Exercise in the Management of Metabolic-Associated Fatty Liver Disease (MAFLD) in Adults: A Position Statement from Exercise and Sport Science Australia.
Journal
Sports medicine (Auckland, N.Z.)
ISSN: 1179-2035
Titre abrégé: Sports Med
Pays: New Zealand
ID NLM: 8412297
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
accepted:
18
08
2023
medline:
30
11
2023
pubmed:
11
9
2023
entrez:
11
9
2023
Statut:
ppublish
Résumé
Metabolic-associated fatty liver disease (MAFLD) is the most prevalent chronic liver disease worldwide, affecting 25% of people globally and up to 80% of people with obesity. MAFLD is characterised by fat accumulation in the liver (hepatic steatosis) with varying degrees of inflammation and fibrosis. MAFLD is strongly linked with cardiometabolic disease and lifestyle-related cancers, in addition to heightened liver-related morbidity and mortality. This position statement examines evidence for exercise in the management of MAFLD and describes the role of the exercise professional in the context of the multi-disciplinary care team. The purpose of these guidelines is to equip the exercise professional with a broad understanding of the pathophysiological underpinnings of MAFLD, how it is diagnosed and managed in clinical practice, and to provide evidence- and consensus-based recommendations for exercise therapy in MAFLD management. The majority of research evidence indicates that 150-240 min per week of at least moderate-intensity aerobic exercise can reduce hepatic steatosis by ~ 2-4% (absolute reduction), but as little as 135 min/week has been shown to be effective. While emerging evidence shows that high-intensity interval training (HIIT) approaches may provide comparable benefit on hepatic steatosis, there does not appear to be an intensity-dependent benefit, as long as the recommended exercise volume is achieved. This dose of exercise is likely to also reduce central adiposity, increase cardiorespiratory fitness and improve cardiometabolic health, irrespective of weight loss. Resistance training should be considered in addition to, and not instead of, aerobic exercise targets. The information in this statement is relevant and appropriate for people living with the condition historically termed non-alcoholic fatty liver disease (NAFLD), regardless of terminology.
Identifiants
pubmed: 37695493
doi: 10.1007/s40279-023-01918-w
pii: 10.1007/s40279-023-01918-w
pmc: PMC10687186
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2347-2371Subventions
Organisme : NIDDK NIH HHS
ID : K23 DK131290
Pays : United States
Informations de copyright
© 2023. The Author(s).
Références
Dig Dis Sci. 2021 Oct;66(10):3604-3611
pubmed: 33098023
Diabetologia. 2016 Oct;59(10):2068-79
pubmed: 27393135
Clin Chem Lab Med. 2013 Oct;51(10):1997-2007
pubmed: 24072574
Liver Transpl. 2021 Apr;27(4):502-512
pubmed: 33232547
Adv Ther. 2019 May;36(5):1052-1074
pubmed: 30888594
Gastroenterology. 2011 Oct;141(4):1249-53
pubmed: 21726509
J Gastroenterol. 2011 Jun;46(6):746-57
pubmed: 21340530
Dig Liver Dis. 2010 May;42(5):310-9
pubmed: 20194050
Med Sci Sports Exerc. 2022 Feb 1;54(2):353-368
pubmed: 35029593
Prog Cardiovasc Dis. 2019 Mar - Apr;62(2):140-146
pubmed: 30685470
Sci Rep. 2017 Nov 21;7(1):15952
