Author (year); country | Intervention | Age range; sample size (% male) | Study duration | Outcome measures | Changes to outcome measures postintervention |
---|---|---|---|---|---|
Johnson (2009);18 Australia | Cycle ergometer 30–45 min 3×/week, increasing from 50–70% pretraining VO2 max | 43–51; 23 (65%) | 4 weeks | Primary: IHTG, SI, ALT Other: WT, BMI, Cholesterol, IMTG, SAT, VAT | ↓ IHTG* 1.76% No significant change SI, ALT, WT, BMI ↓ VAT* |
St George (2009);26 Australia | Counselling sessions; low-intensity: 3 fortnightly consultations; moderate-intensity: 2 groups received 6 fortnightly consultation, with 1 group receiving additional telephone support | 35–60; 141 (61%) | 3 months | Primary: ALT, AST Other: WT, BMI, LDL, HDL, GLC, TC, TG, GGT, physical activity | ↓ ALT*, and ↓ AST* in all groups, greatest seen in moderate-intensity intervention ↓ WT* and ↓ BMI*, greatest in moderate-intensity intervention |
Hallsworth (2011);27 UK | Resistance exercise 45–60 min, 3×/week | 33–72; 21 (NS) | 8 weeks | Primary: IHTG (MRS), ALT Other: WT, BMI, WC, HC, WHR, TC, TG, HbA1C, VAT, SAT, FM, GLC, INS, HOMA-IR | ↓ IHTG* 13%; 3 participants moved from clinical NAFLD to normal (<5% IHTG) No change ALT, WT, BMI |
Sullivan (2012);28 USA | Brisk walk 30–60 min, 5×/week | 44–51; 18 (38%) | 16 weeks | Primary: IHTG (MRS), ALT Other: WT, BM, FM, FFM, VO2 peak, TC, HDL, LDL, TG, FFA, VLDL | ↓IHTG* 10.3% , ↓ ALT* No change WT |
Bacchi (2013);16 Italy | Aerobic exercise (AER) at 60% VO2 max, 60 min 3×/week or, resistance exercises (RES) 60 min, 3×/week | 54–58; 31 (70%) | 4 months | Primary: IHTG (MRI), ALT, AST Other: BMI, HbA1c, GGT, TC, LDL, HDL, TG, FFM, IATG, SAT | ↓ IHTG* ∼35% in both groups; hepatic steatosis resolved in 3 AER and 4 of RES participants ↓ BMI* in both groups No change ALT, AST |
Zelber-Sagi (2014);29 Israel | Resistance training (RT) 40 min 3×/week or, stretching exercises 3×/week | 35–57; 82 (53%) | 3 months | Primary: HRI score (ultrasound), ALT, AST Other: WT, BMI, BP, GLC, INS, HOMA, TC, TG, HbA1C, HDL, LDL, GGT, FER | ↓ HRI score* 11% in RT group ↓ WT* and ↓ BMI* compared with stretching No change ALT, AST |
Keating (2015);19 Australia | Cycling ergometer and walking at either high intensity/low volume, 45 min 3×/week (HI/LO); low intensity/high volume, 60 min 4×/week (LO/HI); or low intensity/low volume, 45 min 3×/week (LO/LO) | 25–59; 48 (35%) | 8 weeks | Primary: IHTG (MRS), ALT, AST, SI, WT, BMI Other: WT, BMI, BP, WC, VO2 max, TG, TC, HDL, LDL, FFA, INS, GLC, VAT | ↓ IHTG* 2.4% (HI:LO), 2.6% (LO:HI), 0.8% (LO:LO) ↓ WT* 1.3% (HI:LO), 1.5% (LO:HI); ↓BMI* No change ALT, AST, SI |
Balducci (2015);17 Italy | Low-intensity resistance and aerobic exercise 2×/week or; high-intensity resistance and aerobic exercise 2× /week | Age NS; 606 (58%) | 12 months | Primary: AST, ALT, FLI Other: BMI, VAI, GGT, TG, WC, HOMA-IR, HbA1c | ↑ AST*, ↑ ALT*, in exercise and control groups ↓ FLI*, ↓BMI*, ↓VAI* in exercise group* |
Takahashi (2015);30 Japan | Regular resistance exercise 20–30 min 3×/week (RES) or education programme on benefits of dietary restrictions and regular physical activity | 36–68; 53 (35%) | 12 weeks | Primary: Steatosis (ultrasound), AST, ALT Other: FM, MM, LDL, HDL, TG, ALP, GGT, FER, GLC, INS, HOMA-IR, HbA1c | Primary: ↓ steatosis* in RES group No change AST, ALT, WT, BMI |
Cuthbertson (2016);31 UK | Supervised moderate-intensity aerobic exercise progressing from 30 min 3×/week to 45 min 5×/week(AER) or control of conventional counselling | 50 years (AER) 52 years (Ctrl) 50 (78%) | 16 weeks | Primary: IHCL (MRS), AST, ALT Other: WT, BMI, BP, TC, LDL, HDL, VO2 max | Primary: ↓ IHCL* 48% in AER only; ↓ AST*, ↓ ALT* in both; greatest in AER ↓ WT* and ↓ BMI* in AER group |
*Statistically significant.
ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BM, body mass; BMI, body mass index (kg/m2); BP, blood pressure; FER, ferritin; FFA, free fatty acids; FFM, fat free mass; FLI, Fatty Liver Index; FM, fat mass, GGT, gamma glutaryl transferase; GLC, glucose; HbA1c, glycosylated haemoglobin; HC, hip circumference; HDL, high-density lipoprotein; HOMA-IR, Homeostasis Model Assessment-Insulin Resistance Index; HRI, hepatorenal-ultrasound index; IATG, intra-abdominal triglyceride; IHCL, intrahepatocellular lipid; IHTG, intrahepatic triglyceride; IMTG, intramyocellular triglyceride; INS, insulin; LDL, low-density lipoprotein; MM, muscle mass; MRS, magnetic resonance spectroscopy; NAFLD, non-alcoholic fatty liver disease; NS, not stated; SAT, subcutaneous adipose tissue; SI, hepatic lipid saturation index; TC, total cholesterol; TG, triglyceride; VAT, visceral adipose tissue; VLDL, very low density lipoprotein; VO2 max, peak oxygen consumption (mL/kg/min); WC, waist circumference; WHR, waist:hip ratio; WT, weight.