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Exercise helps patients with non-alcoholic fatty liver disease
Date:7/1/2009

per week, and those who increased their level of fitness, also showed improvements in liver enzymes and other metabolic indices. The effect was independent of weight loss.

Interestingly, there was no dose-response effect for exercise increases above 60 minutes per week. However, those who increased exercise by at least 60 minutes per week had beneficial changes in liver enzymes, insulin resistance and metabolic risk factors.

While greater increases in exercise time appeared to be related to greater weight loss, there was no additional benefit to liver enzymes or glucose homeostasis. "The reason for this is unclear," the authors write, "but we hypothesize that the threshold for change in liver enzymes may be low so that even a slight increase in physical activity is sufficient to improve liver tests."

Patients who remained sedentary over the course of the study had no improvement in metabolic parameters, and even trended toward deterioration in these areas, even if they lost weight. "The metabolic pathway by which physical activity improves insulin sensitivity may be different to that of weight loss and this is particularly relevant for patients with NAFLD," the authors write. "Physical activity improves insulin resistance through positive changes in fatty acid metabolism in muscle which cannot be achieved through energy restriction."

"We have shown here that physical activity counseling can result in significant increases in physical activity and fitness and subsequent improvement in health, without the need for supervised exercise sessions," the authors conclude.


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