If you’ve been diagnosed with MASLD or MASH, your health care provider has probably mentioned the critical role that exercise can play in your ongoing health. At the very least, regular exercise will keep you as healthy as possible. But oftentimes, it can even help reverse liver disease. That’s why regular physical activity is considered part of the treatment for these liver diseases.
Here’s what you should know.
What Are MASLD and MASH?
MASLD stands for metabolic dysfunction-associated steatotic liver disease, but what does that mean?
This is a group of liver diseases, informally called “fatty liver disease,” that develop when too much fat builds up in your liver. This happens because of metabolic dysfunction. The specific dysfunction could be, for example, obesity, high cholesterol, or type 2 diabetes. These put you at risk for fatty liver disease.
Unchecked, MASLD can lead to liver inflammation or MASH – metabolic dysfunction-associated steatohepatitis – which can be serious and cause liver damage that can’t be fixed.
What Can I Do to Improve My Liver Health?
A healthy lifestyle in general goes a long way toward maintaining or improving the health of your liver. Most of these tips will be things you already know about a healthy lifestyle, but it’s important to know that besides their overall effects on your general health, they also bring direct benefits to your liver:
- Maintain a healthy weight.
- Eat a healthy, balanced diet that’s high in fiber, high in lean protein, and low in saturated fats, sugar, and simple carbohydrates.
- Avoid alcohol and illegal drugs.
- Take all medications correctly, avoiding taking too much or taking certain medications at the same time that your doctor or pharmacist told you to take separately.
- Exercise regularly.
How Does Exercise Help Liver Health?
As you already know, exercise has all kinds of health benefits in general, regardless of your health condition. But it also has specific benefits for your liver.
Exercise improves blood flow to your liver
MASLD slows or blocks blood flow to your liver. Just as exercise increases blood flow elsewhere in your body, it does the same in your liver. Exercise improves how your blood vessels dilate – or widen – to provide more blood and oxygen to your liver.
Exercise improves the good bacteria in your body
You may have heard that the overall makeup of the bacteria in your gut has far-reaching effects – both good and bad – on your whole body’s health. There are helpful bacteria and harmful bacteria. Too much of the harmful stuff than the helpful stuff can cause health problems.
When it comes to your liver health, researchers have found that bacteria from your gut and immune cells in your liver are in conversations with each other. Researchers call this “crosstalk.” Crosstalk between your liver and the helpful “good” bacteria can have positive effects on liver health. Similarly, chatter with “bad” bacteria can have negative effects.
The way to avoid this is to make sure that in the balance between good and bad bacteria, the scale always tips toward good. Exercise can help you achieve that.
Research has found that exercise can increase the number of good bacteria moving around your system and make the overall bacterial makeup more diverse. This is also good for your overall health. Too much of the same thing isn’t as good as a nice mix.
Exercise improves insulin sensitivity
Insulin resistance is another metabolic problem that raises your risk for liver disease. Insulin is a hormone in your body that your cells need to turn sugar into energy. When your cells resist insulin, they can’t turn sugar into energy. It builds up in your bloodstream instead, which can lead to diabetes. Insulin resistance also disrupts normal fat and lipid breakdown, leading to fatty liver.
Exercise makes your cells more sensitive to insulin, so they can process and break down sugar and fats the way they should. By lowering your blood sugar, exercise lowers your risk for both diabetes and liver disease.
Exercise reduces fat in your liver
Studies show that fatty liver disease is more severe in people who aren’t physically active. Exercise has been shown to reduce the amount of fat in your liver – even if it doesn’t get rid of a ton of fat throughout the rest of your body. That is – even if you can’t see the physical effects of exercise when you look in the mirror every day, it’s still working its magic on your liver.
Research shows that exercise amps up the burning of fatty acids into energy in your liver and stops the transformation of fatty acids into fat.
Exercise reduces body fat
This one you already know: Exercise helps you lose weight by building muscle and burning fat. Because obesity and being overweight harm liver health and raise risk for liver disease, losing excess weight can improve liver health. In fact, losing just 7% of your bodyweight – that’s 17 pounds for a person who weighs 250 pounds – can help reverse scarring on your liver, which is an advanced and serious complication of liver disease.
With overweight and obesity, weight loss can also make improvements in many of the other health conditions that might be adding to your liver disease, like diabetes and high cholesterol.
What’s the Best Exercise for Liver Health?
Exercise, of course, is a pretty broad term. So what’s the best kind for your liver? Research has shown that just about any type of exercise comes with benefits to your liver.
In one study, researchers compared a 12-week aerobic exercise program to a 12-week strength training program in people with fatty liver disease and found that both types of exercise led to a decline in fat in the liver and in blood sugar. Several studies have confirmed this: both aerobic exercise, like dancing, brisk walking, or playing tennis, as well as strength training, like weight lifting, pushups, and squats, can lower fat levels in your liver and improve the metabolic factors that impact your risk for liver disease.
Bottom line: Don’t sweat what type of exercise to choose. Pick something you enjoy because that’s the one you’re more likely to stick with.
How Much Should You Exercise for Better Liver Health?
