Quality statement 1: Advice on physical activity, diet and alcohol

Quality statement

People with non‑alcoholic fatty liver disease are given advice on physical activity, diet and alcohol.

Rationale

Adopting a healthy lifestyle can help to reduce the rate of progression of non‑alcoholic fatty liver disease (NAFLD). Providing lifestyle advice to people with NAFLD can encourage them to consider changes they can make that might help them avoid more serious liver disease.

Quality measures

Structure

Evidence of local arrangements to provide advice on physical activity, diet and alcohol to people with NAFLD.

Data source: Local data collection, for example, service protocols.

Process

a) Proportion of people with NAFLD who are given advice on physical activity.

Numerator – the number in the denominator who are given advice on physical activity.

Denominator – the number of people with NAFLD.

Data source: Local data collection, for example, audit of patient health records.

b) Proportion of people with NAFLD who are overweight or obese who are given advice on diet.

Numerator – the number in the denominator who are given advice on diet.

Denominator – the number of people with NAFLD who are overweight or obese.

Data source: Local data collection, for example, audit of patient health records.

c) Proportion of people with NAFLD who drink alcohol who are given advice on alcohol.

Numerator – the number in the denominator who are given advice on alcohol.

Denominator – the number of people with NAFLD who drink alcohol.

Data source: Local data collection, for example, audit of patient health records.

Outcome

a) Awareness of people with NAFLD that lifestyle changes may help them to avoid more serious liver disease.

Data source: Local data collection, for example, a patient survey.

b) Rate of disease progression among people with NAFLD.

Data source: Local data collection, for example, audit of patient health records.

What the quality statement means for different audiences

Service providers (general practices, community healthcare providers, hospitals and specialist liver units) ensure that they give advice on physical activity, diet and alcohol to people with NAFLD. Providers ensure that their staff know where people with NAFLD can get support if they want to make lifestyle changes, such as lifestyle weight management programmes.

Healthcare professionals (such as GPs, practice nurses, hepatologists, gastroenterologists and specialist nurses) give advice on physical activity, diet and alcohol to people with NAFLD and ensure that they know where they can get support to make lifestyle changes, such as lifestyle weight management programmes.

Commissioners (such as clinical commissioning groups and NHS England) commission services that provide advice on physical activity, diet and alcohol to people with NAFLD. Commissioners ensure that information is available to healthcare professionals on the support available locally to help people with NAFLD to make lifestyle changes, such as lifestyle weight management programmes.

People with non‑alcoholic fatty liver disease, and their parents or carers if appropriate, are given advice on diet (if they need to lose weight), physical activity and alcohol consumption (if they drink alcohol), and are told where they can get support to make lifestyle changes. Following this advice can help to improve non‑alcoholic fatty liver disease or stop it from getting worse.

Source guidance

Non-alcoholic fatty liver disease (NAFLD): assessment and management (2016) NICE guideline NG49, recommendations 1.2.12, 1.2.13 and 1.2.16

Definitions of terms used in this quality statement

Advice on physical activity, diet and alcohol

People diagnosed with NAFLD should:

  • be offered advice on physical activity and diet if they are overweight or obese, in line with NICE's guidelines on obesity and preventing excess weight gain

  • be advised that there is some evidence that exercise reduces liver fat content

  • be advised that, if they drink alcohol, it is important to stay within the government's recommended limits for alcohol consumption.

[NICE's guideline on non-alcoholic fatty liver disease, recommendations 1.2.12, 1.2.13 and 1.2.16]