The following is a summary of “Exercise Training Is Associated With Treatment Response in Liver Fat Content by Magnetic Resonance Imaging Independent of Clinically Significant Body Weight Loss in Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis,” published in the July 2023 issue of Gastroenterology by Stine et al.
Exercise training is crucial in managing nonalcoholic fatty liver disease (NAFLD), but its ability to significantly improve liver fat remains uncertain. For a study, researchers sought to investigate the association between exercise training and the attainment of validated thresholds for MRI-measured treatment response.
Through March 2022, randomized controlled trials involving adults with NAFLD were identified. Exercise training was compared with no exercise training, and the primary outcome was achieving a ≥30% relative reduction in MRI-measured liver fat—a threshold indicative of histologic improvement in nonalcoholic steatohepatitis activity, resolution of nonalcoholic steatohepatitis, and liver fibrosis stage. Different exercise doses were also compared.
Fourteen studies comprising 551 subjects met the inclusion criteria, with a mean age of 53.3 years and a body mass index of 31.1 kg/m2. Subjects undergoing exercise training were more likely to achieve a ≥30% relative reduction in MRI-measured liver fat (odds ratio 3.51, 95% CI 1.49–8.23, P = 0.004) than those in the control condition. Notably, an exercise dose of ≥750 metabolic equivalents of task min/week (equivalent to 150 min/week of brisk walking) resulted in a significant treatment response (MRI response odds ratio 3.73, 95% CI 1.34–10.41, P = 0.010), whereas lesser exercise doses did not lead to the same response. Moreover, treatment response was independent of clinically significant body weight loss (>5%).
Despite weight loss, exercise training is 3.5 times more likely to achieve a clinically meaningful treatment response in MRI-measured liver fat than standard clinical care. An exercise dose of at least 750 metabolic equivalents of task-min/week is necessary to achieve this response. The findings further supported the weight-neutral benefit of exercise for all patients with NAFLD.
Source: journals.lww.com/ajg/Abstract/2023/07000/Exercise_Training_Is_Associated_With_Treatment.21.aspx