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The Importance of Exercise

two people biking outdoorsNon-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, owing in no small part to the increasingly high rates of obesity in the American population. In a 2019 study published in Gene Expression: The Journal of Liver Research, researchers found that physical exercise could benefit people with NAFLD - including those who had the disease in its most inflammatory form - nonalcoholic steatohepatitis (NASH). In their study, they relied on a moderate exercise routine lasting 20-to-60 minutes for four to seven days a week. The routine included both aerobic and weights/resistance training. Their results showed that the positive effects of exercise were observed whether or not participants lost weight.

In the study, the researchers were able to comprehend the molecular reactions that occur when human beings engage in both cardiovascular and strength exercises. In one study by Bacchi et al, it was found that both types of exercise substantially increased insulin sensitivity and improved metabolic markers like visceral fat and HbA1C. Considering the fact that insulin resistance is thought to be a contributor to NASH, the findings are certainly worth taking into account.

If you wish to lose weight, your health team may recommend safe yet effective exercises like cycling, walking, and swimming. All these exercise forms can be adapted to various fitness levels, and all are low-stress when it comes to joints like the knees. You should ideally try to include around half an hour of cardio training a day. Outdoor exercises like cycling burn more calories because of terrain changes, wind resistance etc. but arguably the most important thing is to choose a workout you can stick to. If you are pressed for time or you live in an area with very cold or hot weather, an aerobics, spin, or Zumba class at the gym may be your ideal workout.

If you have fatty liver disease, ask your health team if they can recommend a strength exercise regimen covering the major muscles - including biceps, triceps, quadriceps, pectorals, and calves. The precise number of repetitions and the amount of weight recommended to lift will depend on a variety of factors, including your current fitness level, age, and goals. If you wish to lose weight, for instance, your trainer may recommend a high number of reps and lower weight. If muscle building is on the agenda, meanwhile, you may be instructed to complete a smaller number of reps of heavier weights. As found in a study by Kate Hallsworth et al, weight loss is not the ultimate goal when it comes to weight training, since resistance exercise not only reduces liver fat, but also improves fat oxidation and improves glucose control. Aim to complete resistance workouts at least twice a week and ensure there is a progression in your routine. Your trainer should regularly update and add weight or repetitions to give you a bigger challenge. 

Many people consume too much food because of stress and anxiety. If you can relate to this habit, then try to include exercises that reduce stress. Your cardio and strength workouts will probably already be doing plenty to lift your mood and help you sleep better, but for an extra boost, try to make a little time in your day for yoga or Tai Chi. Both these exercises have been found to significantly lower stress hormone, cortisol levels. Just a short session can have major benefits, so including them in your pre-bedtime routine may be useful.

Exercise is necessary for everyone, but when it comes to people with fatty liver disease, it can be particularly vital, since research has shown it can benefit NAFLD by reducing hepatic fat content. Exercise can improve insulin sensitivity and improve liver fatty acid metabolism. Make sure to run by any proposed regime with your health team, enlisting the help of an experienced trainer if necessary.