ObjectivesNon-Alcoholic Fatty Liver Disease (NAFLD) is a silent disease linked to behavioral habits (poor diet and sedentary lifestyle) with inflammatory and oxidative stresses as background, leading to cardiovascular diseases (CVDs) as the worse outcome. These point out to lifestyle modification program(LSMP) as a potential non-pharmacological strategy in modulation NAFLD and CVDs risks. Purpose: To evaluate the LSMP on sulfur-containing markers in the NAFLD- high-risk CVDs course. MethodsIntervention study with 170 subjects with algorithm-diagnosed NAFLD(Fatty Liver Index ≥ 60) undergoing a 10 wks of the LSMP with daily supervised mixed physical exercise and nutritional counseling. Participants, adults (>35 yrs) had data collected before and after 10 wks for variables: demographic, socioeconomic, dietary, anthropometric and plasma biochemistry (inflammatory-oxidative and sulfur-containing markers). CVDs risk was indicated by higher risk of both Plasma Atherogenic Index (PAI) and Coronary Artery Disease (CAD). Statistical analyzes were performed for p = 0.05. ResultsThe sample of 73% women and 51.8% under 60 yrs old presented 37.6% low-physical activity level (PAL) and 95.3% poor-quality diet. At baseline the 30% NAFLD patients presented 13.5% high risk of PAI and 11.2% high-risk CAD along with 90% low PAL and 100% poor-quality diet. Inadequate-food ingestion was detected in protein, lipid, fiber, methionine (Met), Phosphatidylcholine (Pho), choline (Cho) and betaine (Bet). Their plasma profile showed higher inflammatory (us-CRP) and oxidative stress (MDA and GSSG) with lower antioxidant status (GSH) along with higher levels of homocysteine (Hcy) and Trimetylamine N-oxide (TMAO). The 10-wk LSMP improved VO2max (20%) and protein, lipid, fiber, Met, Pho, Cho and Bet intake. There was a reduction of 27% in NAFLD as well as in those with higher-PAI (46.2%) and higher-CAD (45%) associated with improvements in plasma Met, Pho, Cho and Bet, as well in Hcy, and TMAO. ConclusionsBy improving sulfur-containing anti-oxidants and aerobic conditioning (anti-inflammatory effect) the present LSMP was effective in reducing the NAFLD recrudescence to CVDs. Funding SourcesCAPES and CNPq