Effect of Aerobic and Resistance Exercise Training on Liver Enzymes and Hepatic Fat in Iranian Men With Nonalcoholic Fatty Liver Disease Effects of Aerobic Versus Resistance Exercise Without Caloric Restriction on Abdominal Fat, Intrahepatic Lipid, and Insulin Sensitivity in Obese Adolescent Boys Effects of Therapeutic Lifestyle Program on Ultrasound‐diagnosed Nonalcoholic Fatty Liver Disease Effect of aerobic exercise training dose on liver fat and visceral adiposity. Short-term exercise reduces markers of hepatocyte apoptosis in nonalcoholic fatty liver disease. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Higher Levels of ATGL Are Associated with Exercise-Induced Enhancement of Lipolysis in Rat Epididymal Adipocytes Effect of six-week aerobic exercise on Chemerin and Resistin concentration in hypertensive postmenopausal women Therapeutic effects of restricted diet and exercise in obese patients with fatty liver. Inflammatory Markers and Adipocytokine Responses to Exercise Training and Detraining in Men Who Are Obese Physical activity as a treatment of non-alcoholic fatty liver disease: A systematic review. Both resistance training and aerobic training reduce hepatic fat content in type 2 diabetic subjects with nonalcoholic fatty liver disease (the RAED2 Randomized Trial). Randomized trial of exercise effect on intrahepatic triglyceride content and lipid kinetics in nonalcoholic fatty liver disease. Effect of resistance training on non-alcoholic fatty-liver disease a randomized-clinical trial. Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT.
Background : Nonalcoholic fatty liver disease ( NAFLD ) has different prevalence rates in various parts of the world and is a risk factor for diabetes and cardiovascular disease that could progress to nonalcoholic steatohepatitis , cirrhosis , and liver failure . Objectives : The current study aim ed to investigate the effect of Aerobic Training ( AT ) and resistance training ( RT ) on hepatic fat content and liver enzyme levels in Iranian men . Patients and Methods : In a r and omized clinical trial study , 30 men with clinical ly defined NAFLD were allocated into three groups ( aerobic , resistance and control ) . An aerobic group program consisted of 45 minutes of aerobic exercise at 60 % - 75 % maximum heart rate intensity , a resistance group performed seven resistance exercises at intensity of 50 % - 70 % of 1 repetition maximum ( 1RM ) and the control group had no exercise training program during the study . Before and after training , anthropometry , insulin sensitivity , liver enzymes and hepatic fat were elevated . Results : After training , hepatic fat content was markedly reduced , to a similar extent , in both the aerobic and resistance exercise training groups ( P ≤ 0.05 ) . In the two exercise training groups , alanine amino transferase and aspartate amino transferase serum levels were significantly decreased compared to the control group ( P = 0.002 ) and ( P = 0.02 ) , respectively . Moreover , body fat ( % ) , fat mass ( kg ) , homeostasis model assessment insulin resistance ( HOMI-IR ) were all improved in the AT and RT . These changes in the AT group were independent of weight loss . Conclusions : This study demonstrated that RT and AT are equally effective in reducing hepatic fat content and liver enzyme levels among patients with NAFLD . However , aerobic exercise specifically improves NAFLD independent of any change in body weight The optimal exercise modality for reductions of abdominal obesity and risk factors for  type 2 diabetes in youth is unknown . We examined the effects of aerobic exercise ( AE ) versus resistance exercise ( RE ) without caloric restriction on abdominal adiposity , ectopic fat , and insulin sensitivity and secretion in youth . Forty-five obese adolescent boys were r and omly assigned to one of three 3-month interventions : AE , RE , or a nonexercising control . Abdominal fat was assessed by magnetic resonance imaging , and intrahepatic lipid and intramyocellular lipid were assessed by proton magnetic resonance spectroscopy . Insulin sensitivity and secretion were evaluated by a 3-h hyperinsulinemic-euglycemic