Abstract
We compared the effects of 12-week programs of resistance training (RT), high-intensity interval aerobic training (HIAT), and moderate-intensity continuous aerobic training (MICT). The primary goal was to evaluate the therapeutic effects of the exercise modalities for the management of nonalcoholic fatty liver disease (NAFLD). A total of 61 sedentary obese men with NAFLD were randomized into one of the following exercise regimens (RT, HIAT, or MICT). Hepatic fat content was decreased to a similar extent in the RT, HIAT, and MICT groups (−14.3% vs. −13.7% vs. −14.3%) without significant changes in weight and visceral fat. The gene expression levels of fatty acid synthesis were significantly decreased in the subjects’ monocytes. Hepatic stiffness was decreased only in the HIAT group (−16.8%). The stiffness change was associated with restored Kupffer cell phagocytic function (+17.8%) and decreased levels of inflammation such as leptin (−13.2%) and ferritin (−14.1%). RT, HIAT, and MICT were equally effective in reducing hepatic fat content, but only HIAT was effective in improving hepatic stiffness and restoring Kupffer cell function. These benefits appeared to be independent of detectable weight and visceral fat reductions; the benefits were acquired through the modulation of in vivo fatty acid metabolism and obesity-related inflammatory conditions.
Highlights
Dietary and exercise therapies have demonstrated effectiveness for the prevention of the onset and progression of nonalcoholic fatty liver disease (NAFLD)
We reported that exercise alone improved hepatic dysfunction, even though exercise resulted in smaller changes in weight and visceral fat reduction than the results achieved with dietary restriction therapy
A need of alternative strategies with increased exercise or physical activity is strongly emphasized in the management of NAFLD
Summary
Dietary and exercise therapies have demonstrated effectiveness for the prevention of the onset and progression of NAFLD. Exercise is beneficial for reducing visceral fat and is reportedly effective in improving pathological conditions of NAFLD including fat accumulation, inflammation, and fibrosis[5,6]. The improvement and inhibition of the progression of these hepatic conditions by exercise can have a significant impact in the management of NAFLD. Cross-sectional studies have shown that the hepatic pathological conditions of NAFLD are inversely correlated with the levels of physical activity[7] and fitness[8,9], which strongly support the direct benefit of exercise to the liver. We reported that exercise alone improved hepatic dysfunction, even though exercise resulted in smaller changes in weight and visceral fat reduction than the results achieved with dietary restriction therapy. Our results demonstrated that 250 min or more of moderate to vigorous physical activity each week had the greatest effect on hepatic fat reduction and its underlying pathophysiology, independent of weight reduction[14]
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