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Metabolic dysfunction-associated steatotic liver disease (MASLD), a leading cause of chronic liver disease, is closely linked with obesity, insulin resistance, and metabolic disorders.
Structured aerobic and resistance exercise consistently reduces hepatic fat and improves metabolic health in adults with MASLD, regardless of substantial weight loss.
Metabolic dysfunction-associated steatotic liver disease (MASLD), a leading cause of chronic liver disease, is closely linked with obesity, insulin resistance, and metabolic disorders. This review examined evidence from randomized controlled trials (RCTs) to determine how structured exercise impacts liver health and metabolic outcomes in MASLD.
Researchers identified RCTs through a targeted search of the PubMed database. Eleven eligible studies involving adults with MASLD were included. The review evaluated the effects of structured aerobic and resistance exercise on liver fat, liver function, lipid metabolism, insulin sensitivity, and the biological pathways that may contribute to these changes.
Across the 11 RCTs, both aerobic and resistance exercise consistently reduced hepatic fat content and improved key metabolic parameters in adults with MASLD. Exercise interventions were linked with favorable changes in plasma lipid profiles, decrease in liver enzyme concentrations, and enhanced insulin sensitivity, with many of these benefits occurring independently of weight loss.
Exercise-mediated improvements were driven by activation of molecular pathways implicated in mitochondrial function, lipid oxidation, modulation of inflammation, and insulin signaling, supporting improvements in both hepatic and systemic metabolic health. Although considerable heterogeneity existed in exercise modality, intervention duration, intensity, and outcome assessment across studies, the overall evidence consistently depicted clinically meaningful hepatic and metabolic benefits.
Structured aerobic and resistance exercise proved to be a valuable non-pharmacological intervention for improving hepatic steatosis and metabolic dysfunction in MASLD-affected adults. Benefits extended beyond weight reduction and were likely mediated through multiple metabolic and molecular pathways.
International Journal of Molecular Sciences
Structured Exercise Interventions and Hepatic–Metabolic Outcomes in Adults with MASLD: A Narrative Review of Randomized Controlled Trials
Tuva Marie Lindstad et al.
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