Aerobic Exercise in the Management of Metabolic Dysfunction Associated Fatty Liver Disease

Abstract

Sedentarism is the pandemic of modern times. It is associated with several medical conditions including obesity, type 2 diabetes mellitus, cardiovascular diseases and also liver disease, particularly metabolic dysfunction associated fatty liver disease (MAFLD). In an era when MAFLD is the most prevalent chronic liver disease worldwide, whilst no pharmacological therapy has been approved for it, exercise has proved to be effective in improving liver steatosis. Interestingly, exercise decreases liver fat even in the absence of weight loss. The challenge for the clinician is to motivate the obese patient with MAFLD, and associated co-morbidities, who has crystallized a sedentary behavior, at times when every need is at the distance of a click on the Internet, and the entire world can be visited behind a screen. In this review, the aggregate evidence on the mechanisms and effects of exercise in the management of MAFLD is summarized, with simple recommendations for everyday clinical practice.

The Effect of Low Glycemic Index Mediterranean Diet and Combined Exercise Program on Metabolic-Associated Fatty Liver Disease: A Joint Modeling Approach

“…Furthermore, the efficacy of the proposed CEP in the management of MAFLD is confirmed by numerous studies showing that exercise, especially aerobic exercise, is able to reduce visceral adiposity [ 9 ], thereby decreasing the influx of free fatty acids into the liver [ 35 ], and the systemic inflammation associated with metabolism. Moreover, it not only reduces the amount of adipose tissue, but also changes the structure and function of the adipocyte [ 9 ].…”

“…For the management of NAFLD, numerous studies have demonstrated the effectiveness of lifestyle changes in the form of diet and physical activity, although the literature about lifestyle MAFLD treatment is scarce [ 9 ].…”

“…Reducing body weight induces a decrease in liver fat and improves glucose control and insulin sensitivity [ 24 ]. Moreover, exercise can significantly reduce hepatic steatosis even in the absence of considerable weight loss [ 9 ].…”

“…A recent review of patients with established MAFLD reported that both aerobic and resistance exercise training, even without significant weight loss, produces a 20–30% reduction in intrahepatic lipid content as assessed by non-invasive methodologies [ 8 ]. Other studies have been focused exclusively on verifying the benefits of aerobic-type exercise programs (EP) on MAFLD, confirming their effectiveness [ 9 , 10 ]. The effectiveness on MAFLD of combined exercise, involving a planned, structured, and repetitive set of movements, is to this point unclear [ 11 ].…”

Nocturnal Light Pollution Induces Weight Gain in Mice and Reshapes the Structure, Functions, and Interactions of Their Colonic Microbiota

“…Lifestyle in the modern era is associated with profound changes in the diet, where irregular feeding times and high consumption of processed foods are common behaviors [1]. Moreover, changes in the diet such as high caloric diet intake and sedentarism have been associated with higher rates of overweight and obesity [2,3]. Other non-dietary related features of the modern lifestyle are also related to overweight and/or obesity.…”