pubmed: 29162875
JAMA Intern Med. 2016 Aug 1;176(8):1074-82
pubmed: 27379904
J Clin Med. 2021 Apr 13;10(8):
pubmed: 33924482
J Hepatol. 2022 Nov;77(5):1237-1245
pubmed: 35843374
J Clin Med. 2023 Apr 20;12(8):
pubmed: 37109347
Am J Physiol Gastrointest Liver Physiol. 2008 Mar;294(3):G619-26
pubmed: 18174272
Front Physiol. 2022 Jun 28;13:894044
pubmed: 35837021
Medicine (Baltimore). 2020 Mar;99(10):e19471
pubmed: 32150108
Clin Gastroenterol Hepatol. 2022 Dec;20(12):2809-2817.e28
pubmed: 34890795
Diabetologia. 2007 Feb;50(2):404-13
pubmed: 17149589
Liver Transpl. 2019 Jul;25(7):995-1006
pubmed: 30859755
Obes Rev. 2021 Feb;22(2):e13137
pubmed: 32896055
Tohoku J Exp Med. 2020;252(1):23-32
pubmed: 32863329
Psychiatry Res. 1989 May;28(2):193-213
pubmed: 2748771
J Clin Endocrinol Metab. 2016 Nov;101(11):4219-4228
pubmed: 27583475
JHEP Rep. 2022 Nov 02;5(1):100622
pubmed: 36440257
Ann Med. 2005;37(5):347-56
pubmed: 16179270
Front Endocrinol (Lausanne). 2022 Nov 03;13:1032164
pubmed: 36407307
Clin Rehabil. 2009 Apr;23(4):352-61
pubmed: 19237435
Gastroenterology. 2019 Jan;156(1):88-95.e5
pubmed: 30222962
Hepatology. 2016 Jul;64(1):73-84
pubmed: 26707365
J Hepatol. 2019 Jan;70(1):151-171
pubmed: 30266282
Hepatology. 2012 Jun;55(6):1738-45
pubmed: 22213436
Aliment Pharmacol Ther. 2018 Aug;48(3):290-299
pubmed: 29797529
Diabetologia. 2012 Apr;55(4):885-904
pubmed: 22278337
Obes Rev. 2021 Jul;22 Suppl 4:e13269
pubmed: 33960110
J Sci Med Sport. 2021 Dec;24(12):1245-1254
pubmed: 34531124
Nutrients. 2023 May 24;15(11):
pubmed: 37299416
Health Qual Life Outcomes. 2016 Feb 09;14:18
pubmed: 26860700
Hepatology. 2013 Apr;57(4):1357-65
pubmed: 23175136
Physiol Rep. 2019 May;7(9):e14062
pubmed: 31087530
Med Sci Sports Exerc. 2009 Feb;41(2):459-71
pubmed: 19127177
Nat Rev Gastroenterol Hepatol. 2018 Jan;15(1):11-20
pubmed: 28930295
J Hepatol. 2016 Jun;64(6):1388-402
pubmed: 27062661
Nutrients. 2021 Sep 08;13(9):
pubmed: 34579012
Front Med (Lausanne). 2021 Jan 18;7:585618
pubmed: 33537324
J Sports Med Phys Fitness. 2023 Jan;63(1):178-187
pubmed: 35816139
Obes Rev. 2017 Nov;18(11):1310-1322
pubmed: 28913977
Int J Sports Med. 2015 Oct;36(10):848-52
pubmed: 26090879
Hepatology. 2018 May;67(5):1726-1736
pubmed: 28941364
Gastroenterology. 2015 Aug;149(2):367-78.e5; quiz e14-5
pubmed: 25865049
Phys Ther. 2021 Feb 4;101(2):
pubmed: 33104787
Nurs Res. 2000 May-Jun;49(3):154-9
pubmed: 10882320
Hepatology. 2018 Jul;68(1):361-371
pubmed: 29222911
Front Endocrinol (Lausanne). 2023 Feb 16;14:1081096
pubmed: 36875459
J Hepatol. 2018 Dec;69(6):1349-1356
pubmed: 30142427
Ther Clin Risk Manag. 2014 Nov 07;10:925-36
pubmed: 25404857
Hepatology. 2010 Jul;52(1):79-104
pubmed: 20578268
Diabetes. 2012 Nov;61(11):2787-95
pubmed: 22751691
Metabolism. 2017 Mar;68:119-132
pubmed: 28183444
Hepatology. 2017 Apr;65(4):1293-1305
pubmed: 27997989
Eur J Gastroenterol Hepatol. 2018 Jul;30(7):747-755
pubmed: 29683979
Hepatology. 2018 Jan;67(1):328-357
pubmed: 28714183
Hepatology. 2021 Sep;74(3):1611-1644
pubmed: 34233031
BMJ Open Gastroenterol. 2021 Jun;8(1):
pubmed: 34193468
Hepatol Res. 2017 Jun;47(7):622-631
pubmed: 27480242
World J Gastroenterol. 2019 Jul 28;25(28):3669-3683
pubmed: 31391765
Clin Gastroenterol Hepatol. 2016 Oct;14(10):1398-411
