Weight loss and exercise can slow progression of chronic liver disease

Scientists at the Queensland Institute of Medical Research (QIMR) and the Princess Alexandra Hospital have demonstrated that losing weight and exercising regularly can significantly slow progression of chronic liver disease in those who are overweight.

“Being overweight is bad for the liver. And non-alcoholic fatty liver is increasingly being diagnosed in those who are overweight, diabetic, or who have insulin resistance syndrome, a precursor to diabetes. Overweight and obesity are also recognised risk factors for the progression of other chronic liver diseases, such as hepatitis C,” said dietician Dr Ingrid Hickman.

Once considered a relatively benign disease, non-alcoholic fatty liver is deemed to be much more serious as it can progress to cirrhosis and liver cancer.

In the study, 31 overweight patients with chronic hepatitis C and chronic fatty liver disease dieted for 15 months and exercised regularly. Their programme consisted of losing weight for three months and then maintaining their weight for the following 12 months.

The patients were seen by a dietician every week during the first three months and thereafter every month, and they completed 2 and a half hours of aerobic exercise every week for the entire period. Before the study began, only ten patients ever exercised regularly.

Levels of liver enzymes, fats and glucose in the blood were measured at the start of the study, at three months, and at the end of the study. Liver tissue samples were also taken, and the patients were asked to score their quality of life.

“At the end of the programme, over two thirds of the patients (68%) had maintained weight loss. The liver enzyme, ALT, high levels of which are associated with liver disease, also fell. And in those who maintained their weight loss, this was significantly lower than when patients began the programme. Insulin levels also fell,” said Dr Hickman.

Importantly, these improvements were obvious even in those who lost 4% to 5% of their body weight. Patients reported that their quality of life significantly improved after losing weight.

Ten patients regained their weight, mostly because they did less than 2.5 hours of exercise, and their liver ALT levels worsened.