clamp and a 2-h hyperglycemic clamp . Both AE and RE prevented the significant weight gain that was observed in controls . Compared with controls , significant reductions in total and visceral fat and intrahepatic lipid were observed in both exercise groups . Compared with controls , a significant improvement in insulin sensitivity ( 27 % ) was observed in the RE group . Collapsed across groups , changes in visceral fat were associated with changes in intrahepatic lipid ( r = 0.72 ) and insulin sensitivity ( r = −0.47 ) . Both AE and RE alone are effective for reducing abdominal fat and intrahepatic lipid in obese adolescent boys . RE but not AE is also associated with significant improvements in insulin sensitivity Background : To investigate the effects of varied therapeutic lifestyle programs on patients with ultrasound‐diagnosed nonalcoholic fatty liver disease ( NAFLD ) . Methods : A prospect i ve , case‐controlled study was conducted . A total of 54 subjects with NAFLD were subdivided into 3 groups : ( 1 ) diet plus exercise group ( DPE group , n = 16 ) ; ( 2 ) exercise group ( E group , n = 23 ) ; and ( 3 ) control group ( C group , n = 15 ) . The DPE group received a low‐calorie balanced diet and regular high‐intensity stationary bicycle exercise program for 10 weeks , while the E group received the same exercise protocol as the DPE group but without any changes in diet . Anthropometric indices , biochemical data , physical fitness data and liver ultrasound findings were recorded . A generalized estimating equation method was used to determine the differences among groups . Results : Compared with the C group , the DPE group demonstrated significant improvements in anthropometric indices , total cholesterol , insulin sensitivity , liver biochemistry , ultrasound finding and physical fitness , while the E group showed significant improvements in anthropometric indices , insulin sensitivity status , ultrasound finding and physical fitness but not liver biochemistry . Compared with the E group , the DPE group showed greater reduction in anthropometric indices ( body mass index , body weight , abdominal circumference , hip circumference ) , total cholesterol , alanine aminotransferase , and γ‐glutamyltransferase . Conclusion : Our data suggest that both 10‐week diet‐plus‐exercise and exercise‐only therapeutic lifestyle programs are effective for improving anthropometric indices , insulin sensitivity , ultrasound findings and physical fitness in ultrasound‐diagnosed NAFLD patients . However , the range of improvement in patients on the diet‐plus‐exercise program is more obvious than that in patients on the exercise‐only program . Moreover , the diet‐plus‐exercise program result ed in significant improvement in liver biochemistry , but the exercise‐only program did not . In summary , diet plus exercise is more efficacious than exercise alone in the lifestyle modification treatment of NAFLD BACKGROUND & AIMS Aerobic exercise reduces liver fat and visceral adipose tissue ( VAT ) . However , there is limited data from r and omized trials to inform exercise programming recommendations . This study examined the efficacy of commonly prescribed exercise doses for reducing liver fat and VAT using a r and omized placebo-controlled design . METHODS Inactive and overweight/obese adults received 8 weeks of either ; i ) low to moderate intensity , high volume aerobic exercise ( LO : HI , 50 % VO 2peak , 60 min , 4d/week ) ; ii ) high intensity , low volume aerobic exercise ( HI : LO , 70 % VO 2peak , 45 min , 3d/week ) ; iii ) low to moderate intensity , low volume aerobic exercise ( LO : LO , 50 % VO 2peak , 45 min , 3d/week ) ; or iv ) placebo ( PLA ) . Liver fat ( spectroscopy ) and VAT ( magnetic resonance imaging ) were measured before and after intervention . RESULTS Forty-seven of the 48 ( n = 12 in each group ) participants completed the trial . There were no serious adverse events . There was a significant change in group × time interaction in liver fat , which reduced in HI : LO by 2.38 ± 0.73 % , in LO : HI by 2.62 ± 1.00 % , and in LO : LO by 0.84 ± 0.47 % but not in PLA ( increase of 