Exercise can help eliminate dangerous fat around the liver

By Cara Murez HealthDay Reporter

MONDAY, Feb. 13, 2023 (HealthDay News) — Patients with nonalcoholic fatty liver disease are often advised to lose weight, but it can be difficult to do and takes up valuable time.

Now, researchers report that they’ve found another strategy can help reduce liver fat in people with this condition, which affects nearly 30% of the world’s population.

Exercising about 150 minutes a week at moderate intensity — the exact recommendation of public health experts at the U.S. Department of Health and Human Services — significantly reduced liver fat in patients, the new meta-data showed. analysis.

“I spend a lot of time trying to improve the lives of our patients with non-alcoholic fatty liver disease. [NAFLD],” said Dr Jonathan Stine. He is an associate professor of medicine and public health sciences and a hepatologist at Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.

“Right now, we still don’t have a regulatory-approved drug treatment or even a cure for this disease. And there’s about a hundred million adults in this country who have that,” Stine noted.

Although research has shown that exercise can improve liver fat, fitness, body composition, and quality of life, there was no specific amount of exercise known to do this.

For this study, the researchers considered a 30% relative reduction in liver fat – measured by MRI – to be a significant improvement. Next, they reviewed 14 randomized controlled trials with a total of 551 people with NAFLD.

The researchers found that regardless of weight loss, exercise was 3.5 times more likely to achieve this 30% reduction in liver fat compared to standard care.

Next, they determined the optimal dose of exercise, finding that 39% of patients who exercised rapidly for 150 minutes per week or more had a significant response to treatment, compared with 26% of those who exercised less. .

“There is growing evidence that exercise, even if you don’t lose a single pound, has many beneficial effects,” Stine said. “I would really take issue with the idea that we prescribe exercise as a way for someone to lose weight, but it can instead be thought to improve overall health in the absence of clinically meaningful weight loss.”

These reductions were similar to those reported in early phase drug trials for people with “NASH,” which the US National Institutes of Health describes as inflammation and liver damage accompanied by fat in the liver.

An example of moderate exercise would be a brisk walk in which a person might start sweating but can still carry on a conversation with a walking partner, Stine said. Another example would be light cycling.

“A lot of moderate-intensity activity is really something anyone can do, even a sedentary population,” Stine said.

Fat in the liver eventually leads to inflammation and can progress over time to liver fibrosis, cirrhosis, end-stage liver disease, or liver cancer.

It’s not entirely clear how long it would take for the exercise program to work, but the studies in the meta-analysis ranged from four weeks to a year.

Stine suggests getting past the fixation on numbers and becoming more physically active.

“Focusing solely on activity rather than weight loss is, in my opinion, the most important finding of the study,” Stine said.

Weight loss has long been a cornerstone of managing NAFLD, and exercise and dietary changes are an important part of that, said Dr. Annie Kardashianassistant professor of medicine in the division of gastroenterology and liver disease at the Keck School of Medicine at the University of Southern California in Los Angeles.

“But what it suggests is that you can actually have fat reversal just with exercise, even without weight loss, which is great and it’s really great because it’s encouraging for patients,” said Kardashian, who was not involved. in the study.

Why might exercise reduce liver fat?

Kardashian suggests it could burn the type of fat that accumulates around the stomach area, which is more associated with fat accumulation in the liver.

NAFLD is quite common, she noted.

“And the reason it’s bad is that the same way alcohol can damage the liver through inflammation of the liver, fat can do the exact same thing,” Kardashian said.

Kardashian would like to see more research on the impact of exercise on liver inflammation and scarring, but said the impact on liver fat would be good information to provide to patients.

“My message to my patients is going to be that regular exercise can have a very positive effect on the liver. Even if you’re struggling to lose weight, it can still lead to a drop or reduction in the amount of fat in the liver. liver,” Kardashian said.

SOURCES: Jonathan Stine, MD, MSc, associate professor, medicine and public health sciences, and hepatologist, Penn State Health Milton S. Hershey Medical Center, Hershey, PA; Ani Kardashian, MD, assistant professor, medicine, division of gastroenterology and liver disease, Keck School of Medicine, University of Southern California, Los Angeles; American Journal of GastroenterologyJanuary 30, 2023, online

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