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.
Subject(s)
Non-alcoholic Fatty Liver Disease , Diet , Exercise , Female , Health Behavior , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Endoscopic mucosal resection and dissection are advanced endoscopic procedures that have proven essential for resecting premalignant and early malignant lesions throughout the gastrointestinal tract. Over time, these procedures have proven to play a key role in avoiding more invasive surgical approaches and thus decrease overall mortality. However, the success of these procedures does come with a slightly increased risk of adverse events such as bleeding and perforation. In this article, we review the literature for reported adverse events, specifically in the cirrhotic population. This article also discusses experts' opinions on approaches taken to perform these procedures with acceptable risks.
