Effect of aerobic exercise and diet on liver fat in pre-diabetic patients with non-alcoholic-fatty-liver-disease: A randomized controlled trial

Abstract

The study aimed to assess whether aerobic exercise (AEx) training and a fbre-enriched diet can reduce hepatic fat content (HFC) and increase glycaemic control in pre-diabetic patients with non-alcoholic fatty liver disease (NAFLD). Six-hundred-and-three patients from seven clinics in Yangpu district, Shanghai, China were recruited. Of them 115 individuals aged 50–65-year fulflled the inclusion criteria (NAFLD with impaired fasting glucose or impaired glucose tolerance) and were randomly assigned into exercise (AEx n=29), diet (Diet n=28), exercise plus diet (AED n=29), or no-intervention (NI n=29) groups. Progressive supervised AEx training (60–75% VO2max intensity) was given 2-3 times/week in 30–60min/sessions, and the diet intervention was provided as lunch with 38% carbohydrate and diet fbre of 12g/day for 8.6-month. HFC was assessed by 1H MRS. We found that HFC was signifcantly reduced in the AEx (−24.4%), diet (−23.2%), and AED (−47.9%) groups by contrast to the 20.9% increase in the NI group (p=0.001 for all) after intervention. However, only AED group signifcantly decreased HbA1c (−4.4%, p=0.01) compared with the NI group (−0.6%). Aerobic exercise training combined with fbre-enriched diet can reduce HFC more efectively than either exercise or increased fbre-intake alone in pre-diabetic patients with NAFLD.