1.10 ± 0.62 % ) ( p = 0.04 ) . There was a significant reduction in VAT in HI : LO ( -258.38 ± 87.78 cm(3 ) ) , in LO : HI ( -386.80 ± 119.5 cm(3 ) ) , and in LO : LO ( -212.96 ± 105.54 cm(3 ) ) , but not in PLA ( 92.64 ± 83.46 cm(3 ) ) ( p = 0.03 ) . There were no significant differences between the dose or intensity of the exercise regimen and reductions in liver fat or VAT ( p > 0.05 ) . CONCLUSION The study found no difference in efficacy of liver fat reduction by either aerobic exercise dose or intensity . All of the aerobic exercise regimens employed reduced liver fat and VAT by a small amount without clinical ly significant weight loss Increased hepatocyte apoptosis is a hallmark of nonalcoholic fatty liver disease ( NAFLD ) and contributes to the profibrogenic state responsible for the progression to nonalcoholic steatohepatitis ( NASH ) . Strategies aim ed at reducing apoptosis may result in better outcomes for individuals with NAFLD . We therefore examined the effect of a short-term exercise program on markers of apoptosis-plasma cytokeratin 18 ( CK18 ) fragments , alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) , soluble Fas ( sFas ) , and sFas lig and (sFasL)-in  13 obese individuals with NAFLD [ body mass index 35.2 ± 1.2 kg/m(2 ) , > 5 % intrahepatic lipid ( IHL ) assessed by (1)H-MR spectroscopy ]  . Exercise consisted of treadmill walking for 60 min/day on 7 consecutive days at ∼85 % of maximal heart rate . Additionally , subjects underwent an oral glucose tolerance test and a maximal oxygen consumption ( Vo(2max ) ) test before and after the exercise intervention . The Matsuda index was used to assess insulin sensitivity . We observed significant decreases in CK18 fragments ( 558.4 ± 106.8 vs. 323.4 ± 72.5 U/l , P < 0.01 ) and ALT ( 30.2 ± 5.1 vs. 24.3 ± 4.8 U/l , P < 0.05 ) , and an increase in whole body fat oxidation ( 49.3 ± 6.1 vs. 69.4 ± 7.1 mg/min , P < 0.05 ) , while decreases in circulating sFasL approached statistical significance ( 66.5 ± 6.0 vs. 63.0 ± 5.7 pg/ml , P = 0.06 ) , as did the relationship between percent change in circulating CK18 fragments and ALT ( r = 0.55 , P = 0.05 ) . We also observed a significant correlation between changes in fat oxidation and circulating sFasL ( rho = -0.65 , P < 0.05 ) . There was no change in IHL following the intervention ( 18.2 ± 2.5 vs. 17.5 ± 2.1 % , NS ) . We conclude that short-term exercise reduces a circulatory marker of hepatocyte apoptosis in obese individuals with NAFLD and propose that changes in the proapoptotic environment may be mediated through improved insulin sensitivity and increased oxidative capacity OBJECTIVE To determine the efficacy of high-intensity progressive resistance training ( PRT ) on glycemic control in older adults with type 2 diabetes . RESEARCH DESIGN AND METHODS We performed a 16-week r and omized controlled trial in 62 Latino older adults ( 40 women and 22 men ; mean + /- SE age 66 + /- 8 years ) with type 2 diabetes r and omly assigned to supervised PRT or a control group .  Glycemic control , metabolic syndrome abnormalities , body composition , and muscle glycogen stores were determined before and after the intervention . RESULTS Sixteen weeks of PRT ( three times per week ) result ed in reduced plasma glycosylated hemoglobin levels ( from 8.7 + /- 0.3 to 7.6 + /- 0.2 % ) , increased muscle glycogen stores ( from 60.3 + /- 3.9 to 79.1 + /- 5.0 mmol glucose/kg muscle ) , and reduced the dose of prescribed diabetes medication in 72 % of exercisers compared with the control group , P = 0.004 - 0.05 . Control subjects showed no change in glycosylated hemoglobin , a reduction in muscle glycogen ( from 61.4 + /- 7.7 to 47.2 + /- 6.7 mmol glucose/kg muscle ) , and a 42 % increase in diabetes medications . PRT subjects versus control subjects also increased lean mass ( + 1.2 + /- 0.2 vs. -0.1 + /- 0.1 kg ) , reduced systolic blood pressure ( -9.7 + /- 1.6 vs. + 7.7 + /- 1.9 mmHg ) , and decreased trunk fat mass ( -0.7 + /- 0.1 vs. + 0.8 + /- 0.1 kg ; P = 0.01 - 0.05 ) . CONCLUSIONS PRT as an adjunct to st and ard of care is feasible and effective in improving glycemic control and some