National guidelines recommend that all adults, including those with liver disease, get 150 minutes of moderate-to-high-intensity physical activity every week. That’s 30 minutes a day, five days a week, of some sort of activity that gets your heart pumping a little faster and gets you breathing a little heavier. What type of exercise might achieve that depends on your fitness level. For some, all it may take is a brisk walk. Others may need to take off in a run or throw down on the dancefloor to get there.
You don’t need to push yourself to your absolute full breathing capacity. If you’re breathing so heavily that you can’t speak, that may actually mess with your liver. You want to be breathing more heavily but not so heavy that you can’t talk.
In addition to the 150 minutes a week of some activity that gets you breathing heavier, recommendations call for two days a week of strength training, also called resistance training. That’s the kind of exercise that uses weights or your body weight to strengthen muscles. This can include lifting free weights or using weight machines, push-ups, pull-ups, sit-ups, squats – anything that creates resistance and gets you pushing or pulling to move some weight.
Exercise seems to bring benefits for your liver no matter how often you do it. The more exercise, the more benefits, but don’t exercise so much that you hurt yourself. Talk to your health care provider about how much exercise to start with and listen to your body. If it hurts, that might be your body telling you to slow down.
How Do You Start an Exercise Routine?
If exercise isn’t currently a part of your daily life and you’re ready to change that, here are some tips to get you started.
Talk to your health care provider
If you’re unsure of how to start or don’t have any idea what type of exercise to pick, talk to your doctor. They may make recommendations based on your overall health and fitness level. They may also be able to make suggestions that fit your schedule, preferences, and budget. Your doctor might even refer you to an exercise program, trainer, or physical therapist.
Start where you are
If exercise is new for you, you might not be ready for 150 minutes a week right out of the gate. Do what you can. Any movement is better than none.
Maybe you start with a 10-minute walk every day. Or you might start with a seated workout that you find online. Build up to longer, harder, and more frequent workouts when your original workout starts to feel a little easier.
Find a program for beginners
It’s normal to feel intimidated at the gym, especially if it’s your first time. To ease the nerves, look for an exercise program for beginners. For example, if you’re interested in running, many communities have a couch-to-5K program that prepares true beginners for an upcoming 3-mile race.
Choose something you enjoy
If running on a treadmill or riding a stationary bike sounds like a drag to you, don’t do it! Pick something that truly sounds fun to you. Sign up for a salsa class. Join a Zumba class. Walk dogs for your local animal shelter. If you go for something you enjoy, you’re more likely to stick with it. It’s less likely to feel like medicine and more likely to feel like a hobby.
Make it social
Grab a few friends for a power walk and a gossip session. Or round up friends or family to join a community softball team. Making your exercise time your social time can make it more enjoyable and make you less likely to make an excuse to back out.
Make it part of your daily routine
Put exercise on your calendar just as you would a business meeting, doctor’s appointment, or social event. That way you have the time in your schedule and you’ve committed to doing it.
It may also help to add physical activity into things you already need to do. Walk or bike to work if you can. Park further away from the supermarket or the office. Take the stairs instead of the elevator.
Get an accountability partner
Tell someone close to you about your plan to start a new exercise routine. When you share a plan or goal with someone else, you may be more likely to stick to it. You can lean on your partner in many ways. You could ask them to check in every few days to ask how the exercise is going. Or maybe the two of you want to work out together. You may be much better about getting to the gym knowing your friend is waiting there for you!
Get ready the night before
If your new exercise routine involves getting to the gym on your lunch break or heading to a dance class after work, pack your bag the night before and leave it by the door. Make sure you have your shoes, clothes, towel, water bottle, and any toiletries you need to freshen up afterward. It’s so easy to blow off a workout if you’re late getting out the door and don’t have time to grab your stuff.
Don’t get discouraged
If you miss a day or get off track when life gets in the way, that’s no reason to quit. All is not lost. Just get back on the horse and build back up to where you were before.
Recap
- MASLD and MASH are fatty liver diseases caused by other conditions like obesity or diabetes. They can lead to serious damage if untreated.
- Regular exercise can help by lowering fat in your liver, improving blood flow, and boosting insulin sensitivity. Aim to get 150 minutes of activity every week, and maintain a healthy lifestyle to support your liver.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
British Liver Trust: “Physical activity and exercise.”
Liver Foundation: “13 Tips on How to Have a Healthy Liver.”
Journal of Hepatology: “Vascular pathobiology in chronic liver disease and cirrhosis – Current status and future directions.”
Penn State Health: “How patients with liver disease can benefit from exercise.”
Biomedicines: “The Gut Microbiota: How Does It Influence the Development and Progression of Liver Diseases.”
Cleveland Clinic: “Metabolic dysfunction-associated steatotic liver disease.”
BMJ Open Sport and Exercise Medicine: “Update on the effects of physical activity on insulin sensitivity in humans.”
Gene Expression: “The Effects of Physical Exercise on Fatty Liver Disease.”
Mediators of Inflammation: “Understanding the Role of Exercise in Nonalcoholic Fatty Liver Disease: ERS-Linked Molecular Pathways.”
National Institute on Aging: “5 Tips to Help You Stay Motivated to Exercise.”
Duke Recreation and Physical Education: “Accountability Partners: Don't Achieve Your Goals Alone!”
