Effects of Therapeutic Lifestyle Program on Ultrasound-diagnosed Nonalcoholic Fatty Liver Disease

Chen, Shiming; Liu, Chieh‐Yu; Li, Shian-Rei; Huang, Hui-Ting; Tsai, Ching-Yen; Jou, Hei-Jen

doi:10.1016/s1726-4901(08)70168-0

Cited by 55 publications

(62 citation statements)

References 27 publications

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“…However, the oral hypoglycemic agents who were received by participants in both groups may have some effect on insulin resistance, the more profound improvement in insulin resistance in group (A) and the little non significant changes in group (B) proved that weight reduction was of great value to enhance the therapeutic pharmacological effects of oral hypoglycemic agents. Results of this study supported with many previous studies [11][12][13][14][15][16][17][18][19][20][21] . Adherence to combined dietary restriction and increased physical activity result in larger and progressive weight loss that can be maintained through the years 11 .…”

Section: Discussionsupporting

confidence: 92%

Weight reduction improves markers of hepatic function and insulin resistance in type-2 diabetic patients with non-alcoholic fatty liver

Al-Jiffri¹,

Al-Sharif²,

El-Kader³

et al. 2013

Afr H. Sci.

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Objective: The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing dramatically affecting up to 30% of the population worldwide. At present, treatment options are limited and pharmacological management of NAFLD has had disappointing results. Some of the best available evidence to improve NAFLD concerns lifestyle modification. Objective: To detect the degree of weight reduction needed to improve the markers of hepatic function and insulin resistance in type-2 diabetics with NAFLD. Methods: One hundred type-2 diabetic male patients with NAFLD were included into this study and divided into two equal groups. Group (A) received aerobic exercise training in addition to diet regimen. Group (B) received no treatment intervention.Results: There was a 26.99%, 40.8%, 33.81%, 32.73%, 37.8% and 15 % reduction in mean values of Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Gamma -Glutamyltransferase (GGT) and Homeostasis Model Assessment-Insulin Resistance-index (HOMA-IR) and BMI respectively in group (A) at the end of the study. While there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. Conclusion: About 15 % reduction in BMI is effective to improve the liver condition and insulin resistance in type-2 diabetics with NAFLD.

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Section: Discussionsupporting

confidence: 92%

Weight reduction improves markers of hepatic function and insulin resistance in type-2 diabetic patients with non-alcoholic fatty liver

Al-Jiffri¹,

Al-Sharif²,

El-Kader³

et al. 2013

Afr H. Sci.

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“…This study involved a multidisciplinary team for health screening and lifestyle modification implementation. Current knowledge suggests that diet and exercise lifestyle modification is effective and should be the first line of treatment for NAFLD [Harrison and Day, 2007;Suzuki et al 2005;Tamura et al 2005;Cankurtaran et al 2007;Chen et al 2008;Toshimitsu et al 2007]. Perhaps this type of approach could be of use in the future as a template for standardizing lifestyle modification in this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Prospective histopathologic evaluation of lifestyle modification in nonalcoholic fatty liver disease: a randomized trial

Eckard¹,

Cole²,

Lockwood

et al. 2013

Therap Adv Gastroenterol

130

134

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Background and aims: Nonalcoholic fatty liver disease (NAFLD) is now recognized as part of the metabolic syndrome, and is specifically related to obesity and insulin resistance. Lifestyle modification is advocated for the treatment of NAFLD, but few studies have evaluated its impact on liver histology. The purpose of this study was to investigate which, if any, specific diet and exercise recommendations are associated with histopathologic changes. Methods: A total of 56 participants were randomly assigned to 1 of 4 lifestyle modification subgroups for 6 months: standard care, low-fat diet and moderate exercise, moderate-fat/lowprocessed-carbohydrate diet and moderate exercise, or moderate exercise only. All subjects had biopsy-proven NAFLD, to include nonalcoholic steatohepatitis (NASH), and received a repeat 6-month biopsy to detect histopathologic changes. Other measures included blood assay of liver enzymes (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase), fasting glucose, serum insulin, lipid panel, body weight, dietary intake, fat mass, and fitness level. Results: Among the 41 participants who completed the study (88% with NASH), a significant change was found in pre-to post-NAFLD activity score in the group as a whole (p < 0.001) with no difference detected between subgroups (p = 0.31). Our results confirm that lifestyle modification is effective in improving NAFLD and NASH. Conclusions: Regardless of intervention group, lifestyle modification improved liver histology, as verified by repeat biopsy, after a 6-month intervention. This study reinforces the importance of lifestyle modification as the primary treatment strategy for patients with NAFLD.

