In a bid to combat the rising prevalence of metabolic-dysfunction associated fatty liver disease (MAFLD), experts from the Asian Pacific Association for the Study of the Liver (APASL) have released their first-ever clinical guidelines for managing the condition. These guidelines emphasize the role of regular exercise in reducing liver fat by up to 30% and improving overall liver health.
Exercise Key to Liver Health
The newly published guidelines in Hepatology International highlight the profound impact of physical activity on liver function. They suggest that moderate-to-vigorous-intensity exercise, such as brisk walking, cycling, or jogging, should be performed for 150-240 minutes per week to achieve a reduction in liver fat. The experts also note that even as little as 135 minutes per week can offer substantial benefits.
“Regular exercise significantly enhances insulin sensitivity, reduces inflammation, and alters metabolic processes in the muscle, liver, and fat tissues, helping to reduce the flow of fatty acids to the liver,” the guideline states. While combining exercise with a balanced diet is beneficial, the report emphasizes that exercise alone can lead to major liver-related and cardiometabolic improvements.
The Growing Threat of MAFLD
MAFLD, characterized by fat accumulation in the liver alongside metabolic risk factors like obesity, Type 2 diabetes, and high cholesterol, is becoming increasingly prevalent. A recent survey conducted in 11 districts of Delhi found that nearly half of adults over the age of 18 are affected by this condition, highlighting the urgent need for effective prevention and management strategies.
Health Risks and Long-Term Impact
According to Dr. S.K. Sarin, one of the experts behind the guideline and the director of ILBS, the health risks of untreated MAFLD are significant. “Fatty liver can precede other major health conditions such as high cholesterol, diabetes, and hypertension by 10-15 years. By addressing and reversing fatty liver, we can reduce the burden of these diseases in the coming decade,” Dr. Sarin explained. If left unmanaged, MAFLD can progress to more severe liver conditions, including non-alcoholic steatohepatitis (NASH), cirrhosis, liver cancer, and even premature death.
The Role of High-Intensity Interval Training and Diet
While the exact impact of high-intensity interval training (HIIT) on fatty liver remains uncertain, the guidelines note that HIIT, which alternates between intense bursts of activity and recovery periods, can also be an effective strategy, provided it is done under professional supervision. Additionally, the guidelines stress the importance of dietary modifications, recommending that individuals with MAFLD aim to consume between 1200-1800 kcal per day, or reduce their intake by 500-750 kcal to promote weight loss. The consumption of three or more cups of coffee per day—regardless of caffeine content—is also considered beneficial for liver health.
Early Intervention is Crucial
Given that MAFLD can progress to chronic liver diseases and liver cancer if left untreated, early intervention is vital. The new APASL guidelines provide a structured, practical approach to preventing and managing this widespread condition through a combination of exercise, dietary adjustments, and lifestyle changes.
By following these recommendations, individuals with MAFLD can significantly reduce liver fat, improve liver function, and lower the risk of long-term complications.
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