Physical activity and
non alcoholic fatty liver disease
WHAT IS NON ALCOHOLIC FATTY LIVER DISEASE Non alcoholic fatty liver disease (NAFLD) is an excessive storage of fat within liver cells which is not due to high alcohol consumption. It is one of the most common forms of liver disease. The vast majority of patients have no symptoms related to their fatty liver and the condition is usually diagnosed when doctors do a blood test of liver function and find tests are abnormal. Occasionally, patients may present with right-sided abdominal discomfort.
WHY EXERCISE? Weight loss remains the primary goal in the management of fatty liver in overweight/obese people, but this is wrongly thought of as the reason for promoting regular exercise. There is increasing evidence that exercise itself is beneficial.. Several studies show that the chance of fatty liver is increased in people with low habitual physical activity or fitness levels and that exercise interventions reduce liver fatness and improve liver function tests in patients with NAFLD.
n To reduce weight effectively it is important that the amount of energy you use up during your daily activities (your energy expenditure) is greater than the amount of energy you take in (the food you eat). Physical activity is a crucial tool in helping increase energy expenditure (burn calories) and can help use up stored fat.
WHAT TYPE OF ACTIVITY IS BEST?
While stamina-based activity is particularly important for health benefits, you also need to include some strength and flexibility- based activity to get the best health gains.
Stamina-type activities: Walking, swimming, cycling, dancing, tennis and housework (washing floors or windows) Strength-type activities: Walking uphill, carrying shopping, climbing stairs, gardening (digging or mowing) and housework Flexibility-type activities: Dancing, yoga, Pilates, T’ai Chi and gardening
Tips on increasing your activity level n Walking is an ideal activity as it’s free and easy to do anywhere. Perhaps take a dog for a walk to make it more interesting or use a pedometer to count your steps.
n Look for opportunities to be active during your whole day. For example park at the far end of the car park, or walk one stop further to catch the bus, and take 10 minutes out of your lunch break to go for a walk.
n Try using the stairs instead of the escalator. If you do use the escalator start by walking part of the way up and progress to walking up the whole way.
n Choose activities that you enjoy doing. Involve your friends and family to make your activities fun, sociable and enjoyable.
n Physical activity also helps build muscle which speeds up your metabolic rate. This increases the amount of calories you burn even when you are not exercising.
n Reducing the fat around your stomach will help reduce the risk of developing high blood pressure, diabetes and having a heart attack or stroke.
n Physical activity also helps reduce high blood cholesterol levels. n Physical activity, along with a healthy diet, helps reduce stress and improves your overall feeling of wellbeing and quality of life.
STAYING SAFE If you suffer from other illnesses such as uncontrolled type 2 diabetes, uncontrilled high blood pressure or abnormal heart rythms it is important that you consult your doctor or a specialist fitness advisor (with a GP referral qualification) before undertaking an exercise programme.
If you get any of the following problems stop ask for medical advice from your GP or by contacting NHS Direct on 0845 4647: n discomfort in your chest or upper body brought on by physical activity
n uncomfortable or severe breathlessness during your activity n dizziness or nausea on exertion n fainting during or just after doing physical activity n palpitations (a very fast or irregular heart beat) during activity.
HOW MUCH AND HOW OFTEN?
Frequency Your main aim is to build up to 30 minutes of moderate intensity activity on 5 or more days of the week. If this seems too much to start with, try starting with 3 x 10 minute walks spread throughout the day and work towards 2 x 15 minute walks and then 30 continuous minutes. One goal is to try and increase your activity by 2 minutes each day. If you want to loose weight you need to aim for 250-300 minutes per week or 60 mins x 5 days.
Intensity Moderate intensity means breathing harder and getting warmer than normal. It does not need to be hard. You should be able to talk and be active at the same time.
Advice Whatever your chosen activity, it should be performed at a gentle intensity which gradually increases until after about 10 minutes you have reached the level you can maintain for your chosen period of activity. This gets the blood flowing to your muscles and allows your heart rate to increase gradually. When you are nearing the end of your activity you should also slowly decrease the level of activity over 5-10 minutes to allow your heart rate to slow down gradually.
Remember Set yourself realistic goals and don’t worry if you miss one day. Just make sure that the next day you pick up where you left off.
The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. To the extent permissible by law, the publisher, editors and contributors accept no liability for any loss, injury or damage howsoever incurred (including negligence) as a consequence, whether directly or indirectly, of the use by any person of the contents of this article.
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