title: Aerobic vs. resistance exercise in non-alcoholic fatty liver disease: A systematic review.
abstract: Exercise is a first-line therapy for patients with non-alcoholic fatty liver disease (NAFLD). We sought to: 1) summarize effective aerobic and resistance exercise protocols for NAFLD; and 2) compare the effects and energy consumption of aerobic and resistance exercises.
  
  
  
  A literature search was performed using PubMed, Web of Science, and Scopas to January 28, 2016. From a total of 95 articles, 23 studies including 24 aerobic and 7 resistance exercise protocols were selected for the summary of exercise protocols. Twelve articles including 13 aerobic and 4 resistance exercise protocols were selected for the comparative analysis.
  
  
  
  For aerobic exercise, the median effective protocol was 4.8 metabolic equivalents (METs) for 40min/session, 3times/week for 12weeks. For resistance exercise, the median effective protocol was 3.5 METs for 45min/session, 3times/week for 12weeks. Aerobic and resistance exercise improved hepatic steatosis. No significant difference was seen in the duration, frequency, or period of exercise between the two exercise groups; however, %VO2max and energy consumption were significantly lower in the resistance than in the aerobic group (50% [45-98] vs. 28% [28-28], p=0.0034; 11,064 [6394-21,087] vs. 6470 [4104-12,310] kcal/total period, p=0.0475).
  
  
  
  Resistance exercise improves NAFLD with less energy consumption. Thus, resistance exercise may be more feasible than aerobic exercise for NAFLD patients with poor cardiorespiratory fitness or for those who cannot tolerate or participate in aerobic exercise. These data may indicate a possible link between resistance exercise and lipid metabolism in the liver.
  
  
  
  Both aerobic and resistance exercise reduce hepatic steatosis in non-alcoholic fatty liver disease (NAFLD) with similar frequency, duration, and period of exercise (40-45min/session 3times/week for 12weeks); however, the two forms of exercise have different characteristics. Intensity and energy consumption were significantly lower for resistance than for aerobic exercise. Resistance exercise may be more feasible than aerobic exercise for NAFLD patients with poor cardiorespiratory fitness or for those who cannot tolerate or participate in aerobic exercise.
authors.affiliation: Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan; Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.
authors.forename: Ryuki
authors.initials: R
authors.lastname: Hashida
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan. Electronic address: takumi@med.kurume-u.ac.jp.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawaguchi
authors.affiliation: Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan; Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Bekki
authors.affiliation: Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan; Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Omoto
authors.affiliation: Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan; Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Matsuse
authors.affiliation: Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan; Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nago
authors.affiliation: Department of Physical Therapy School of Health Sciences at Fukuoka, International University Health and Welfare, Enokizu, Okawa, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takano
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Asakura Medical Association Hospital, Asakura, Japan; Liver Cancer Division, Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan.
authors.forename: Takato
authors.initials: T
authors.lastname: Ueno
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan; Liver Cancer Division, Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Koga
authors.affiliation: Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia.
authors.forename: Jacob
authors.initials: J
authors.lastname: George
authors.affiliation: Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan; Division of Rehabilitation, Kurume University Hospital, Kurume, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Shiba
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan; Liver Cancer Division, Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Torimura
mesh_terms: D015444:Exercise / Q000502:physiology*; D006801:Humans; D065626:Non-alcoholic Fatty Liver Disease / Q000628:therapy*; D018579:Patient Selection; D055070:Resistance Training / Q000379:methods*
keywords: Adipokine; Aerobic training; Exercise energy consumption; Myokine; Resistance training