Resistance training carried out in a gym can help reduce fatty liver – the most common liver disease that affects nearly a third of the Western world’s population and can lead to inflammation and cirrhosis of the liver and eventually death.
Until now, doctors have not known how to reverse the condition.
A study by the University of Haifa, Tel Aviv University and the Sourasky Medical Center has now found that gym training – and not only aerobic exercises – can help reduce the amount of fat in the liver, said Dr. Shira Zelber-Sagi from the University of Haifa’s School of Public Health.
“For patients suffering from physical limitations or low motivation that prevents them from performing aerobic exercises, resistance training can be an effective alternative,” she said.
On the basis of past studies, fatty liver disease is defined as a fat rate in excess of 5 percent to 10% of liver volume.
The disease is regarded as the most common liver disease in the Western world. Excessive weight, abdominal obesity, diabetes, high levels of fats in the blood (especially triglycerides) increase the risk of developing fatty liver disease.
The disease is usually asymptomatic, although patients sometimes report fatigue and a lack of vitality by comparison to healthy individuals.
Fatty liver causes disease and death due to metabolic complications such as diabetes and cardiovascular disease, the development of cirrhosis and liver cancer. Because drug treatment for the disease is very limited or nonexistent, the main emphasis is on lifestyle modifications.
In this aspect our study is one of a few clinical trials to show the benefit of resistance training in reducing liver fat.”
According to Zelber-Sagi, although patients with the disease recognize the importance of physical activity, they often lack the motivation to engage in such activity, particularly in the case of aerobic exercises, which are usually time consuming.
The study was undertaken by a team of researchers from the University of Haifa, together with TAU Prof. Oren Shibolet, an internal medicine specialist and dietitian Assaf Buch of Sourasky.
The researchers decided to examine the impact of resistance training – which is usually briefer and more focused than aerobic exercises – on fatty liver disease. The study included 82 subjects aged 20 to 65 who were diagnosed by ultrasound as suffering from fatty liver disease over the six months before the beginning of the study.
The participants were then divided randomly into a resistance training group and a control group asked only to undertake stretching exercises.
The participants were asked not to change their physical activity habits during the study, to continue their usual diet and to take their prescribed medicines.
During the study, the participants underwent examinations of weight and blood pressure, plus a blood test for liver enzymes, lipids, blood sugar and insulin. Resistance training in the gym was defined according to a uniform protocol, with the level of resistance adjusted to the patient’s capabilities. The training, that was designed and delivered by dietitian Buch, included several sets of different resistance exercises involving the arms, chest and legs and lasting for a total of 40 minutes, three times a week.
At the end of the three-month study, the researchers found that resistance training in the gym led to a decrease in liver fat based on the fat content of the liver as detected in the special ultrasound examination employed by the study. Developed by Dr. Muriel Webb, this examination enables the quantification of liver fat.
Zelber-Sagi explained, “The resistance training was not intended to reduce body weight significantly, and indeed, overall weight loss was very slight.
However, it seems that the resistance training had a specific impact in terms of a fall in liver fat levels as measured in the ultrasound examination.”
The study also found that gym training led to a significant fall in blood cholesterol levels.
“We assume that the physical exercise improves the resistance to insulin, thereby reducing the production of cholesterol in the liver and its level in the blood,” the researchers commented.
This study also shows for the first time that resistance training led to a reduction in ferritin levels in the blood. Ferritin is a protein found in the liver that facilitates the storage of iron.
However, elevated levels of ferritin can be an indication of liver damage, including inflammation. Thus, a fall in ferritin levels may reflect an improvement in the condition of the liver.
“We strongly recommend that patients with fatty liver get involved in routine physical activity, be it resistance training or aerobics, maintain a healthy diet and reduce weight,” said Shibolet.
Zilber-Sagi concluded: “We know how hard it is for people to lose weight and stick to weight reduction diets. So it is important to find additional ways in which we can treat patients on a long-term basis while enabling them to maintain a high quality of life. Anaerobic training is one of these ways.”
Meanwhile, the WHO called for urgent action to reduce the amount of viral hepatitis infections, another dangerous liver disease, and to ensure that people who have been infected are diagnosed and offered treatment.
This year, the WHO is focusing particularly on hepatitis B and C, which together cause approximately 80% of all liver cancer deaths and kill close to 1.4 million people every year. World Hepatitis Day will be held July 28.
The WHO is alerting people to the risks of contracting hepatitis from unsafe blood, unsafe injections and sharing drug-injection equipment. Some 11 million people who inject drugs have hepatitis B or C infections.
Children born to mothers with hepatitis B or C and sex partners of people with hepatitis are also at risk of becoming infected.
The organization stresses the need for all health services to reduce risks by using only sterile equipment for injections and other medical procedures, test all donated blood and blood components for hepatitis B and C (as well as HIV and syphilis) and to promote the use of the hepatitis B vaccine. Safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), also protect against transmission.
About two million people a year contract hepatitis from unsafe injections. These infections can be averted through the use of sterile syringes that are specifically designed to prevent reuse. Eliminating unnecessary injections is also an effective strategy to protect against hepatitis transmission, the WHO said. Some 16 billion injections are carried out every year. Around 5% of these injections are for immunization, a further 5% for procedures like blood transfusions and injectable contraceptives, and the remaining 90% to administer medicines. For many diseases, injections are not the first recommended course of treatment and oral medications could be used.
All Israeli infants receive hepatitis B vaccinations, one soon after birth and another two or three booster doses later. Since 1982, more than 1 billion doses of hepatitis B vaccine have been used worldwide and millions of future deaths from liver cancer and cirrhosis have been prevented.
There is no available vaccine against hepatitis C, but medications are now available that can cure most people with hepatitis C and control hepatitis B infection.
People who receive these medicines are much less likely to die from liver cancer and cirrhosis and much less likely to transmit the virus to others.