Highlights • Adults with nonalcoholic fatty liver disease (NAFLD) followed a protocol of intermittent fasting plus exercise for 3 months. • Hepatic steatosis was significantly reduced by 5.5% compared to controls. • Body weight, fat mass and waist circumference also decreased compared to controls. • By month 3, ALT was reduced, while insulin sensitivity increased, compared to controls. |
Summary
Innovative non-pharmacological lifestyle strategies are urgently needed to treat nonalcoholic fatty liver disease (NAFLD). This study compared the effects of alternate-day fasting (ADF) combined with exercise with fasting alone, or exercise alone, on intrahepatic triglyceride (IHTG) content.
Adults with obesity and NAFLD (n = 80, 81% women, age: 23–65 years) were randomly assigned to 1 of 4 groups for 3 months: ADF combination (600 kcal/2500 kJ “fasting day” alternating with ad libitum intake “holiday”) and moderate intensity aerobic exercise (5 sessions per week, 60 min/session); exercise alone; or a control group without intervention.
At month 3, IHTG content was significantly reduced in the combination group (−5.48%; 95% CI, −7.77% to −3.18%), compared with the exercise group ( −1.30%; 95% CI, −3.80% to 1.20%; p = 0.02) and the control group (−0.17%; 95% CI, −2.17% to 1 .83%; p < 0.01), but was not significantly different compared to the ADF group (−2.25%; 95% CI, −4.46% to −0.04%; p = 0.05).
Body weight , fat mass, waist circumference, and alanine transaminase (ALT) levels decreased significantly, while insulin sensitivity increased significantly in the combination group compared to the control group.
Fat-free mass, aspartate transaminase (AST), HbA1c, blood pressure, plasma lipids, liver fibrosis score, and hepatokines (fetuin-A, FGF-21, and selenoprotein P) did not differ between groups.
Combining intermittent fasting with exercise is effective in reducing hepatic steatosis in patients with NAFLD, but may not offer any additional benefit compared to fasting alone.
