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Nonalcoholic Fatty Liver Disease and Exercise: 5 Facts

Medically reviewed by Hailey Pash, APN-BC
Posted on July 10, 2024

Nonalcoholic fatty liver disease (NAFLD) can be a serious complication of obesity. The condition was recently renamed metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD is a term that acknowledges how much metabolism is involved in this form of liver disease.

Up to 90 percent of people with class 3 obesity (a body mass index of 35 or higher) have MASLD. It’s also more common in people with type 2 diabetes compared to the general population.

Fortunately, healthy lifestyle changes can help protect your body against liver problems. Exercise isn’t just helpful for managing obesity, it’s also an effective strategy to prevent related issues like fatty liver disease. Check out these facts to learn what exercise can do for your liver.

1. Exercise Lowers Risk Factors for Liver Disease

In addition to obesity and diabetes, fatty liver disease is also linked to metabolic syndrome, high blood pressure, high cholesterol, and high triglyceride levels (a type of fat found in the blood). Unlike certain treatments, which target one of these issues at a time, exercise tackles several problems at once.

Physical activity has multiple effects on blood pressure. It helps your blood vessels expand more easily and supports the formation of new vessels for blood flow. In people with high blood pressure, exercise reduces the constriction or tightening of blood vessels. Although exercise is an active process, it ultimately helps you relax better during rest periods.

Exercise can also make the body better at using fat for energy. As a result, regular exercise helps break down lipids, including fat, in the blood, improving cholesterol and triglyceride levels.

2. Exercise Directly Affects the Liver

People with obesity can benefit from exercise. Lowering your body weight, even by as little as 5 percent, which is considered “meaningful weight loss,” is associated with health benefits. However, if you’re working out and not noticing a big difference in your weight, that doesn’t mean you’ve been wasting your time.

Studies on NAFLD have found that even if exercise doesn’t lead to weight loss, it can still decrease fat in the liver. Multiple studies have found that structured exercise, even without weight loss, reduces liver fat by 20 percent to 30 percent.

Exercise also lowers the body’s insulin resistance. When that happens, less fat is absorbed by and produced in the liver. Additionally, exercise helps encourage the breakdown of liver fat.

In some people with MASLD, the liver is inflamed. Liver inflammation is a progression of MASLD. It’s called metabolic dysfunction-associated steatohepatitis (MASH). In the past, this condition was referred to as nonalcoholic steatohepatitis (NASH). There’s some evidence that exercise boosts protective antioxidants and anti-inflammatory markers in the liver.

3. Any Type of Exercise Can Help Liver Health

Research has shown that 12 weeks of intense aerobic exercise or resistance training can improve a fatty liver. If you’re hung up about how to spend your exercise time, don’t overthink it.

Everyone has a different starting point. An article in Frontiers and Nutrition shows that being active for 20 to 60 minutes per session at least four days per week can reverse liver damage in people with MASH (whether they change their diet or not). Specifics on the type and intensity of exercise aren’t as important as simply being consistent.

It can take at least six months of regular exercise to have an impact on liver health. Aim for a workout that’s challenging but not so hard that you need days to recover between sessions. Varying your workouts and listening to your body when something doesn’t feel right can help you safely increase your activity level over time.

4. Exercise May Help Advanced Liver Disease

Exercise can do more than prevent fatty liver disease or reverse the early stages of damage. It can also be an important part of treatment for people with advanced liver disease.

Nonalcoholic fatty liver disease can lead to serious complications, like liver cancer and fibrosis or cirrhosis (severe scarring) of the liver. Cirrhosis is considered permanent damage that can only be reversed by having a liver transplant. However, exercise can improve the quality of life in people with cirrhosis. Resistance training helps combat the loss of muscle mass and strength that accompanies cirrhosis. Exercise helps people with cirrhosis build endurance and can lead to better transplant results and longer lives.

No negative effects have been reported in studies on exercise with cirrhosis. Nonetheless, people with cirrhosis should only start exercising under the supervision of their health care team. Special considerations are needed to ensure that the program is tailored to their needs and doesn’t overly stress the body. These findings are an important reminder that it’s never too late to focus on your health and well-being.

5. Being Sedentary May Lead to Liver Disease

Even if you’re not working out regularly, making an effort to move more throughout the day can also help your liver. Being inactive is an independent risk factor for fatty liver disease. Break up long periods of sitting by standing up, taking a short walk, stretching, or doing some body weight squats.

On MyObesityTeam, members have shared how they add physical activity to their daily lives. “When I grocery shop, I walk to the store for about 15 minutes longer,” said one member. “I also use a stretch band to do exercises sitting in a chair, on the couch, or sitting on my bed. I do three to four 10- to 15-minute sessions a day, anything to keep me moving. A couple of times a week, I do armchair Pilates.”

Another wrote, “The best exercise for me is swimming, walking in the water, and doing exercises in the pool. It’s amazing how quickly you tone up, and it’s not tiring because you’re having fun.”

“I always say put some music on and just move until you feel out of breath, take a rest, and then continue to move,” another member suggested.

If you’re new to exercise training or not sure how to get started, ask your doctor to connect you with a physical therapist. They can assess your current fitness level and screen for any injuries or weaknesses. A physical therapist can help create an exercise program that’s right for you and offer support as you learn new ways to move.

Talk With Others Who Understand

MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 53,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.

Did you know about the positive effects of exercise on liver function? What other healthy lifestyle modifications have you been working on? Share your comments below, or start a conversation by posting on your Activities page.

    Hailey Pash, APN-BC , a registered nurse and advanced practice nurse, holds a Master of Science in Nursing from the University of South Alabama. Learn more about her here.
    Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

    A MyObesityTeam Member

    I have fatty liver disease but not diabetes. So far I've been able to keep the necrosis on the liver down to a minimum even though I weigh over 400lbs. I think it's because I buy staple food and… read more

    September 24
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    I Have COPD Are There Exercises I Could Do That Would Work And Not Affect My Breathing

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