Fatty liver disease is the result of fat build up in the liver beyond normal ranges. Categorized into two groups- non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD), both can result in liver damage, scarring, and even liver failure. Recent studies have shown that obese patients with a sedentary lifestyle who started regular aerobic exercise lowered their risk of NAFLD, regardless of whether they lost weight, again highlighting the importance of regular physical activity.
NAFLD affects about 30% of adults and the majority of obese people. For most people, the condition results in no symptoms or complications, but in others it causes inflammation and scarring of the liver. It extreme cases, it can lead to liver failure (you can read about causes, symptoms, treatment here). Most doctors recommend weight loss as the most common therapy for obese patients and those with NAFLD, but efforts to diet and exercise typically only result in modest weight reduction. Therapies that reduce fat buildup in the liver but don’t require significant weight loss may be the most practical, the authors of the study suggested.
The Australian study found that after a month of regular aerobic cycling exercise, patients reduced their visceral adipose tissue volume by 12% and hepatic triglyceride concentration (HTGC) by 21% on average, according to a report in the October 2019 edition of Hepatology.
Reduction in all of these factors are known to improve metabolic function and to reduce the risks of cardiovascular problems and diabetes associated with obesity and NAFLD.
For four weeks, 12 of the participants rode stationary bicycles three times per week for sessions of 30 to 45 minutes that increased in intensity over the final two weeks. The other seven patients were assigned to a placebo regimen that included stretching exercises. While the aerobic exercise regime did not result in significant weight loss, it did reduce participants’ visceral adipose tissue, HTGC, and levels of fatty acids in the blood. Researchers consequently asserted that the debate on type of treatment for NAFLD should be refocused, as weight loss itself wasn’t as much a factor in preventing NAFLD as were the overall benefits of physical activity in supporting liver health.
What Type of Workout should People with Fatty Liver Disease Complete?
The rise of obesity rates in America has coincided with the rise of cases of NAFLD, now the most common chronic liver disease. In a 2019 study published in Gene Expression: The Journal of Liver Research, researchers found further evidence that physical exercise could benefit people with NAFLD – including those who had the disease in its most inflammatory form – nonalcoholic steatohepatitis (NASH). Relying on different methodologies than previous studies, participants took part in aerobic and resistance training for 4-7 days a week. The studies mirrored previous findings, that patients experienced positive effects in reducing key risk factors that determine NAFLD, regardless of weigh loss.
Additional studies have found that both aerobic and resistance training substantially increased insulin sensitivity and improved metabolism. Considering the fact that insulin resistance is thought to be a contributor to NASH, the findings are certainly worth taking into account.
Exercise is necessary for everyone, but when it comes to people with fatty liver disease, it can be particularly vital since research has shown it can benefit NAFLD by reducing hepatic (liver) fat content. Make sure to speak to your providers and enlist the help of an experienced trainer if necessary.
Aerobic Exercise: Low Impact or High?
If you wish to lose weight, your health team may recommend safe yet effective exercises like cycling, walking, and swimming. All these exercise forms can be adapted to various fitness levels, and all are low-impact when it comes to joints like the knees. You should ideally try to include around half an hour of cardio training a day.
Outdoor exercises like cycling burn more calories because of terrain changes, wind resistance etc. but arguably the most important thing is to choose a workout you can stick to.
What Type of Resistance Program Should You Follow?
If you have fatty liver disease, ask your health team if they can recommend a strength exercise regimen covering the major muscles – including biceps, triceps, quadriceps, pectorals, and calves. The precise number of repetitions and the amount of weight recommended to lift will depend on a variety of factors, including your current fitness level, age, and goals.
If you wish to lose weight, for instance, your trainer may recommend a high number of reps and lower weight. If muscle building is on the agenda, meanwhile, you may be instructed to complete a smaller number of reps of heavier weights. As found in a study by Kate Hallsworth et al, weight loss is not the ultimate goal when it comes to weight training, since resistance exercise not only reduces liver fat, but also improves fat oxidation and improves glucose control.
If you are pressed for time or do not have access to a gym, try virtual classes, or check out the exercises we share every Tuesday; combine a grouping of 6-8 of the exercises and you have built your own circuit of moves to get you going.
What about Stress-Busting Exercises?
Many people consume too much food because of stress and anxiety. If you can relate to this habit, then try to include exercises that reduce stress, and also read these other methods to prevent stress eating. Your cardio and strength workouts will probably already be doing plenty to lift your mood and help you sleep better, but for an extra boost, try to make a little time in your day for yoga or Tai Chi. Both these exercises have been found to significantly lower stress hormones (cortisol).
The studies surrounding physical activity and the reduction of risk factors leading to NAFLD and NASH are promising. Don’t allow the sometimes overwhelming thought of beginning a weight-loss journey stop you from being physically active. Even if you don’t initially see results, these studies underline that the body still benefits from physical activity, improving overall wellness, including liver health.
-sciencedirect.com/science/article/abs/pii/S0168827816304883
-medscape.com/answers/175472-100897/what-is-the-role-of-exercise-in-the-treatment-of-fatty-liver-disease
-fattyliverfoundation.org/exercise_and_nafld
-ncbi.nlm.nih.gov/pmc/articles/PMC5954622/#idm140120960310864title
-medpagetoday.org/gastroenterology/generalhepatology/15927?vpass=1
-pubmed.ncbi.nlm.nih.gov/29212576/