Losing a bit of weight and doing some exercise slows progression of chronic liver disease

Losing weight and exercising regularly slows progression of chronic liver disease in those who are overweight, indicates a study in Gut.

Being overweight is bad for the liver. And non-alcoholic fatty liver is increasingly being diagnosed in those who are overweight, diabetic, or who have insulin resistance syndrome, a precursor to diabetes. Overweight and obesity are also recognised risk factors for the progression of other chronic liver diseases, such as hepatitis C.

Once considered a relatively benign disease, non-alcoholic fatty liver is deemed to be much more serious as it can progress to cirrhosis and liver cancer.

Thirty one overweight patients with fatty liver dieted for 15 months and exercised regularly. Their programme consisted of losing weight for three months and then maintaining their weight for the following 12.

The patients were seen by a dietician every week during the first three months and thereafter every month, and they completed 2.5 hours of aerobic exercise every week for the entire period. Before the study began, only 10 patients ever exercised regularly.

Levels of liver enzymes, fats and glucose in the blood were measured at the start of the study, at three months, and at the end of the study. Liver tissue samples were also taken, and the patients were asked to score their quality of life.

Liver tissue samples were taken from 14 of the patients between three to six months after the first three months of the programme. These showed striking falls in the amount of fatty tissue present.

At the end of the programme, over two thirds of the patients (68%) had maintained their weight loss. The liver enzyme, ALT, high levels of which are associated with liver disease, was significantly lower than at the start of the programme. Insulin levels also fell.

Importantly, these improvements were obvious even in those who lost 4% to 5% of their body weight.

Ten patients regained their weight, mostly because they did less than 2.5 hours of exercise, and their liver ALT levels worsened. Patients reported that their quality of life significantly improved after losing weight.