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Aerobic exercise may reduce liver fat, NAFLD risk

Regular aerobic exercise reduced liver and visceral fat in overweight adults and therefore, could decrease the risk for nonalcoholic fatty liver disease, according to newly published data in the Journal of Hepatology.

Forty-eight overweight or obese adults with NAFLD (31 women, 17 men) who were inactive began an exercise regimen of either low to moderate intensity, high-volume aerobic exercise for 60 minutes, 4 days per week; a high intensity, low volume aerobic exercise regimen of 45 minutes, 3 days per week; low to moderate intensity, low volume aerobic exercise at 45 minutes, 3 days per week; or placebo for 8 weeks. There were 12 patients in each group and all patients’ liver fat and visceral adipose tissue (VAT) were measured at baseline and after the study was completed.  

Overall, 47 patients completed the trial and no serious adverse events were reported. In all the groups, a reduction in liver fat and VAT were observed, except in the placebo group; 2.38 ± 0.73% in the high intensity, low volume group; 2.62 ± 1% in the low to moderate intensity, high volume group; and 0.84±0.47% in the low to moderate intensity, low to moderate volume group (P = .04).

No differences between the dose or intensity of the exercise regimen and reductions in liver fat or VAT were observed (P > .05), according to the research.

“The results from our study show that all exercise doses, irrespective of volume or intensity, were efficacious in reducing liver fat and visceral fat by an amount that was clinically significant, in previously inactive, overweight, or obese adults compared with placebo,” Nathan Johnson, PhD, senior lecturer at the University of Sydney, Australia, said in a press release.

In an accompanying editorial, Rohit Loomba, MD, MHSc, of the division of gastroenterology and epidemiology at the University of California, San Diego, in La Jolla, and Helena Cortez-Pinto, MD, PhD, of the gastroenterology service, Hospital de Santa Maria in Lisbon, Portugal, stated that there was good evidence to support the researchers’ conclusion that exercise can reduce the risk of NAFLD.

Rohit Loomba

“The study leverages from a careful reporting of both the dose and intensity of exercise,” Loomba told Healio.com/Hepatology. “These data demonstrate that exercise improves NAFLD, and should be encouraged as first line therapy for the treatment of NAFLD along with a diet to induce weight loss in overweight or obese individuals.”

However, Loomba and Cortez-Pinto advised that exercise alone cannot improve nonalcoholic steatohepatitis, according to the editorial.

“There are no data to support that exercise alone without weight loss can improve or reverse NASH,” the researchers said. “There is preliminary evidence that vigorous exercise may be associated with a decreased risk of having NASH. The individual, the joint effect of dose and intensity of exercise and their association with improvement in liver fat and other histologic features that are associated with NASH are key research priorities.

The researchers added: “In our expert opinion, a more stringent exercise-regimen than the U.S. Department of Health and Human Services recommends, coupled with dietary interventions, may be needed to induce improvement in liver histologic features associated with NASH.” – by Melinda Stevens

Disclosure: Johnson reports receiving honoraria for speaking engagements for Merck Sharp & Dohme. Please see the full study for a list of all other authors’ relevant financial disclosures.