Aerobic exercise could have the final say on fatty livers

In a new study, researchers highlight that fitness may be a more important clinical endpoint for improvement in patients with fatty liver diseases during exercise trials, rather than weight loss.

The research was conducted by a team from Trinity College Dublin.

Metabolic associated fatty liver disease (MAFLD) is a condition characterized by a build-up of fat in the liver.

The liver is central to a suite of vital processes in the body including digestion, blood clotting, and energy production.

If left untreated, MAFLD can lead to serious complications like liver fibrosis (scarring), cirrhosis, liver failure, and liver cancer, as well as cardiovascular and metabolic issues.

Risk factors for developing MAFLD include type 2 diabetes and obesity.

The global estimated prevalence of MAFLD is 25%, making it the leading cause of chronic liver disease worldwide, and is quickly becoming the leading cause of cirrhosis and liver cancer in liver transplant candidates in the western world.

Up to now, due to the lack of approved pharmacological interventions, treatment has been a combination of prescribed weight loss and physical activity, with a weight loss target of 7-10% being the primary treatment endpoint.

There is some evidence that exercise training alone without strong weight loss can reduce liver fat content in MAFLD patients.

This new study highlights that increased fitness, the result of aerobic exercise participation, maybe a more important clinical endpoint for improvement in MAFLD patients during exercise trials, rather than weight loss.

The study is the first to demonstrate significant improvements in biopsy-measured liver outcomes in a MAFLD cohort following an exercise-only intervention, without clinically significant weight loss.

The study also demonstrates that improvements in biopsy-measured liver outcomes were significantly related to improvements in fitness levels.

The study also found, however, that when patients were followed up longitudinally, none of the benefits of the exercise intervention were sustained.

These findings suggest that there is an urgent need to better transition exercise into the community setting for these patients as the benefits of exercise intervention were not sustained longitudinally.

This study clearly demonstrates the clinical benefit of exercise in MAFLD in as little as 12 weeks and shows the clinical benefit of improving cardiorespiratory fitness, which is increasingly being considered a ‘clinical vital sign.’

One author of the study is Dr. Philip O’Gorman, Department of Physiotherapy.

The study is published in Alimentary Pharmacology and Therapeutics.

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