Effect of exercise on hepatic steatosis: Are benefits seen without dietary intervention? A systematic review and meta‐analysis
Abstract
Abstract Background Interventions involving both exercise and dietary modification are effective in reducing steatosis in nonalcoholic fatty liver disease (NAFLD). However, exercise alone may reduce liver fat and is known to have other positive effects on health. The primary aim of this study was to systematically review the effect of exercise alone without dietary intervention on NAFLD and to examine correlations across changes in liver fat and metabolic markers during exercise. Methods Relevant online databases were searched from earliest records to May 2020 by two researchers. Studies were included where the trial was a randomized controlled trial, participants were adults, exercise intervention was longer than 4 weeks, no dietary intervention occurred, and the effect of the intervention on liver fat was quantified via magnetic resonance imaging/proton magnetic resonance spectroscopy. Results Of 21 597 studies retrieved, 16 were included involving 706 participants. Exercise was found to have a beneficial effect on liver fat without dietary modification (−2.4%, −3.13 to −1.66) (mean, 95% CI). Pearson correlation showed significant relationships between change in liver fat and change in weight (r = 0.67, P = .007), liver enzymes aspartate aminotransferase (r = 0.76, P = .002) and alanine aminotransferase (r = 0.91, P < .001), and cardiorespiratory fitness VO 2 peak (peak volume oxygen consumption) (r = −0.88, P = .004). By multivariate regression, change in weight and change in VO 2 peak significantly contributed to change in liver fat (R 2 = 0.84, P = .01). Conclusions This systematic review found that exercise without dietary intervention improves liver fat and that clinical markers may be useful proxies for quantifying liver fat changes.
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Several RCTs and meta-analyses have demonstrated that exercise alone, without dietary interventions or significant weight loss, reduces liver steatosis in individuals with MASLD.
“while several RCTs and meta-analyses have demonstrated that exercise alone, without dietary interventions or signi fi cant weight loss, reduces liver steatosis in individuals with MASLD. 313”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [313]
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BackgroundEstimating the mean and variance from the median, range, and the size of a sample
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- Authors
- Baker, C. J., Martinez‐Huenchullan, S. F., D'Souza, M., Xu, Y., Li, M., Bi, Y., Johnson, N. A., & Twigg, S. M.
- Affiliations
- The University of Sydney (AU)
- Greg Brown Diabetes & Endocrinology Laboratory, Charles Perkins Centre University of Sydney Sydney New South Wales Australia
- Ruijin Hospital (CN)
- Austral University of Chile (CL)
- Corresponding author
- Twigg, Stephen Morris
- ORCID
- Venue
- Journal of Diabetes
- Publisher
- Wiley
- Published
- 2020-08-11
- Volume
- 13
- Issue
- 1
- Pages
- 63-77
- ISSN
- 1753-0393 (ISSN-L)
- 1753-0407
- OpenAlex
- W3042590857
- Cited by
- 69
- References
- 40
- Citations by year
- 2026: 12 · 2025: 14 · 2024: 14 · 2023: 11 · 2022: 5 · 2021: 13
- FWCI
- 1.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Shanghai Jiao Tong University
- University of Sydney
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- physical activity, hepatic steatosis, non-alcoholic fatty liver disease, liver fat, dietary intervention, weight change, aspartate aminotransferase, alanine aminotransferase, cardiorespiratory fitness, peak oxygen uptake, metabolic biomarkers
- MeSH terms
- Adipose Tissue, Adult, Exercise Therapy, Fatty Liver, Humans, Liver, Exercise, Randomized Controlled Trials as Topic, Treatment Outcome, Non-alcoholic Fatty Liver Disease
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