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“…Evidence from cross-sectional studies suggests that physical activity will likely reduce liver fat (29). However, we are aware of only three exercise studies in humans that have examined the effects of aerobic exercise on liver fat, and none of the studies has reported a significant effect (3,8,25). This is likely explained by the short duration (6, 10, and 12 wk) and small number of subjects in all three of these studies, which resulted in a limited exercise stimulus and a limited statistical ability to detect an effect.…”

Section: E1036 Effects Of Aerobic Vs Resistance Training On Ectopic Fatmentioning

confidence: 99%

Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT

Slentz¹,

Bateman²,

Willis³

et al. 2011

American Journal of Physiology-Endocrinology and Metabolism

191

180

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While the benefits of exercise are clear, many unresolved issues surround the optimal exercise prescription. Many organizations recommend aerobic training (AT) and resistance training (RT), yet few studies have compared their effects alone or in combination. The purpose of this study, part of Studies Targeting Risk Reduction Interventions Through Defined Exercise-Aerobic Training and/or Resistance Training (STRRIDE/ AT/RT), was to compare the effects of AT, RT, and the full combination (AT/RT) on central ectopic fat, liver enzymes, and fasting insulin resistance [homeostatic model assessment (HOMA)]. In a randomized trial, 249 subjects [18 -70 yr old, overweight, sedentary, with moderate dyslipidemia (LDL cholesterol 130 -190 mg/dl or HDL cholesterol Յ40 mg/dl for men or Յ45 mg/dl for women)] performed an initial 4-mo run-in period. Of these, 196 finished the run-in and were randomized into one of the following 8-mo exercise-training groups: 1) RT, which comprised 3 days/wk, 8 exercises, 3 sets/ exercise, 8 -12 repetitions/set, 2) AT, which was equivalent to ϳ19.2 km/wk (12 miles/wk) at 75% peak O2 uptake, and 3) full AT ϩ full RT (AT/RT), with 155 subjects completing the intervention. The primary outcome variables were as follows: visceral and liver fat via CT, plasma liver enzymes, and HOMA. AT led to significant reductions in liver fat, visceral fat, alanine aminotransferase, HOMA, and total and subcutaneous abdominal fat (all P Ͻ 0.05). RT resulted in a decrease in subcutaneous abdominal fat (P Ͻ 0.05) but did not significantly improve the other variables. AT was more effective than RT at improving visceral fat, liver-to-spleen ratio, and total abdominal fat (all P Ͻ 0.05) and trended toward a greater reduction in liver fat score (P Ͻ 0.10). The effects of AT/RT were statistically indistinguishable from the effects of AT. These data show that, for overweight and obese individuals who want to reduce measures of visceral fat and fatty liver infiltration and improve HOMA and alanine aminotransferase, a moderate amount of aerobic exercise is the most time-efficient and effective exercise mode. aerobic training; liver fat; resistance training; weight lifting; homeostasis model assessment WHILE THE BENEFITS OF BEING physically active are clear, many unresolved issues surround the optimal exercise prescription for these benefits. Many organizations recommend both aerobic training (AT) and resistance training (RT) for all adults. However, these recommendations are mainly based on the evaluation of each modality separately, as few studies have investigated the effects of combined AT and RT regimens compared with each modality individually. Furthermore, adherence to exercise recommendations of physicians is notoriously poor, and many patients cite lack of time as a reason for noncompliance. Understanding the effects of AT and RT is of critical importance if we are to apply evidence-based approaches to exercise recommendations to a wide population.Visceral fat and liver fat are associated with type 2 diabetes, metaboli...

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Effects of Therapeutic Lifestyle Program on Ultrasound-diagnosed Nonalcoholic Fatty Liver Disease

Cited by 55 publications

References 27 publications

Weight reduction improves markers of hepatic function and insulin resistance in type-2 diabetic patients with non-alcoholic fatty liver

Weight reduction improves markers of hepatic function and insulin resistance in type-2 diabetic patients with non-alcoholic fatty liver

Prospective histopathologic evaluation of lifestyle modification in nonalcoholic fatty liver disease: a randomized trial

Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT

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