Exercise and diet in the management of nonalcoholic fatty liver disease

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

“…Most recent advances in the management and treatment of NAFLD show that a multifaceted approach, using a multidisciplinary team is likely to achieve the best outcome[40]. Combination of physical activity, medications, and dietetic interventions can be more effective than each prescription alone[24].…”

“…Combination of physical activity, medications, and dietetic interventions can be more effective than each prescription alone[24]. In addition, intervention tailored and aimed at encouraging self-empowerment and behavioral change are regarded as essential for increasing adhesion to treatments[40]. …”

Effect of exercise on the development of new fatty liver and the resolution of existing fatty liver

“…The available evidence to date suggests a benefit of exercise to decrease fatty liver in NAFLD [13][14][15][16]23], and the question of the optimum prescribed 'dose' of exercise for all liver diseases [14] and the effect of aerobic exercise on liver fat [24] have recently been examined. These analyses show that it remains uncertain as to what exercise should be advised and how intense (and for how long), that exercise needs to be, in order to influence liver fat.…”

“…In short duration studies, lifestyle changes that have focussed on diet and exercise modification have shown promise in decreasing liver fat as a manifestation of early disease in NAFLD [13][14][15][16]. However, guidelines from Specialist societies regarding recommendations for amounts and intensity of exercise/physical activity in NAFLD are variable.…”

NAFLD therapy and monitoring disease progression

“…The Mediterranean diet contains predominantly monounsaturated fats from olive oil with a greater ratio of omega-3 polyunsaturated fatty acids (PUFAs) to omega-6 PUFAs, whereas the ratio is reversed in Western diets. 55 In a study comparing Mediterranean diet with a low-carbohydrate diets or a low-fat diet, Shai et al 56 found that the mean weight loss was similar in the lowcarbohydrate and Mediterranean diet cohorts and that both were significantly better than the low-fat group. The low-carbohydrate group showed better more beneficial effects on lipid profiles while glycemic control was better in the Mediterranean diet group.…”