If you've been diagnosed with fatty liver disease, you're not alone. In fact, it's estimated that at least a quarter of the world's population is affected by the unhealthy buildup of liver fat. And as the number of people with elevated blood sugar, body weight, and cholesterol levels continues to rise, the incidence of fatty liver disease is only expected to grow.
Fortunately, it doesn't have to be this way, as fatty liver disease is both avoidable and reversible.
One method that's gaining more attention for its potential role in the treatment and prevention of fatty liver is exercise. But is it really possible that something as simple as physical activity can actually treat and even reverse this chronic and sometimes deadly health condition? In this article, we're going to review the evidence and uncover everything you need to know about the potentially remarkable beneficial effect of exercise for fatty liver.
Fatty Liver Disease: Causes, Types, and Risk Factors
The liver is the body's largest internal organ and is responsible for processing every single thing that enters the body, from foods and liquids to medications and environmental pollutants.
It's also the toughest organ in the body and can regenerate itself even if 75% of it is diseased.
However, certain genetic abnormalities, diseases, toxic exposures, and lifestyle choices can compromise the liver's ability to function normally. And one of the main culprits in altered liver function is excess liver fat.
One of the liver's main duties is taking the nutrients we eat and drink and breaking them down into their constituent parts. This includes proteins and carbohydrates, some of which are converted into triglycerides.
These special types of fats are then further broken down into glycerol and fatty acids so they can be used by the body as energy or stored as fat in the adipose tissue. Any leftover triglycerides are stored in the liver.
Under normal circumstances, the liver keeps only a tiny amount of triglycerides on hand. But factors such as poor diet, excess body fat, elevated blood pressure and cholesterol, sedentary lifestyle, and too much alcohol can decrease the liver's ability to metabolize excess triglycerides. And this can cause the buildup of liver fat.
Once fat comprises at least 5% to 10% of total liver volume, a diagnosis of fatty liver disease, or hepatic steatosis, can be made.
Alcoholic and Nonalcoholic Fatty Liver Disease
The most common form of fatty liver disease is nonalcoholic fatty liver disease (NAFLD), which is associated with conditions including obesity, metabolic syndrome, insulin resistance, type 2 diabetes, and high cholesterol.
The second major type of fatty liver disease is associated with long-term heavy alcohol use and is known as—you guessed it—alcoholic fatty liver disease.
While a person can live with fatty liver disease his or her entire life and never know anything is wrong, with continued poor diet, alcohol abuse, etc., excess liver fat can eventually cause significant liver damage.
In the case of liver damage associated with nonalcoholic fatty liver disease, the condition is known as nonalcoholic steatohepatitis (NASH)—a disease characterized by liver cell damage and inflammation.
However, when it comes to fatty liver disease, alcoholic and nonalcoholic fatty liver disease share two things in common:
- Both can lead to serious complications, including cirrhosis, liver failure, and liver cancer.
- Both can be treated and even reversed with simple lifestyle modifications.
Risk Factors for Fatty Liver Disease
Unfortunately, anyone who follows the standard Western lifestyle is at risk of fatty liver disease.
What's the standard Western lifestyle?
Basically, it boils down to two things:
- Lack of regular exercise
- A diet that emphasizes red meat, processed food, saturated fat, and sugar and limits the intake of fruits, vegetables, whole grains, and healthy fats
Identifying Symptoms and Diagnosing Fatty Liver Disease
As mentioned, fatty liver disease doesn't necessarily progress to overt liver damage. And chances are, if you do notice symptoms, the damage has already begun. However, symptoms to watch out for include:
- Abdominal pain
- Weight loss
- Dark-colored urine
If you have any of these symptoms, your health care provider will likely first perform liver function tests to measure levels of liver enzymes. If enzymes are elevated, they may then perform imaging studies—including ultrasound and magnetic resonance imaging (MRI)—to look for signs of liver abnormalities.
Finally, if all of these tests are positive, a liver biopsy may be performed to determine the exact diagnosis.
However, it's important to remember that the remarkable ability of the liver to carry on without complaint even when most of it is riddled with disease means that it's entirely possible to be in full-blown cirrhosis before you ever know anything is wrong.
And you don't want to get to that point.
That's why it's so important to implement lifestyle changes now. Because watching your weight, eating a healthy diet, and controlling alcohol intake can make a significant difference in overall liver health.
And, perhaps not surprisingly, studies have found that exercise intervention may be as important for preventing and treating fatty liver disease as it is for improving overall health and well-being.
