Exercise for NAFLD: Does Intensity Matter?

BACKGROUND Non-alcoholic steatohepatitis (NASH) has become one of the leading causes of liver disease in the western world. In obese patients weight reduction is recommended. Up to now there are no specific guidelines for weight loss in order to reduce hepatic fat content. AIM To investigate the effects of a 24-wk guided lifestyle intervention program compared to a meal replacement regimen based on soy protein. METHODS Twenty-six subjects with NASH participated in a randomized single-center study. They were randomly assigned to either meal replacement group (MR-G) with soy-yogurt-honey preparation or to guided lifestyle change group (LC-G) with endurance activity and nutrition counselling. Serum alanine transaminase (ALT), aspartate transaminase (AST), lipid parameters, and adipokines were measured. Liver fat content and lipid composition were determined by magnetic resonance imaging and magnetic resonance spectroscopy. Body fat mass and lean body mass were assessed using Bod Pod ® device. Pre- and post-intervention monitoring of parameters was performed. Statistical analyses were conducted with SPSS software, results were expressed as median (interquartile range). RESULTS Twenty-two subjects (MR-G, n = 11 and LC-G, n = 11) completed the study (9 women, 13 men; age 52.1 (15.0) years, body mass index (BMI) 32.3 (3.3) kg/m²). In both groups a significant weight loss was achieved (MR-G: -6.4 (3.6) kg, P < 0.01; LC-G: -9.1 (10.4) kg, P < 0.01). BMI dropped in both groups (MR-G: -2.3 (1.5) kg/m 2 , P = 0.003; LC-G: -3.0 (3.4) kg/m 2 , P = 0.006). Internal fat and hepatic lipid content were markedly reduced in both groups in comparable amount. There was a strong correlation between reduction in liver fat and decrease in ALT. Likewise, both groups showed an improvement in glycemic control and lipid profile. Changes in adipokines, particularly in adiponectin and leptin were closely related to intrahepatic lipid changes. CONCLUSION Comprehensive lifestyle intervention and meal replacement regimen have comparable effects on body and liver fat, as well as decrease in markers of hepatic inflammation among NASH patients.

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“…However, there is no evidence on the specific kinds of exercise ( e.g . in terms of duration, intensity) which will be of most benefit[11].…”

Section: Introductionmentioning

confidence: 99%

Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis

Deibert

Lazaro

Schaffner

et al. 2019

WJG

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“…There is no well-known medicine for the treatment or prevention of NAFLD. For obese subjects, lifestyle changes (i.e., weight loss, regular physical activity, and dietary changes) and pharmaceutical therapies are commonly suggested as a first-line, but these interventions are difficult to be achieved or continued in clinical practice (3). On the other hand, pharmaceutical therapies such as insulin sensitizers, renin-angiotensin system blockers, lipid reducing drugs, vitamin E and natural antioxidants, have been used in clinical trials (7).…”

Section: Treatment or Prevention Of Nafldmentioning

confidence: 99%

“…Normalizing IR has been documented to associate with a decrease in total body fat, particularly in visceral adiposity, which in turn is involved in delivery of FAs to the hepatocyte (22). Subsequently, any intervention that causes the improvement of insulin sensitivity can help hepatic steatosis decline and consequently NASH development (3).…”

Section: Role Of Glucagon-like Peptide-1 In the Treatment Of Nafldmentioning

confidence: 99%

Glucagon like Peptide-1(GLP-1) a Novel Therapeutic Strategy in Non-Alcoholic Fatty Liver Disease (NAFLD)

Oshaghi

2017

Avicenna J Med Biochem

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Non-alcoholic fatty liver disease (NAFLD) is a main cause of liver disease and its global prevalence is estimated to be 24%. At present no approved medicines are available for NAFLD treatment. Glucagon-like peptide-1 (GLP-1) is a significant regulator of energy balance, show potential efficacy in the management of NAFLD. GLP-1 and GLP-1 receptor agonist (GLP-1RAs) are attractive options for the treatment of type 2 diabetes (T2D) since they efficiently reduce weight, HbA1C and blood glucose without having a risk of hypoglycaemia. This incretin hormone by normalizing of insulin resistance (IR), oxidative stress, lipid accumulation, lipotoxicity, and liver cell apoptosis is proposed for the management of NAFLD and nonalcoholic steatohepatitis (NASH) patient. Hence, the aim of this review was to discuss the useful effects of GLP-1, GLP-1 receptor agonist (GLP-1RAs) and dipeptidyl peptidase-4 (DPP-4) on NAFLD. In this paper we provided a new finding which highlighted the role of GLP-1 and GLP-1RAs in the treatment of NAFLD.

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“…Nevertheless, among the most important recommendations for NAFLD, one can mention body weight loss through modifying the diet and doing regular physical activities (4). Unfortunately, most people with NAFLD do not engage in physical activities and due to their working conditions, the excuse of dearth of time or some physical restrictions are not adequately active (5). Studies on high fat diet fed rats showed that exercise reduce visceral fat, body weight, food intake and fat mass (6).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Aerobic Continuous Training on Myonectin, Insulin Resistance and Liver Enzymes in Rats with Nonalcoholic Fatty Liver Disease

KoohestaniSini¹,

Afzalpour²,

Mohammadnia-Ahmadi³

et al. 2020

Ann Appl Sport Sci

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Background. Non-alcoholic fatty liver disease, is the most common reason of liver disorders that can be controlled by dieting and regular physical activity. Objectives. The aim of this study was to investigate the effect of aerobic continuous training on serum levels of myonectin, insulin resistance and liver enzymes in rats with non-alcoholic fatty liver disease. Methods. Thirty-four male Wistar rats (6-8 weeks old) were randomly assigned into two groups: normal diet (N = 9) and high-fat diet (N = 25). Through 12-week high-fat diet, induction of fatty liver was performed. In order to confirm non-alcoholic fatty liver induction, seven rats fed with high-fat diet were tested. The 18 remaining rats were randomly assigned to two groups: high-fat diet plus sedentary activity (n = 9) and high-fat diet plus aerobic continuous training (n = 9). The aerobic group has performed running on a treadmill at the intensity of 50-60% VO2max, for eight weeks and five sessions per week. The results were analyzed by one-way ANOVA and Tukey's post hoc tests at the statistical significance level of p<0.05. Results. The significant body weight increase induced by high-fat diet was controlled by aerobic continuous training (p<0.05). The serum levels of myonectin, insulin, glucose, alanine aminotransferase and aspartate aminotransferase enzymes and insulin resistance improved significantly after eight weeks of aerobic continuous training (p<0.05). Conclusion. It seems that aerobic continuous training can improve insulin resistance and liver enzymes by reducing serum myonectin levels in rats with non-alcoholic fatty liver disease.

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Exercise for NAFLD: Does Intensity Matter?

Cited by 9 publications

References 25 publications

Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis

Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis

Glucagon like Peptide-1(GLP-1) a Novel Therapeutic Strategy in Non-Alcoholic Fatty Liver Disease (NAFLD)

The Effect of Aerobic Continuous Training on Myonectin, Insulin Resistance and Liver Enzymes in Rats with Nonalcoholic Fatty Liver Disease

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