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Sci Rep. 2017 Nov 21;7(1):15952. doi: 10.1038/s41598-017-16159-x.

Effect of aerobic exercise and diet on liver fat in pre-diabetic patients with non-alcoholic-fatty-liver-disease: A randomized controlled trial.

Cheng S1,2,3, Ge J4, Zhao C5, Le S6, Yang Y6, Ke D5, Wu N6, Tan X6,7, Zhang X6, Du X4, Sun J8, Wang R5, Shi Y9, Borra RJH10,11, Parkkola R10, Wiklund P7,12,13, Lu D14.

Author information

1
Exercise, Health and Technology Centre, Department of Physical Education, Shanghai Jiao Tong University, 200240, Shanghai, China. Sulin.cheng@jyu.fi.
2
Faculty of Sport and Health Sciences, University of Jyväskylä, 40014, Jyväskylä, Finland. Sulin.cheng@jyu.fi.
3
The Key Laboratory of Systems Biomedicine, Ministry of Education, Shanghai Center for Systems Biomedicne, Shanghai Jiao Tong University, 200240, Shanghai, China. Sulin.cheng@jyu.fi.
4
Shanghai Yangpu district Shidong Hospital, 200090, Shanghai, China.
5
School of Kinesiology, Shanghai University of Sport, 200438, Shanghai, China.
6
Exercise, Health and Technology Centre, Department of Physical Education, Shanghai Jiao Tong University, 200240, Shanghai, China.
7
Faculty of Sport and Health Sciences, University of Jyväskylä, 40014, Jyväskylä, Finland.
8
Clinical Nutrition Centre, Fudan University Huadong Hospital, 200040, Shanghai, China.
9
Bio-X, Shanghai Jiao Tong University, 200030, Shanghai, China.
10
Department of Diagnostic Radiology, University of Turku and Turku University Hospital, Turku, Finland.
11
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
12
Department of Epidemiology and Biostatistics, Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
13
Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
14
School of Kinesiology, Shanghai University of Sport, 200438, Shanghai, China. ludajiang2000@aliyun.com.

Abstract

The study aimed to assess whether aerobic exercise (AEx) training and a fibre-enriched diet can reduce hepatic fat content (HFC) and increase glycaemic control in pre-diabetic patients with non-alcoholic fatty liver disease (NAFLD). Six-hundred-and-three patients from seven clinics in Yangpu district, Shanghai, China were recruited. Of them 115 individuals aged 50-65-year fulfilled the inclusion criteria (NAFLD with impaired fasting glucose or impaired glucose tolerance) and were randomly assigned into exercise (AEx n = 29), diet (Diet n = 28), exercise plus diet (AED n = 29), or no-intervention (NI n = 29) groups. Progressive supervised AEx training (60-75% VO2max intensity) was given 2-3 times/week in 30-60 min/sessions, and the diet intervention was provided as lunch with 38% carbohydrate and diet fibre of 12 g/day for 8.6-month. HFC was assessed by 1H MRS. We found that HFC was significantly reduced in the AEx (-24.4%), diet (-23.2%), and AED (-47.9%) groups by contrast to the 20.9% increase in the NI group (p = 0.001 for all) after intervention. However, only AED group significantly decreased HbA1c (-4.4%, p = 0.01) compared with the NI group (-0.6%). Aerobic exercise training combined with fibre-enriched diet can reduce HFC more effectively than either exercise or increased fibre-intake alone in pre-diabetic patients with NAFLD.

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