How to improve liver health: Expert-recommended diet and aerobic exercise

The Asian Pacific Association for the Study of the Liver recommends diet and physical activity as primary treatments for MAFLD.

Diet and physical activity are the main treatments for metabolic-associated fatty liver disease (MAFLD), according to clinical guidelines issued by the Asian Pacific Association for the Study of the Liver. It said that weekly 2.5-4 hours of moderate to vigorous aerobic exercise -- such as cycling, brisk walking or jogging -- is related to a meaningful 30 per cent reduction in liver fat.

Guidelines recommend diet and exercise for treating metabolic-associated fatty liver disease. (Twitter/AHealthyBod)

The guidelines, published in the Hepatology International journal, advised overweight or obese MAFLD patients to shed 5-10 per cent of body weight, and recommended "frequent self-weighing (at least weekly), reduced-calorie diets, and increased physical activity" for managing weight in the long-term.

Best diet for MAFLD

Authors of the guidelines said that MAFLD affects over a fourth of the world's adult population and is the leading cause of liver disease globally. They said that a weight reduction of over five per cent helps lower excess fat in liver, and that of over 10 per cent improves liver fibrosis, in which scar tissue builds up due to chronic inflammation.

Outlining 'practical recommendations' for diet for weight loss, the guidelines advised 1,200-1,800 kilocalories a day or 500-750 kilocalories less daily for MAFLD patients. Mediterranean diet, with an increased intake of monounsaturated and omega-3 fatty acids and reduced refined carbohydrates and sugars, is the most evidence-based food regime suggested to address MAFLD.

The diet, stressing on whole grains, nuts and seeds, fruits and vegetables, and olive oil, is associated with a reduced risk of type 2 diabetes, cardiovascular disease, liver fat and fibrosis in patients with MAFLD, the authors said. Mediterranean diet also includes seafood, lean proteins and a moderate amount of dairy, eggs, and poultry.

Exercise for better liver health

The authors added that while intermittent fasting and time-restricted feeding help with weight loss and improving metabolism, evidence regarding their efficacy on MAFLD is limited. Drinking three or more cups of coffee daily, regardless of caffeine content, is considered beneficial, the team said.

Aerobic exercise -- which gets one's heart rate up and improve oxygen delivery to muscles and organs -- helps people with MAFLD by reducing visceral adiposity (abdominal fat) and 'bad' cholesterol, along with improving cardiorespiratory fitness and vascular health, the authors said.

"As little as 135 minutes (over two hours) per week may be effective," they wrote. The authors also recommended resistance, or weight, training for 2-3 days a week, in addition to aerobic exercise, for its profound benefits on lean mass, bone mass, blood pressure and glycaemic control.