Clinical

Exercise reduces steatosis in non-alcoholic fatty liver disease

Last Updated: 2009-08-24 14:43:06 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - In patients with non-alcoholic fatty liver disease (NAFLD), dietary counseling and a moderate increase in physical activity can reduce hepatic steatosis, particularly in patients who have good maximal aerobic capacity at baseline.

The diet and exercise "lifestyle intervention" is described by German researchers in the September issue of Gut.

Dr. Norbert Stefan and colleagues at the University of Tubingen studied 50 patients with NAFLD and 120 control subjects at risk of metabolic diseases, all of whom received dietary counseling aimed at reducing body weight and caloric intake and were asked to undertake a moderate increase in aerobic physical activity.

At a mean follow-up of 8.7 months, the researchers found that total, subcutaneous abdominal and visceral adipose tissue had decreased overall, and fitness had increased. The most pronounced change was a 31% drop in liver fat.

NAFLD resolved in 20 patients, according to the article.

Fitness at baseline was the strongest predictive factor for change in liver fat, the authors said. As Dr. Stefan told Reuters Health, the predictive effect of fitness "was not only greater than the impact of total and visceral fat, but it was also independent of these parameters. This suggests that there are specific effects of cardiorespiratory fitness, an estimate of mitochondrial function, on hepatic lipid metabolism."

"Our findings," he added, "suggest that in the future, particularly measurement of cardiorespiratory fitness, could be helpful for identifying patients with NAFLD who are more or less likely to respond to a lifestyle intervention."

"Patients with NAFLD and low fitness," Dr. Stefan concluded, "may profit more from a more intense lifestyle intervention or an additional pharmacological intervention to reduce liver fat and experience a resolution of NAFLD."

Gut 2009;58:1281-1288.