pubmed: 27155553
J Physiol. 2022 Mar;600(5):1013-1026
pubmed: 33760255
Diabetologia. 2020 Aug;63(8):1464-1474
pubmed: 32529412
Transplantation. 2017 Oct;101(10):2288-2296
pubmed: 28930104
Hepatology. 2016 Mar;63(3):1026-40
pubmed: 26313307
Gut. 2013 Nov;62(11):1625-33
pubmed: 23077135
J Sci Med Sport. 2010 Sep;13(5):496-502
pubmed: 20005170
Therap Adv Gastroenterol. 2013 Jul;6(4):249-59
pubmed: 23814606
Z Gastroenterol. 2022 Nov;60(11):1644-1658
pubmed: 35636454
J Hepatol. 2010 Jan;52(1):112-6
pubmed: 19897272
Biochem J. 2009 Mar 1;418(2):261-75
pubmed: 19196246
Rev Gastroenterol Mex (Engl Ed). 2019 Jul - Sep;84(3):326-343
pubmed: 31262552
J Gerontol. 1994 Mar;49(2):M85-94
pubmed: 8126356
Diabetologia. 2003 Aug;46(8):1071-81
pubmed: 12856082
Hepatol Commun. 2022 Feb;6(2):334-344
pubmed: 34697917
J Hepatol. 2020 Jul;73(1):202-209
pubmed: 32278004
J Hepatol. 2018 Nov;69(5):1164-1177
pubmed: 29964066
Medicine (Baltimore). 2023 Apr 7;102(14):e33147
pubmed: 37026928
Obes Rev. 2021 Jul;22 Suppl 4:e13273
pubmed: 34076949
JAMA. 1999 Nov 3;282(17):1659-64
pubmed: 10553793
J Clin Transl Hepatol. 2023 Oct 28;11(5):1050-1060
pubmed: 37577222
Liver Int. 2020 Nov;40(11):2879-2880
pubmed: 32738082
Ann Endocrinol (Paris). 2020 Oct;81(5):493-499
pubmed: 32768394
Dig Dis Sci. 2023 May;68(5):2123-2139
pubmed: 36538276
Front Physiol. 2021 Nov 22;12:748517
pubmed: 34880774
J Gastroenterol Hepatol. 2020 Sep;35(9):1628-1635
pubmed: 32048317
World J Gastroenterol. 2014 Apr 21;20(15):4382-92
pubmed: 24764677
Hepat Mon. 2015 Oct 10;15(10):e31434
pubmed: 26587039
Clin Gastroenterol Hepatol. 2021 Nov;19(11):2274-2283.e5
pubmed: 32882428
Am J Physiol Endocrinol Metab. 2011 Nov;301(5):E1033-9
pubmed: 21846904
Am J Clin Nutr. 2005 Jun;81(6):1330-4
pubmed: 15941883
Sports Med. 2019 Nov;49(11):1687-1721
pubmed: 31401727
Am J Clin Nutr. 2000 Aug;72(2 Suppl):558S-63S
pubmed: 10919960
Am J Gastroenterol. 2023 Jul 1;118(7):1204-1213
pubmed: 36705333
Child Obes. 2017 Aug;13(4):272-282
pubmed: 28322576
Hepatology. 2022 Jul;76(1):172-185
pubmed: 34890063
Am J Physiol Heart Circ Physiol. 2014 Nov 1;307(9):H1298-306
pubmed: 25193471
J Phys Act Health. 2016 Jun;13(6):671-94
pubmed: 26694194
Clin Transl Gastroenterol. 2016 Jul 14;7(7):e180
pubmed: 27415618
Hepatology. 2008 Apr;47(4):1158-66
pubmed: 18266250
Metabolism. 2018 Jan;78:128-140
pubmed: 28941598
Transplant Rev (Orlando). 2016 Oct;30(4):218-26
pubmed: 27496067
Dig Dis Sci. 2020 Nov;65(11):3238-3243
pubmed: 32239376
World J Gastroenterol. 2016 Jul 21;22(27):6318-27
pubmed: 27468220
Gut. 2009 Sep;58(9):1281-8
pubmed: 19074179
Prog Cardiovasc Dis. 2018 Jul - Aug;61(2):222-231
pubmed: 29452135
Physiol Behav. 2021 Jul 1;236:113416
pubmed: 33823178
Gut. 2022 Jun 16;:
pubmed: 35710299
Int J Obes (Lond). 2016 Dec;40(12):1927-1930
pubmed: 27439593
Aliment Pharmacol Ther. 2020 Oct;52(8):1387-1398
pubmed: 32717123
Hepatology. 2009 Oct;50(4):1105-12
pubmed: 19637289
Front Endocrinol (Lausanne). 2021 Jan 27;11:575843
pubmed: 33584535
Biol Res Nurs. 2022 Apr;24(2):259-276
pubmed: 35130757
BMC Gastroenterol. 2020 Mar 12;20(1):66
pubmed: 32164541
J Clin Endocrinol Metab. 2022 Feb 17;107(3):862-881
pubmed: 34724062
Clin Liver Dis. 2023 May;27(2):187-210