of the abnormalities associated with the metabolic syndrome among high-risk older adults with type 2 diabetes Background In adipose cells , adipose triglyceride lipase ( ATGL ) catalyzes the first step in adipocyte triacylglyceride hydrolysis , thereby regulating both basal and hormone-stimulated lipolysis . However , little is known about the molecular mechanism(s ) underlying habitual exercise-induced adaptive modulation of ATGL in white adipocytes via alteration in transcription regulator and lipolytic cofactors . Methodology /Principal Results Male Wistar rats were r and omly divided into 2 groups a sedentary control group ( CG ) and a habitual exercise group ( EG ) . The EG was subjected to running on a treadmill set at 5 days per week for 9 weeks . The CG was not subjected to running on a treadmill . In the EG , levels of ATGL mRNA and protein were elevated with a significant increase in lipolysis compared with the CG , accompanied by a significant increase in associations of CGI-58 with ATGL protein . Under these conditions , an upregulation of peroxisome proliferation-activated receptorg-2 ( PPARg-2 ) was observed . In the EG , the addition of rosiglitazone further significantly increased the levels of ATGL protein compared with the CG . However , attenuated levels of the ATGL protein in adipocytes were obtained by the addition of insulin , which is known to inhibit the expression of ATGL , in both types of groups . Actually , levels of plasma insulin were significantly reduced in the EG compared with the CG . Conclusions These data suggest that elevated levels of ATGL are involved in the exercise-induced enhancement of lipolysis in primary adipocytes . The exact mechanism(s ) underlying this phenomenon is associated , at least in part , with upregulated transcriptional activation of PPARg-2 . In addition , exercise-induced lower circulation levels of insulin also correlate with habitual exercise-induced higher levels of ATGL in primary adipocytes Background : Physical activity reduces symptoms of cardiovascular diseases . The aim of this study was to examine the effect of six-week aerobic exercise upon Chemerin and Resistin concentration in women with menopause who had hypertension . Methods : The population of this quasi-experimental study included postmenopausal women diagnosed with hypertension . They were 50 to 55 years old and lived in Amol , a city in north part of Iran . Twenty volunteers were filled the personal consent and Health Question naire . They were r and omly assigned to Experimental and control groups equally ( n=10 per group ) . The experimental group conducted a 6-week aerobic training program from 8–10am every day . Results : Endurance exercise  decreased Chemerin ( t=10.41 , P<0.000 ) and Resistin ( t=2.42 , P<0.051 ) ; indicating the decline of inflammation and cardiovascular disease . Conclusion : Considering anti-inflammatory effects of exercise , training plays an important role in reducing inflammatory indices in human ; and endurance training can be a good strategy to deal with inflammation and cardiac- vascular risk factors BACKGROUND / AIMS The incidence of obese patients with fatty liver has recently increased in Japan as well as in the United States and Europe . Fatty liver may occasionally progress to liver cirrhosis . In this study , we have compared the effects of restricted diet and exercise versus no treatment in obese patients with fatty liver . METHODS Twenty-five obese patients with fatty liver were divided into treated and control groups . Fifteen obese patients followed a program of restricted diet ( ideal weight x 25 Cal x kg(-1 ) ) and exercise ( walking or jogging ) for a trial period of 3 months . No changes in diet or lifestyle were made by the other 10 patients during the same trial period . Blood biochemical tests and liver histology were compared in all patients before and after the trial . RESULTS In the treated group , weight , blood biochemical data such as aminotransferase , albumin , cholinesterase , total cholesterol and fasting blood glucose values , and steatosis were significantly decreased after the trial . In the control group , there were no significant differences in the clinical and histological findings before and after the trial . CONCLUSIONS These results indicate that restricted diet and exercise therapy , such as walking and jogging , are useful means of improving blood biochemical data and histological findings in liver tissues related to fatty liver Abstract Nikseresht , M , Sadeghifard , N , Agha-Alinejad , H , and Ebrahim , K. Inflammatory markers and adipocytokine responses to exercise training and detraining in men who are obese . J Strength Cond Res 28(12 ) : 3399–3410 , 2014—The purpose of this study was to compare the effects of nonlinear resistance training ( NRT ) and aerobic interval training ( AIT ) , and detraining on selected inflammatory markers in men who are middle aged and obese . Subjects first were matched by aerobic capacity , age , and percentage body fat and then r and omly assigned to NRT ( n = 12 ) , AIT ( n = 10 ) and , control ( CON , n = 11 ) groups . The experimental groups performed 3 weekly sessions for 12 weeks followed by a 4-week detraining period . Nonlinear resistance training consisted of 40–65 minutes of weight training with flexible periodization . Aerobic interval training consisted of running on a treadmill ( 4 × 4 minutes at 80–90 % maximal heart rate , with 3-minute recovery intervals ) . Compared with CON , serum levels of interleukin 6 ( IL-6 ) , C-reactive protein ( CRP ) , and tumor necrosis factor alpha ( TNF-&agr ; ) did not significantly change after training , but adiponectin ( ADPN ) increased significantly only with AIT ( 5.09 ± 2.29 vs. 4.36 ± 0.84 & mgr;g·ml−1 ) . No significant changes in CRP and TNF-&agr ; occurred in both training groups after detraining , but ADPN ( NRT : 3.6 ± 1.2 and AIT : 3.4 ± 1.7 vs. CON : 4.7 ± 1.2 & mgr;g·ml−1 ) and IL-6 ( NRT : 5.8 ± 3.3 and AIT : 5.5 ± 2.9 vs. CON : 2.3 ± 1.2 pg·ml−1 ) worsened significantly . Both the AIT and NRT were equally effective at reducing soluble intercellular cell adhesion molecule 1 ( NRT : 187.2 ± 117.5 and AIT : 215.2 ± 142.4 vs. CON : 416.2 ± 205.9 ng·ml−1 ) and insulin ( NRT : 4.0 ± 1.0 and AIT : 4.8 ± 2.7 vs. CON : 7.4 ± 3.0 & mgr;U·ml−1 ) levels , but these variables returned to the pretraining levels after detraining . The practical applications are that both the AIT and NRT and detraining had similar effects on most inflammatory markers in men who are obese , but the AIT seems to have better anti-inflammatory effects ( as indicated by ADPN ) compared with NRT AIM To review the effectiveness of exercise as a therapy for nonalcoholic fatty liver disease ( NAFLD ) and potential benefits in treating insulin resistance and atherosclerosis . METHODS Medline ( EBSCOhost ) and PubMed were search ed for English- language r and omized controlled trials and prospect i ve cohort studies in human adults aged ≥ 18 which investigated the various effects of exercise alone , a combination of exercise and diet , or exercise and diet coupled with behavioral modification on NAFLD from 2010 to Feburary 2015 . RESULTS Eighteen of 2298 available studies were chosen for critical review , which included 6925 patients . Nine ( 50 % ) studies were r and omized controlled trials . Five ( 27.8 % ) studies utilized biopsy to examine the effects of physical activity on hepatic histology . The most commonly employed imaging modality to determine change in hepatic steatosis was hydrogen-magnetic resonance spectroscopy . Only two studies examined the effects of low impact physical activity for patients with significant mobility limitations and one compared the efficacy of aerobic and resistance exercise . No studies examined the exact duration of exercise required for hepatic and metabolic improvement in NAFLD . CONCLUSION  While exercise improved hepatic steatosis and underlying metabolic abnormalities in NAFLD , more studies are needed to define the most beneficial form and duration of exercise treatment UNLABELLED Although lifestyle interventions are considered the first-line therapy for nonalcoholic fatty liver disease ( NAFLD ) , which is extremely common in people with type 2 diabetes , no intervention studies have compared