Exercise for Fatty Liver
The main factor underlying the importance of physical activity in the treatment and prevention of fatty liver is related to the same process that makes exercise an integral part of any sensible weight-loss plan—namely, fat burning.
In fact, getting up and moving on a regular basis has been shown to lower levels of triglycerides and raise levels of high-density lipoprotein (HDL)—the so-called good cholesterol. And this can help lower fat stores in the liver.
What's also interesting is that recent studies have discovered that exercise intensity and type are less important than simply including regular physical activity as part of any lifestyle intervention.
For example, a study published in the journal Hepatology found that sedentary adults with nonalcoholic fatty liver disease who underwent just 8 weeks of resistance training experienced a 13% improvement in both insulin sensitivity and lipid oxidation.
But perhaps the most remarkable finding was that these improvements in fatty liver biomarkers were seen despite the fact that none of the participants saw any changes in actual body weight.
In addition, a study published in the journal Lipids in Health and Disease found that obese mice with fatty liver disease experienced improvements in both glucose tolerance and liver fat levels regardless of whether they were treated with exercise or diet or a combination of the two.
A small study published in the journal Diabetologia found that diabetic patients with fatty liver and cardiovascular disease who underwent 12 weeks of high-intensity training (HIT) not only had positive changes in cardiac structure and function but also experienced significant reductions in hemoglobin A1c as well as an astounding 39% decrease in liver fat.
By contrast, another small study published in the journal Diabetes Research and Clinical Practice found that patients with type 2 diabetes and NAFLD who were given aerobic and resistance training twice a week for 1 year experienced significant decreases in liver and abdominal fat regardless of exercise intensity.
Finally, a systematic review published in the journal Gene Expression made note of several clinical trials that have shown the benefits of both resistance exercise and aerobic exercise training on liver fat content.
Moreover, the authors of the review concluded that physical activity is an effective method of treating fatty liver disease due to its ability to decrease insulin resistance, prevent oxidative stress, and reduce levels of glucose and fatty acids in the liver.
While these study results are great news for anyone suffering from fatty liver disease, it may be possible to increase your results even more by simply adding additional amino acids to your diet.
Amino Acids for Fatty Liver
Known as the building blocks of life, amino acids are required for the creation of proteins and are involved in almost every process that goes on in the body. Without a steady supply of these building blocks, overall health and well-being suffer.
Based on this fact, it should come as no surprise then that amino acids play a significant role in liver health. What's more, they're essential for building muscle mass and strength and can make your workouts even more effective.
And although the body requires a balanced supply of all nine essential amino acids, studies have found that several amino acids have specific benefits for liver health.
A study published in the journal Amino Acids found that the amino acid taurine helps to suppress both oxidative stress and the accumulation liver fatty acids in mice given high-fat diets.
Another study published in Nutrition Research demonstrated that supplementation with leucine, isoleucine, and valine—the branched-chain amino acids (BCAAs)—reduces liver cell death and scar tissue, thus delaying the progression of chronic liver disease.
You may be at least vaguely familiar with the supplemental form of the amino acid cysteine, N-acetylcysteine (NAC), due to its ability to prevent liver damage associated with acetaminophen overdose. The reason NAC is the treatment of choice for acetaminophen overdose is because it has the ability to replenish the liver's store of glutathione.
What is glutathione, you ask?
Glutathione is known as the body's master antioxidant, and it's especially good at decreasing oxidative stress, which in turn protects the liver from cellular damage. This effect can also be helpful in the treatment of fatty liver disease.
For example, a study published in the journal Hepatitis Monthly found that patients with nonalcoholic fatty liver disease who received supplemental N-acetylcysteine for 3 months experienced significant decreases in both spleen size—a symptom of chronic liver disease—and levels of liver enzymes.
Finally, several studies have found that a compound known as S-adenosylmethionine (SAMe)—which is a combination of the amino acid methionine and the energy molecule adenosine triphosphate (ATP)—has the ability to protect liver health by reducing both liver fat and scar tissue formation.
S-adenosylmethionine (SAMe)—which is composed of the amino acid methionine bound to a molecule of adenosine triphosphate (ATP)—helps protect liver cells and prevent progression of fatty liver disease.
When it comes to treating and preventing fatty liver disease, it's good to know that simple lifestyle changes, including healthy diet, regular exercise, decreased alcohol intake, and supplementation amino acids are all that's needed to reverse unhealthy levels of liver fat. However, if you're having difficulty reaching your goals, don't hesitate to seek the advice of a qualified health care professional.