pubmed: 37024202
J Sci Med Sport. 2012 Jan;15(1):25-31
pubmed: 21621458
Lancet Gastroenterol Hepatol. 2021 Nov;6(11):889-902
pubmed: 34560015
Br J Sports Med. 2018 Jul;52(13):834-843
pubmed: 27317790
Am J Gastroenterol. 2011 Mar;106(3):460-8; quiz 469
pubmed: 21206486
Gastroenterology. 2005 Jul;129(1):113-21
pubmed: 16012941
Diabetes Care. 2020 Oct;43(10):2371-2378
pubmed: 32732374
Ther Clin Risk Manag. 2015 Mar 04;11:371-80
pubmed: 25767392
J Appl Physiol (1985). 2019 Jun 1;126(6):1756-1768
pubmed: 30998125
Cochrane Database Syst Rev. 2006 Oct 18;(4):CD003817
pubmed: 17054187
Dig Liver Dis. 2023 Sep;55(9):1178-1186
pubmed: 36653265
Diabetes Metab. 2017 Jun;43(3):195-210
pubmed: 28162956
Clin Gastroenterol Hepatol. 2021 Aug;19(8):1723-1725
pubmed: 32882426
Br J Sports Med. 2014 Aug;48(16):1227-34
pubmed: 24144531
Med Sci Sports Exerc. 2019 Nov;51(11):2391-2402
pubmed: 31626056
Med Sci Sports Exerc. 2010 Nov;42(11):1973-80
pubmed: 20351587
Am J Physiol Endocrinol Metab. 2009 Aug;297(2):E552-9
pubmed: 19531640
Obes Rev. 2012 Jan;13(1):68-91
pubmed: 21951360
Obes Rev. 2017 Aug;18(8):943-964
pubmed: 28513103
Eat Behav. 2003 Sep;4(3):265-82
pubmed: 15000970
PLoS One. 2022 Feb 17;17(2):e0263931
pubmed: 35176096
Patient. 2021 Sep;14(5):533-543
pubmed: 33336323
Diabetes Metab J. 2016 Aug;40(4):253-71
pubmed: 27535644
Int J Environ Res Public Health. 2021 Mar 21;18(6):
pubmed: 33801028
Am J Physiol Endocrinol Metab. 2016 Oct 1;311(4):E730-E740
pubmed: 27577854
Clin Gastroenterol Hepatol. 2017 Jan;15(1):96-102.e3
pubmed: 27521509
J Hepatol. 2017 Jan;66(1):142-152
pubmed: 27639843
Am J Physiol Endocrinol Metab. 2013 Nov 15;305(10):E1222-9
pubmed: 24045865
J Hepatol. 2012 Jul;57(1):157-66
pubmed: 22414768
Am J Cardiol. 2019 Feb 1;123(3):466-473
pubmed: 30502049
Clin Nutr. 2022 Sep;41(9):1913-1931
pubmed: 35947894
Sports Med. 2008;38(12):1009-24
pubmed: 19026018
Am J Gastroenterol. 2018 Nov;113(11):1649-1659
pubmed: 29880964
Eur Rev Med Pharmacol Sci. 2021 Dec;25(24):7687-7697
pubmed: 34982430
BMJ Open Gastroenterol. 2016 Aug 16;3(1):e000106
pubmed: 27648297
Clin Sci (Lond). 2016 Jan;130(2):93-104
pubmed: 26424731
Obes Rev. 2018 Oct;19(10):1446-1459
pubmed: 30092609
BMC Gastroenterol. 2020 Jan 14;20(1):10
pubmed: 31937252
Transl Behav Med. 2020 Oct 8;10(4):1016-1030
pubmed: 31120519
Gut. 2011 Sep;60(9):1278-83
pubmed: 21708823
Nurs Open. 2021 Nov;8(6):3135-3142
pubmed: 34405583
Clin Gastroenterol Hepatol. 2017 Dec;15(12):1968-1971
pubmed: 28624648
J Diabetes. 2021 Jan;13(1):63-77
pubmed: 32667128
Hepatology. 2013 Oct;58(4):1287-95
pubmed: 23504926
J Clin Invest. 2005 May;115(5):1343-51
pubmed: 15864352
Obes Rev. 2022 Aug;23(8):e13446
pubmed: 35383401
Clin Sci (Lond). 2015 Dec;129(12):1097-105
pubmed: 26265792
Ir J Med Sci. 2023 Feb;192(1):131-142
pubmed: 35366201
JAMA. 2009 May 20;301(19):2024-35
pubmed: 19454641
J Hepatol. 2015 Jul;63(1):174-82
pubmed: 25863524
Eur J Sport Sci. 2019 Aug;19(7):994-1003
pubmed: 30732555
Liver Int. 2017 Aug;37(8):1209-1218
pubmed: 28211165
Front Nutr. 2021 Jul 22;8:716783
pubmed: 34368214
Eur J Transl Myol. 2021 Mar 26;31(1):
pubmed: 33709647
Scand J Med Sci Sports. 2015 Dec;25 Suppl 3:1-72
pubmed: 26606383
Gastroenterology. 2008 May;134(5):1369-75
pubmed: 18355813