The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: a systematic review and meta‐analysis

Sargeant, Jack A; Gray, Laura J.; Bodicoat, Danielle H.; Willis, Scott A.; Stensel, David J.; Nimmo, Myra A.; Aithal, Guruprasad P.; King, James A.

doi:10.1111/obr.12719

Cited by 82 publications

(93 citation statements)

References 71 publications

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“…Although some therapeutic interventions such as the use of peroxisome proliferator-activated receptor (PPAR)γ agonists, vitamin E or liraglutide showed some efficacy in the treatment of NAFLD (Tilg et al 2017), body fat reduction is still considered the primary form of treatment of this condition (Bacchi et al 2013). Thus, aerobic physical exercise is considered an effective strategy in controlling NAFLD due to the reduction of both adiposity and hepatic lipids , Muñoz et al 2018, Sargeant et al 2018). On the other hand, the effects of strength exercise in the fatty liver accumulation and its consequences have not yet been deeply investigated.…”

Section: Introductionmentioning

confidence: 99%

Short-term strength training reduces gluconeogenesis and NAFLD in obese mice

Pereira

Rodrigues

Anaruma

et al. 2019

Journal of Endocrinology

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Non-alcoholic fatty liver disease (NAFLD) has a positive correlation with obesity, insulin resistance and type 2 diabetes mellitus (T2D). The aerobic training is an important tool in combating NAFLD. However, no studies have demonstrated the molecular effects of short-term strength training on the accumulation of hepatic fat in obese mice. This study aimed to investigate the effects of short-term strength training on the mechanisms of oxidation and lipid synthesis in the liver of obese mice. The short duration protocol was used to avoid changing the amount of adipose tissue. Swiss mice were separated into three groups: lean control (CTL), sedentary obese (OB) and strength training obese (STO). The obese groups were fed a high-fat diet (HFD) and the STO group performed the strength training protocol 1 session/day for 15 days. The short-term strength training reduced hepatic fat accumulation, increasing hepatic insulin sensitivity and controlling hepatic glucose production. The obese animals increased the mRNA of lipogenic genes Fasn and Scd1 and reduced the oxidative genes Cpt1a and Ppara. On the other hand, the STO group presented the opposite results. Finally, the obese animals presented higher levels of lipogenic proteins (ACC and FAS) and proinflammatory cytokines (TNF-α and IL-1β), but the short-term strength training was efficient in reducing this condition, regardless of body weight loss. In conclusion, there was a reduction of obesity-related hepatic lipogenesis and inflammation after short-term strength training, independent of weight loss, leading to improvements in hepatic insulin sensitivity and glycemic homeostasis in obese mice. Key points: (1) Short-term strength training (STST) reduced fat accumulation and inflammation in the liver; (2) Hepatic insulin sensitivity and HPG control were increased with STST; (3) The content and activity of ACC and content of FAS were reduced with STST; (4) STST improved hepatic fat accumulation and glycemic homeostasis; (5) STST effects were observed independently of body weight change.

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Section: Introductionmentioning

confidence: 99%

Short-term strength training reduces gluconeogenesis and NAFLD in obese mice

Pereira

Rodrigues

Anaruma

et al. 2019

Journal of Endocrinology

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“…While we were able to capture enrollment in WM programs offered through the healthcare plan, we were not able to account for participation in other formal or self-directed weight loss programs. Likewise, exercise is an important aspect of lifestyle modification for NAFLD with data supporting improved liver fat content, particularly when accompanied by weight loss [ 28 ]. While the benefits of exercise in management of NAFLD were included in NAFLD patient education, there was no routine assessment for physical activity level to determine if this parameter was impacted by the intervention.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of a dedicated care pathway for nonalcoholic fatty liver disease in an integrated US healthcare system demonstrates support of weight management and improved ALT

