title: Independent effects of physical activity in patients with nonalcoholic fatty liver disease.
abstract: Nonalcoholic fatty liver disease, characterized by elevated liver enzymes, central obesity, and insulin resistance, is becoming increasingly prevalent. The effects of changes in physical activity on the metabolic profile of this group have not been reported. We assessed at 3 months the impact of a behavior change-based lifestyle intervention on physical activity and the effects of this change on the metabolic profile of people with fatty liver disease. In all, 141 participants with nonalcoholic fatty liver disease were prospectively enrolled into either a low- or moderate-intensity lifestyle intervention or to a control group. Physical activity was assessed using a validated reporting tool and physical fitness was measured using the YMCA protocol on a cycle ergometer. Individualized counseling to increase physical activity was provided. Overall, 96% of participants attended the 3-month follow-up assessment. Participants in the moderate- and low-intensity intervention groups were 9 times more likely to increase physical activity by an hour or more per week compared to controls. Patients increasing or maintaining their reported physical activity to > or =150 minutes/week, and those who increased their objective levels of fitness, had the greatest improvements in liver enzymes and other metabolic indices compared to those who were least active. This effect was independent of weight loss and was corroborated by an objective measure of fitness. There was no dose-response effect on liver enzymes with incremental increases in physical activity above 60 minutes/week.
  
  
  CONCLUSIONS
  Lifestyle counseling interventions are effective in improving physical activity behavior. Maintaining or increasing physical activity provides health benefits for patients with fatty liver, independent of changes in weight.
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney and Westmead Hospital, Canberra, Australia.
authors.forename: Alexis
authors.initials: A
authors.lastname: St George
authors.forename: Adrian
authors.initials: A
authors.lastname: Bauman
authors.forename: Amanda
authors.initials: A
authors.lastname: Johnston
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Farrell
authors.forename: Tien
authors.initials: T
authors.lastname: Chey
authors.forename: Jacob
authors.initials: J
authors.lastname: George
mesh_terms: D005234:Fatty Liver / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011446:Prospective Studies