Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder worldwide, affecting as much as a quarter of humanity.
It is characterized by fat accumulation in liver cells and may progress to inflammation, cirrhosis and liver failure.
In a new study from the University of Tsukuba in Japan, researchers found the positive effects, beyond the expected weight-loss benefit, of exercise on the liver.
NAFLD is associated with unhealthy behaviors such as overeating and a sedentary lifestyle.
In Japan 41% of middle-aged men have NAFLD and 25% will progress to non-alcoholic steatohepatitis (NASH) and hepatic dysfunction.
Weight reduction is fundamental to NAFLD management. Unfortunately, achieving a targeted bodyweight without supervision is difficult, and maintaining this over time even more so.
Hitherto, exercise was considered adjunctive to dietary restrictions for weight loss but the other benefits such as reduced hepatic steatosis (fatty change) and stiffness are being increasingly recognized.
In the study, the team compared data from obese Japanese men with NAFLD on a 3-month exercise regimen with those on dietary restriction targeting weight loss.
They found that exercise preserved muscle mass better, though with a modest decrease of body and fat mass.
Remarkably, ultrasound test revealed that the exercise reduced liver steatosis by an additional 9.5%, liver stiffness by an additional 6.8%, and the FibroScan-AST Score (a measure of liver fibrosis) by an additional 16.4% over the weight-loss exercise.
Additionally, exercise altered the circulating concentrations of specific organokines and apparently induced anti-inflammatory and anti-oxidative stress responses through activation of the Nrf2 (nuclear factor E2-related factor 2), an oxidative stress sensor.
It also enhanced the phagocytic capacity of Kupffer cells which help maintain liver function.
The findings showed how exercise prevents liver steatosis and fibrosis in NAFLD and clarify that this benefit is compounded by the preservation of muscle mass and is independent of weight changes.
Patients on exercise regimens may become demotivated and drop out if they do not experience significant weight loss.
Therefore, moderate to vigorous-intensity exercise should be integrated in all NAFLD therapeutic regimens, and patients at risk for NASH should be encouraged to persevere with moderate to high-intensity exercise regardless of whether or not they lose weight.
If you care about liver health, please read studies about the key to stopping the silent killer of liver disease and findings of many middle-aged people have this dangerous liver disease without knowing it.
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The study is published in JHEP Reports. One author of the study is Professor Junichi Shoda.
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