception. Patients with prediabetes or diabetes vs normoglycemia were more likely to accurately self-perceive their fruit/vegetable intake. Most NAFLD patients accurately self-perceived their body weight. A third or more of those not meeting fruit/vegetable intake or PA guidelines had inaccurate perceptions about their behaviors. Our findings highlight key areas to target in NAFLD-specific behavioral modification programs.