et al. 2020

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Background A care pathway for nonalcoholic fatty liver disease (NAFLD) in Kaiser Permanente San Diego, California was instituted in August 2017 to improve efficiency of disease staging and promote lifestyle modification. Methods The NAFLD Care Pathway includes: (1) patient education (2) vibration controlled transient elastography (VCTE) examination (3) hepatology consultation for VCTE ≥ 8 kPa and (4) referral to weight management (WM). Patients referred to the pathway during the first 6 months of its implementation were studied for adherence to its components and impact on weight change and ALT values in the 12 months following referral. Retrospective assessment of WM participation, change in weight, and change in ALT were evaluated in the 12-months following referral and compared to changes 12-months prior. Student’s t-test or Wilcoxon signed rank test were used as appropriate (p < 0.05). Results 632 patients were included. 575 (91.0%) completed VCTE examination with mean liver stiffness 8.5 kPa (SD 9.2). 52 patients had mean liver stiffness ≥ 15 kPa. 180/632 (28.5%) attended NAFLD education. 153/632 (24.2%) were offered hepatology clinic and 136/153 (88.9%) completed at least 1 appointment. Participation in WM was 24/632 (3.8%) prior to referral and 67/632 (10.6%) after referral and increased among patients who attended NAFLD education. Mean weight change following referral was − 0.69 kg (SD 6.58 kg) among patients without WM and − 7.78 kg (SD 13.43 kg) with WM. Overall, 44.2% of participants experienced weight gain after referral, 40.8% had weight loss < 5% and 15% had weight loss ≥ 5%. Variables associated with weight loss included WM (p < 0.0001) and higher liver stiffness (p = 0.0066). Mean ALT change was − 15.2 (SD 38.5) U/L without WM and − 28.8 (SD 29.6) U/L with WM. Conclusions A care pathway for NAFLD within a large, integrated healthcare system provides non-invasive disease staging and minimizes hepatology clinic utilization to those with more advanced disease. Referral was associated with increased enrollment in WM, weight loss, and decreased ALT. Given its impact on healthcare resources, strategies to improve NAFLD identification, staging, and promotion of lifestyle modification are imperative.

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“…A systematic review and meta-analysis from 17 studies on the impact of structured exercise training, and associated weight loss, on intrahepatic triglycerides (IHTGs) in individuals with NAFLD, showed exercise reduced IHTG levels independent of significant weight change. However, the benefits achieved were substantially greater when weight loss occurred [71]. The guidelines from the European Associations for the Study of the Liver (EASL), Diabetes (EASD), and Obesity (EASO) recommend 150 to 200 min/week of moderate-intensity aerobic physical activity for NAFLD patients, in three to five sessions [72].…”

Section: The Effect Of Exercise On Nafldmentioning

confidence: 99%

Dietary Patterns and Components in Nonalcoholic Fatty Liver Disease (NAFLD): What Key Messages Can Health Care Providers Offer?

et al. 2019

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Nonalcoholic fatty liver disease (NAFLD) is a rising epidemic worldwide and will be the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplant within the next decade. NAFLD is considered as the hepatic manifestation of metabolic syndrome. Behaviors, such as a sedentary lifestyle and consuming a Western diet, have led to substantial challenges in managing NAFLD patients. With no curative pharmaceutical therapies, lifestyle modifications, including dietary changes and exercise, that ultimately lead to weight loss remain the only effective therapy for NAFLD. Multiple diets, including low-carbohydrate, low-fat, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean (MD) diets, have been evaluated. NAFLD patients have shown better outcomes with a modified diet, such as the MD diet, where patients are encouraged to increase the consumption of fruits and vegetables, whole grains, and olive oil. It is increasingly clear that a personalized approach to managing NAFLD patients, based on their preferences and needs, should be implemented. In our review, we cover NAFLD management, with a specific focus on dietary patterns and their components. We emphasize the successful approaches highlighted in recent studies to provide recommendations that health care providers could apply in managing their NAFLD patients.

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The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: a systematic review and meta‐analysis

Cited by 82 publications

References 71 publications

Short-term strength training reduces gluconeogenesis and NAFLD in obese mice

Short-term strength training reduces gluconeogenesis and NAFLD in obese mice

Retrospective analysis of a dedicated care pathway for nonalcoholic fatty liver disease in an integrated US healthcare system demonstrates support of weight management and improved ALT

Dietary Patterns and Components in Nonalcoholic Fatty Liver Disease (NAFLD): What Key Messages Can Health Care Providers Offer?

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