the effects of aerobic ( AER ) or resistance ( RES ) training on hepatic fat content in type 2 diabetic subjects with NAFLD . In this r and omized controlled trial , we compared the 4-month effects of either AER or RES training on insulin sensitivity ( by hyperinsulinemic euglycemic clamp ) , body composition ( by dual-energy X-ray absorptiometry ) , as well as hepatic fat content and visceral ( VAT ) , superficial ( SSAT ) , and deep ( DSAT ) subcutaneous abdominal adipose tissue ( all quantified by an in-opposed-phase magnetic resonance imaging technique ) in 31 sedentary adults with type 2 diabetes and NAFLD . After training , hepatic fat content was markedly reduced ( P < 0.001 ) , to a similar extent , in both the AER and the RES training groups ( mean relative reduction from baseline [ 95 % confidence interval ] -32.8 % [ -58.20 to -7.52 ] versus -25.9 % [ -50.92 to -0.94 ] , respectively ) . Additionally , hepatic steatosis ( defined as hepatic fat content > 5.56 % ) disappeared in about one-quarter of the patients in each intervention group ( 23.1 % in the AER group and 23.5 % in the RES group ) . Insulin sensitivity during euglycemic clamp was increased , whereas total body fat mass , VAT , SSAT , and hemoglobin A1c were reduced comparably in both intervention groups . CONCLUSION This is the first r and omized controlled study to demonstrate that resistance training and aerobic training are equally effective in reducing hepatic fat content among type 2 diabetic patients with NAFLD UNLABELLED Nonalcoholic fatty liver disease ( NAFLD ) and alterations in hepatic lipoprotein kinetics are common metabolic complications associated with obesity . Lifestyle modification involving diet-induced weight loss and regular exercise decreases intrahepatic triglyceride ( IHTG ) content and very low density lipoprotein ( VLDL ) triglyceride ( TG ) secretion rate . The aim of this study was to evaluate the weight loss-independent effect of following the physical activity guidelines recommended by the Department of Health and Human Services on IHTG content and VLDL kinetics in obese persons with NAFLD . Eighteen obese people ( body mass index [ BMI ] : 38.1 ± 4.6 kg/m(2 ) ) with NAFLD were r and omized to 16 weeks  of exercise training ( 45%-55 % VO(2peak ) , 30 - 60 minutes × 5 days/week ; n = 12 ) or observation ( control ; n = 6 ) . Magnetic resonance spectroscopy and stable isotope tracer infusions in conjunction with compartmental modeling were used to evaluate IHTG content and hepatic VLDL-TG and apolipoprotein B-100 ( apoB-100 ) secretion rates  . Exercise training result ed in a 10.3 % ± 4.6 % decrease in IHTG content ( P < 0.05 ) , but did not change total body weight ( 103.1 ± 4.2 kg before and 102.9 ± 4.2 kg after training ) or percent body fat ( 38.9 % ± 2.1 % before and 39.2 % ± 2.1 % after training ) . Exercise training did not change the hepatic VLDL-TG secretion rate ( 17.7 ± 3.9 μmol/min before and 16.8 ± 5.4 μmol/min after training ) or VLDL-apoB-100 secretion rate ( 1.5 ± 0.5 nmol/min before and 1.6 ± 0.6 nmol/min after training ) . CONCLUSION Following the Department of Health and Human Services recommended physical activity guidelines has small but beneficial effects on IHTG content , but does not improve hepatic lipoprotein kinetics in obese persons with NAFLD AIM To evaluate the effect of resistance training ( RT ) on non alcoholic liver disease ( NAFLD ) patients . METHODS A r and omized clinical trial enrolling NAFLD patients without secondary liver disease ( e.g. , without hepatitis B virus , hepatitis C virus or excessive alcohol consumption ) . Patients were r and omly allocated either to RT , three times weekly , for 3 mo or a control arm consisting of home stretching . The RT included leg press , chest press , seated rowing , latissimus pull down etc . with 8 - 12 repetitions , 3 sets for each exercise , for a total duration of 40 min . Hepatic ultrasound , fasting blood tests , anthropometrics and body composition by dual energy X-ray absorptiometry were assessed . At baseline and follow-up , patients filled out a detailed semi-quantitative food frequency question naire