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American College of Sports Medicine (ACSM) International Multidisciplinary Roundtable report on physical activity and nonalcoholic fatty liver disease
Open accessAbstract
BACKGROUND AND AIMS: We present findings from the inaugural American College of Sports Medicine (ACSM) International Multidisciplinary Roundtable, which was convened to evaluate the evidence for physical activity as a means of preventing or modifying the course of NAFLD. APPROACH AND RESULTS: A scoping review was conducted to map the scientific literature and identify key concepts, research gaps, and evidence available to inform clinical practice, policymaking, and research. The scientific evidence demonstrated regular physical activity is associated with decreased risk of NAFLD development. Low physical activity is associated with a greater risk for disease progression and extrahepatic cancer. During routine health care visits, all patients with NAFLD should be screened for and counseled about physical activity benefits, including reduction in liver fat and improvement in body composition, fitness, and quality of life. While most physical activity benefits occur without clinically significant weight loss, evidence remains limited regarding the association between physical activity and liver fibrosis. At least 150 min/wk of moderate or 75 min/wk of vigorous-intensity physical activity are recommended for all patients with NAFLD. If a formal exercise training program is prescribed, aerobic exercise with the addition of resistance training is preferred. CONCLUSIONS: The panel found consistent and compelling evidence that regular physical activity plays an important role in preventing NAFLD and improving intermediate clinical outcomes. Health care, fitness, and public health professionals are strongly encouraged to disseminate the information in this report. Future research should prioritize determining optimal strategies for promoting physical activity among individuals at risk and in those already diagnosed with NAFLD.
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“Therefore, increased physical activity, exercise and reduction in sedentary behaviour, independent of weight loss, has hepatic and cardiometabolic bene fi t and should be routinely recommended. 312,327”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [312]
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“and is associated with a greater risk of MASLD progression, 312”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [312]
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Metadata
- Authors
- Stine, J. G., Long, M. T., Corey, K. E., Sallis, R. E., Allen, A. M., Armstrong, M. J., Conroy, D. E., Cuthbertson, D. J., Duarte-Rojo, A., Hallsworth, K., Hickman, I. J., Kappus, M. R., Keating, S. E., Pugh, C. J. A., Rotman, Y., Simon, T. G., Vilar-Gomez, E., Wong, V. W.-S., & Schmitz, K. H.
- Affiliations
- Pennsylvania State University (US)
- Boston University (US)
- Massachusetts General Hospital (US)
- Kaiser Permanente Fontana Medical Center (US)
- Mayo Clinic (US)
- Queen Elizabeth Hospital Birmingham (GB)
- University of Liverpool (GB)
- Department of Medicine, Division of Gastroenterology and Hepatology, Northwestern University, Chicago, Illinois, USA
- Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
- Princess Alexandra Hospital (AU)
- Duke University (US)
- The University of Queensland (AU)
- Cardiff Metropolitan University (GB)
- National Institutes of Health (US)
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Chinese University of Hong Kong (HK)
- Corresponding author
- Stine, Jonathan G.
- ORCID
- Stine, Jonathan G.
- Long, Michelle T.
- Corey, Kathleen E.
- Sallis, Robert E.
- Allen, Alina M.
- Armstrong, Matthew J.
- Conroy, David E.
- Cuthbertson, Daniel J.
- Hallsworth, Kate
- Hickman, Ingrid J.
- Kappus, Matthew R.
- Keating, Shelley E.
- Pugh, Christopher J.A.
- Rotman, Yaron
- Simon, Tracey G.
- Vilar-Gomez, Eduardo
- Wong, Vincent Wai-Sun
- Schmitz, Kathryn H.
- Venue
- Hepatology Communications
- Published
- 2023-03-30
- Volume
- 7
- Issue
- 4
- ISSN
- 2471-254X (ISSN-L)
- PMC
- PMC10069861
- OpenAlex
- W4361267179
- Cited by
- 89
- References
- 138
- Citations by year
- 2026: 21 · 2025: 26 · 2024: 32 · 2023: 10
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Hepatology Communications (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Funders
- Pfizer
- American Association for the Study of Liver Diseases
- Gilead Sciences
- National Institute for Health and Care Research (CAT CL-2013-04-010, NIHR300760)
- Diabetes Australia
- Novo Nordisk
- Ipsen
- Grifols
- Norgine
- National Institutes of Health
- Medical Research Council
- National Health and Medical Research Council (1122190)
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- physical activity, non-alcoholic fatty liver disease, NAFLD prevention, exercise training, aerobic exercise, resistance training, liver fat, liver fibrosis, body composition, extrahepatic cancer, physical activity guidelines, physical activity counseling, NAFLD screening
- MeSH terms
- Humans, Quality of Life, Sports Medicine, United States, Exercise, Disease Progression, Non-alcoholic Fatty Liver Disease
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