Suitable exercise protocol for people with fatty liver

Non-alcoholic fatty liver disease (NAFLD) is closely associated with other metabolic disease and cardiovasculardisease. Regular exercise reduces hepatic fat content and could be the first-line treatment in the management ofNAFLD. This review aims to summarize the current evidence of the beneficial effects of exercise training andidentify the molecular pathways involved in the response to exercise to define their role in the resolution ofNAFLD both in animal and human studies. According to the inclusion criteria, ۴۳ animal studies and ۱۴ RCTswere included in this systematic review. Several exercise modalities were demonstrated to have a positive effecton liver function. Physical activity showed a strong association with improvement in inflammation, and reductionin steatohepatitis and fibrosis in experimental models. Furthermore, both aerobic and resistance exercise in humanstudies were demonstrated to reduce liver fat, and to improve insulin resistance and blood lipids, regardless ofweight loss, although aerobic exercises may be more effective. Resistance exercise is more feasible for patientswith NAFLD with poor cardiorespiratory fitness. More effort and awareness should be dedicated to encouragingNAFLD patients to adopt an active lifestyle and benefit from it its effects in order to reduce this growing publichealth problem.