Exercise as Medicine: The Impact of Exercise Training on Nonalcoholic Fatty Liver Disease
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FATTY LIVER DISEASE (V AJMERA, SECTION EDITOR)
Exercise as Medicine: The Impact of Exercise Training on Nonalcoholic Fatty Liver Disease Audrey Thorp 1 & Jonathan G. Stine 2,3,4,5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Nonalcoholic fatty liver disease (NAFLD) is a leading cause of global liver disease. Because current pharmacologic treatments are ineffective, lifestyle change centered on exercise remains the most effective NAFLD treatment. The aim of this systematic review is to summarize and evaluate the current evidence supporting the use of exercise training as a medical treatment for adult patients with NAFLD. Recent Findings At least 150 min each week of moderate intensity exercise of any type can improve NAFLD, both with and without modest weight loss. Exercise training reduces hepatic steatosis and liver inflammation, favorably changes body composition, improves vascular endothelial function, increases cardiorespiratory fitness, and can lead to histologic response. To date, exercise-based NAFLD trials are limited by small sample size and significant heterogeneity. Summary While several key questions remain unanswered, exercise training will always be an important part of the medical management of patients with NAFLD. Keywords Physical activity . Lifestyle modification . Cardiovascular disease . Nonalcoholic steatohepatitis . Fatty liver
Abbreviations (AASLD) (ACSM) (ALT) (AMPK) (AST)
American Association for the Study of Liver Disease American College of Sports Medicine Alanine aminotransferase AMP-activated protein kinase Aspartate aminotransferase
This article is part of the Topical Collection on Fatty Liver Disease * Jonathan G. Stine [email protected] 1
Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
2
Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, 500 University Drive, PO Box 850, Mail Code HU33, Hershey, PA 17033, USA
3
Department of Public Health Sciences, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
4
Liver Center, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
5
Cancer Institute, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, USA
(BMI) (CRF) (CVD) (DHHS) (EASL) (EIM) (FGF21) (FMD) (HS) (HIIT) (IHTG) (mTORC1) (VO2max) (METs) (MIC) (NHANES) (NAFL) (NAFLD) (NAS) (NASH)
Body mass index Cardiorespiratory fitness Cardiovascular disease Department of Health and Human Services European Association for the Study of Liver Exercise is Medicine Fibroblast growth factor 21 Flow-mediated dilation Hepatic steatosis High intensity interval training Intrahepatic triglyceride Mammalian target of rapamycin complex 1 Maximal oxygen uptake Metabolic equivalents Moderate intensity continuous National Health and Nutrition Examination Survey Nonalcoholic fatty liver Nonalcoh
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