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Aerobic or Resistance Training for Nonalcoholic Fatty Liver Disease?

Summary and Comment |
October 23, 2013

Aerobic or Resistance Training for Nonalcoholic Fatty Liver Disease?

  1. Atif Zaman, MD, MPH

Each type of exercise resulted in similarly impressive reductions in disease indicators.

  1. Atif Zaman, MD, MPH

Lifestyle interventions that induce weight loss, primarily dietary changes and exercise, are considered the cornerstone of therapy for nonalcoholic fatty liver disease (NALFD). However, data are mixed regarding which type of exercise is most effective in this setting: Is aerobic or resistance training best?

To answer this question, investigators randomized 31 patients with type 2 diabetes and NAFLD to participate in a scripted aerobic-exercise regimen or resistance-training regimen for 4 months. All participants received nutritional counseling from a single nutritionist in an effort to control for differences in diet. Outcomes measured were insulin sensitivity (by hyperinsulinemic euglycemic clamp), total body fat mass (by dual-energy x-ray absorptiometry), and hepatic fat content (by magnetic resonance imaging).

After 4 months of training, hepatic fat content was significantly reduced from baseline in both the aerobic-exercise and resistance-training groups by similar percentages (mean relative reductions, 32.8% and 25.9%, respectively). Approximately 23% of participants in each group had complete resolution of hepatic steatosis. Insulin sensitivity improved significantly from baseline in both groups. Both body-mass index and total body fat mass were significantly reduced in both groups; however, these improvements were only modest from a clinical standpoint.

Comment

Findings of this well-executed study suggest that both aerobic and resistance exercise are effective in the treatment of nonalcoholic fatty liver disease. After only 4 months, the results of either program were impressive, particularly the resolution of hepatic steatosis in nearly one quarter of patients with type 2 diabetes and NAFLD. I suspect that longer duration of exercise would lead to clinically meaningful improvements in body-mass index and total body fat mass. Bottom line: Any exercise is good exercise for the treatment of NAFLD.

  • Disclosures for Atif Zaman, MD, MPH at time of publication Speaker’s bureau Bristol-Myers Squibb; Genentech; Gilead; Kadmon; Merck; Salix; Vertex

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