What lifestyle modifications should I recommend to patients with mildly elevated liver enzymes?

Lifestyle modifications recommended for patients with mildly elevated liver enzymes, particularly if related to non-alcoholic fatty liver disease (NAFLD), include:

• Weight management: Advise patients who are overweight or obese to follow weight loss strategies in line with NICE guidelines on overweight and obesity management, as weight loss can reduce liver fat content.
• Physical activity: Encourage regular exercise, as there is evidence that physical activity reduces liver fat content.
• Dietary advice: Recommend a healthy diet consistent with general guidelines for overweight and obesity management to support liver health.
• Alcohol consumption: Advise patients to stay within the national recommended limits for alcohol intake to prevent alcohol-related liver damage.

These lifestyle interventions should be considered regardless of the patient’s BMI, and patients should be involved in discussions to make informed decisions about their care.