{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:06:32Z","timestamp":1789787192436,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Non\u2010alcoholic fatty liver disease (NAFLD) is characterized by the accumulation of excess fat in the liver, causing liver cell damage, increased inflammation, and weight gain. Despite its high prevalence, diagnosis and follow\u2010up of the disease is difficult. Irisin, a slimming myokine produced in response to physical activity (PA), exhibits anti\u2010inflammatory and anti\u2010obesity effects. This study aimed to investigate changes in irisin levels, inflammation markers (tumor necrosis factor\u2010\u03b1 [TNF\u2010\u03b1] and interleukin\u20106 [IL\u20106]), and myeloid differentiation factor\u20102 (MD2) levels in NAFLD, as well as anthropometric and routine biochemical parameters, by providing PA recommendations and nutrition education (NE) to individuals diagnosed with NAFLD over a period of 12\u00a0weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study included 62 patients diagnosed with NAFLD who did not use alcohol. They were divided into groups: PA, NE, both (NE\u00a0+\u00a0PA), and untreated (control) patients. Patients receiving NE were provided with 1\u2010h NE sessions every 4\u00a0weeks for 12\u00a0weeks, and their personal information, nutritional status, 24\u2010h retrospective food consumption record, and anthropometric measurements were recorded at the beginning (day 0) and end (week 12) of the study. The PA group was recommended aerobic walking for 30\u00a0min, 5\u00a0days a week. At the beginning (day 0) and end (week 12) of the study, patients' anthropometric and routine biochemical tests were conducted, and irisin, MD2, TNF\u2010\u03b1, and IL\u20106 levels were measured using the ELISA method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All groups were similar in demographic characteristics and dietary habits. After 12\u00a0weeks, there were no significant differences in biochemical parameters among the groups. Glucose levels increased in the untreated group but decreased in the PA and PA\u00a0+\u00a0NE groups compared to baseline, with a significant decrease in the PA group. Insulin levels significantly decreased in the NE group. The PA\u00a0+\u00a0NE group showed decreased aspartate aminotransferase (AST), gamma\u2010glutamyl transferase, alkaline phosphatase, total cholesterol, low\u2010density lipoprotein, and triglyceride levels and significant decrease in ALT levels. AST decreased significantly in the PA group while high\u2010density lipoprotein increased significantly. There were no statistically significant differences between the groups in irisin, MD2, IL\u20106, and TNF\u2010\u03b1 levels. After 12\u00a0weeks, irisin levels significantly increased in nutrition and PA groups except the untreated group. There were no statistically significant differences in IL\u20106 and MD2 levels compared with baseline after 12\u00a0weeks. PA recommendations alone were not effective in observing significant changes in anthropometric measurements in individuals with NAFLD. It was detected that only nutritional recommendations provided a significant decrease in body fat ratio but were insufficient for the change in other anthropometric measurements. In the group where NE and PA were recommended together, a significant decrease in anthropometric measurements was found. The NE group significantly reduced their energy and carbohydrates (%EI) intake after 12\u00a0weeks of intervention compared with the baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NE and PA recommendations led to improvements in liver\u2010related biochemical parameters and significant reductions in anthropometric measurements among individuals with NAFLD. Moreover, patients receiving NE experienced a decrease in energy and carbohydrates intake as a percentage of total energy intake (%EI). Increased irisin levels in NE, PA, and NE\u00a0+\u00a0PA groups may have contributed to the decrease in body fat percentage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.16756","type":"journal-article","created":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T21:53:47Z","timestamp":1727646827000},"page":"2723-2734","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Non\u2010alcoholic fatty liver disease: The importance of physical activity and nutrition education\u2014A randomized controlled study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0465-8403","authenticated-orcid":false,"given":"Diler","family":"Us Altay","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Health Science Ordu University  Ordu Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7360-8090","authenticated-orcid":false,"given":"Yasemin","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine Ordu University  Ordu Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2136-1545","authenticated-orcid":false,"given":"Duygu","family":"Mataraci De\u011firmenci","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Health Science Ordu University  Ordu Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9459-9557","authenticated-orcid":false,"given":"Emine","family":"Kocyi\u011fit","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Health Science Ordu University  Ordu Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7060-2216","authenticated-orcid":false,"given":"Abdullah","family":"\u00dcner","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine Ordu University  Ordu Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7733-0177","authenticated-orcid":false,"given":"Tevfik","family":"Noyan","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine Ordu University  Ordu Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.04.008"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28699"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.03.008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2174\/1381612811319290006"},{"key":"e_1_2_6_6_1","first-page":"536","volume-title":"Current Diagnosis & Treatment Gastroenterology","author":"Greenberger NJ","year":"2016"},{"key":"e_1_2_6_7_1","first-page":"100","volume-title":"\u00c7ocuk Gastroenterolojisinde Hatalar ve Bunlar\u0131 \u00d6nleme Yollar\u0131","author":"Salman H","year":"2021"},{"key":"e_1_2_6_8_1","unstructured":"\u0130lkerM.2019.Nonalkolik ya\u011fl\u0131 karaci\u011fer hastalar\u0131nda t\u0131bbi beslenme tedavisinin \u00f6nemi ve etkilerinin saptanmas\u0131[Master's thesis Bah\u00e7e\u015fehir \u00dcniversitesi Sa\u011fl\u0131k Bilimleri Enstit\u00fcs\u00fc Beslenme ve Diyetetik B\u00f6l\u00fcm\u00fc]. \u0130stanbul."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118872796"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2012.02.010"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2018.01.012"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1547261"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yjmcc.2016.09.005"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/db13-1106"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2014.42"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-014-0458-9"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2017.03.037"},{"key":"e_1_2_6_18_1","first-page":"1440","article-title":"Correlation between irisin level and insulin resistance in patients with fatty liver disease","volume":"29","author":"Jiang Q","year":"2017","journal-title":"Mod. Pract. Med."},{"key":"e_1_2_6_19_1","first-page":"517","article-title":"Expression of irisin in liver tissue of patients with nonalcoholic fatty liver disease","volume":"51","author":"Ma Y","year":"2016","journal-title":"J. Zhengzhou Univ."},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells10123306"},{"key":"e_1_2_6_21_1","volume-title":"T\u00fcrkiye Beslenme Rehberi 2022 (T\u00dcBER)","author":"Pekcan EG","year":"2022"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.13659"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)91169-7"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.2310\/JIM.0b013e31822a29f5"},{"key":"e_1_2_6_25_1","unstructured":"Ayd\u0131n G\u00f6kbenD.2012.Obez Kad\u0131nlarda T\u0131k\u0131n\u0131rcas\u0131na Yeme Bozuklu\u011funun Psikobiyolojik Model'e G\u00f6re \u0130ncelenmesi. [Master's thesis Istanbul Arel \u00dcniversitesi Sosyal Bilimler Enstit\u00fcs\u00fc Psikoloji Ana Bilim Dal\u0131 \u0130stanbul]."},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms151223163"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476-511X-14-2"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2660"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1159\/000437173"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.04.030"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1139\/cjpp-2015-0371"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0110680"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.7762\/cnr.2019.8.3.238"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13124453"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.08.023"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.110.007674"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijpo.12630"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2020.0067"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.16756","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.16756","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.16756","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:28:28Z","timestamp":1772990908000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.16756"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,29]]},"references-count":37,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/jgh.16756"],"URL":"https:\/\/doi.org\/10.1111\/jgh.16756","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,29]]},"assertion":[{"value":"2024-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}