reporting their habitual nutritional intake . Steatosis was quantified by the hepatorenal-ultrasound index ( HRI ) representing the ratio between the brightness level of the liver and the right kidney . The HRI has been previously demonstrated to be highly reproducible and was vali date d against liver biopsy and proton magnetic resonance spectroscopy . RESULTS Eighty two patients with primary NAFLD were r and omized to receive 3 mo of either RT or stretching . After dropout or exclusion from analysis because of protocol violation ( weight change > 3 kg ) , thirty three patients in the RT arm and 31 in the stretching arm completed the study per protocol . All baseline characteristics were similar for the two treatment groups with respect to demographics , anthropometrics and body composition , blood tests and liver steatosis on imaging . HRI score was reduced significantly in the RT arm as compared to the stretching arm ( -0.25 ± 0.37 vs -0.05 ± 0.28 , P = 0.017 ) . The RT arm had a significantly higher reduction in total , trunk and and roid fat with increase in lean body mass . There was no correlation between the reduction in HRI in the RT arm and weight change during the study , but it was positively correlated with the change in trunk fat ( r = 0.37 , P = 0.048 ) . The RT arm had a significant reduction in serum ferritin and total cholesterol . There was no significant difference between arms in dietary changes and these did not correlate with HRI change . CONCLUSION Three months RT  improves hepatic fat content accompanied by favorable changes in body composition and ferritin . RT may serve as a complement to treatment of NAFLD While the benefits of exercise are clear , many unresolved issues surround the optimal exercise prescription . Many organizations recommend aerobic training ( AT ) and resistance training ( RT ) , yet few studies have compared their effects alone or in combination . The purpose of this study , part of Studies Targeting Risk Reduction Interventions Through Defined Exercise-Aerobic Training and /or Resistance Training ( STRRIDE/AT/RT ) , was to compare the effects of AT , RT , and the full combination ( AT/RT ) on central ectopic fat , liver enzymes , and fasting insulin resistance [ homeostatic model assessment ( HOMA ) ] . In a r and omized trial , 249 subjects [ 18 - 70 yr old , overweight , sedentary , with moderate dyslipidemia ( LDL cholesterol 130 - 190 mg/dl or HDL cholesterol ≤ 40 mg/dl for men or ≤ 45 mg/dl for women ) ] performed an initial 4-mo run-in period . Of these , 196 finished the run-in and were r and omized into one of the following 8-mo exercise-training groups : 1 ) RT , which comprised 3 days/wk , 8 exercises , 3 sets/exercise , 8 - 12 repetitions/set , 2 ) AT , which was equivalent to ∼19.2 km/wk ( 12 miles/wk ) at 75 % peak O(2 ) uptake , and 3 ) full AT + full RT ( AT/RT ) , with 155 subjects completing the intervention . The primary outcome variables were as follows : visceral and liver fat via CT , plasma liver enzymes , and HOMA . AT led to significant reductions in liver fat , visceral fat , alanine aminotransferase , HOMA , and total and subcutaneous abdominal fat ( all P < 0.05 ) . RT result ed in a decrease in subcutaneous abdominal fat ( P < 0.05 ) but did not significantly improve the other variables . AT was more effective than RT at improving visceral fat , liver-to-spleen ratio , and total abdominal fat ( all P < 0.05 ) and trended toward a greater reduction in liver fat score ( P < 0.10 ) . The effects of AT/RT were statistically indistinguishable from the effects of AT . These data show that , for overweight and obese individuals who want to reduce measures of visceral fat and fatty liver infiltration and improve HOMA and alanine aminotransferase , a moderate amount of aerobic exercise is the most time-efficient and effective exercise mode
BACKGROUND & AIMS Exercise is a first-line therapy for patients with non-alcoholic fatty liver disease ( NAFLD ) .
We sought to : 1 ) summarize effective aerobic and resistance exercise protocol s for NAFLD ; and 2 ) compare the effects and energy consumption of aerobic and resistance exercises .