NEW DELHI: Moderate-to-vigorous-intensity exercise, for example brisk walking, cycling and jogging, for 150-240 min per week can help reduce liver fat by 30%, the Asian Pacific Association for the Study of the Liver (APASL) has said.
In its first-ever clinical guideline for managing metabolic-dysfunction associated fatty liver disease (MAFLD), the expert body has said while a combination of diet and structured exercise training has synergistic benefits for persons suffering from the condition, regular exercise alone elicits broad hepatic (liver-related) and cardiometabolic benefits irrespective of weight loss and can improve health-related quality of life. “Regular exercise improves insulin sensitivity, reduces inflammation, and alters substrate metabolism in the muscle, liver and adipose tissue, which affects hepatic free fatty acid flux,” says the APASL guideline, which has been published in Hepatology International. It recommends 150-240 min per week of moderate-to-vigorous-intensity aerobic exercise for meaningful reduction in liver fat but suggests that as little as 135 min per week may also be effective.
MAFLD refers to a build-up of fat in the liver, in addition to one or more metabolic risk factors such as overweight/obesity, Type2 diabetes, raised cholesterol in blood and metabolic dysregulation, among others.
A recent survey carried out across 11 districts of Delhi has found that nearly one in every two persons above 18 years of age have MAFLD.
Dr S K Sarin, an expert involved in developing the APASL guideline, who is also the director of ILBS, said MAFLD is associated with severe liver diseases like non-alcoholic steatohepatitis (accumulation of liver fat in people who drink little or no alcohol), scarring or permanent damage of the liver, liver cancer, and premature death. “Fatty liver precedes high cholesterol, diabetes, high blood pressure and other non-communicable diseases by 10-15 years. By preventing and reversing fatty liver, we could reduce this burden in a decade,” Dr Sarin said.
While intensity-dependent benefits are not apparent for fatty liver, the APASL says, emerging evidence demonstrates that high-intensity interval training involving one or more bursts of high-intensity exercise interspersed with lower-intensity recovery periods is equally effective under the supervision of an exercise professional. Healthy eating is another key aspect of MAFLD management. The APASL guideline recommends that MAFLD patients should be advised to consume 1200-1800 kcal a day or 500-750 kcal less daily for weight loss. “Coffee consumption (three or more cups per day), regardless of caffeine content, is considered to be beneficial,” it adds. If left untreated or not managed well, MAFLD can lead to serious complications, such as chronic liver disease and liver cancer.