Globally, the incidence of non-alcoholic fatty liver disease (NAFLD) is climbing at an alarming rate and is becoming a health problem that cannot be ignored. This disease is characterized by the accumulation of fat in the liver and is not associated with excessive alcohol consumption. Non-alcoholic fatty liver disease is not only strongly associated with obesity, but is also a strong predictor of insulin resistance and the development of type 2 diabetes. Although there are currently drugs that can alleviate the accumulation of liver fat to some extent, the safety of these drugs and the side effects that may cause weight gain have attracted a lot of attention. As a result, scientists and doctors are increasingly inclined to explore non-pharmacological treatments, particularly through lifestyle changes to combat the disease.
Among them, physical activity has been shown to be an effective lifestyle therapy, not only to reduce liver fat, but also to improve cardiovascular health and improve quality of life. In addition, alternate day fasting has received widespread attention in recent years as an emerging dietary strategy, which has demonstrated the potential for weight loss and improved indicators of non-alcoholic fatty liver disease by alternating between strict "fasting days" and free "eating days".
With this in mind, a recent study aimed to explore the effects of combining fasting with aerobic exercise to see if this approach could lead to more significant benefits than fasting or exercise alone while reducing non-alcoholic fatty liver disease. In a three-month trial of obese and non-alcoholic fatty liver disease patients, the research team compared the effects of different interventions on liver health, with the aim of providing more effective non-pharmacological treatment options for this common condition.
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Fasting and exercise regimens
In the three-month study, 80 adults with obesity and nonalcoholic fatty liver disease from the Liver Disease Clinic at the University of Illinois Medical Center at Chicago were randomly assigned to four different groups: a control group that fasted and exercised at the same time, fasted only, did aerobic exercise only, or did no intervention at all. The participants ranged in age from 23 to 65 years, and 81% were women. The main objective of this experiment was to examine the effects of these different methods on visceral triglyceride content, which is a key indicator of liver fat accumulation.
In the alternating fasting group, participants consumed a 600-calorie dinner on the evening of fasting days (5:00 p.m. to 8:00 p.m.) and were allowed to eat ad libitum on alternating ad libitum days. This pattern means that on fasting days, participants will fast for approximately 17 to 20 hours. Participants were encouraged to drink plenty of water during fasting periods and were allowed to consume non-caloric beverages such as black coffee, tea, and diet soda in moderation. In addition, the aerobic exercise group and the fasting combined exercise group participated in moderate-intensity aerobic exercise supervised by the investigators for 60 minutes five times a week.
Aerobic exercises include treadmill, stationary cycling and elliptical training.
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Key findings:
After 3 months of intervention, the content of visceral triglycerides, a marker of fatty liver in the combined intervention group, was significantly reduced (-5.48%), which was significantly different from the exercise group (-1.30%) and the control group (-0.17%), but not with the fasting group (-2.25%).
Body weight (-4.58%) and fat mass (-3.24 kg) were significantly reduced in the combined intervention group compared with the exercise and control groups, but there was no significant difference compared with the alternating fasting group (-5.06% weight loss and -3.32 kg reduction in fat mass).
Insulin resistance and sensitivity improved in the combination intervention group compared to the control group, with no significant difference compared to exercise or fasting alone.
There were no significant differences in blood pressure, heart rate, and concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides between the four groups.
Actual energy intake was consistent with the energy target (600 kcal) on the scheduled fasting day, and participants had a high level of compliance with the intervention. Ninety-five percent of participants in the combined intervention group and 85 percent of participants in the fasting group expressed a willingness to continue the fasted diet after the end of the study.
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conclusion
This study suggests that a combination of alternating fasting and aerobic exercise is effective in reducing liver fat accumulation in patients with NAFLD, but may not provide additional benefit compared with fasting alone. In addition, the high level of compliance of participants with this intervention suggests that the approach is feasible for improving non-alcoholic fatty liver disease.
Source: International Hepatobiliary Information