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Original Research

Open Access

Effect of a combination of aerobic exercise and dietary modification on liver function in overweight and obese men

  • Xiao-Guang Zhao1,2
  • Hui-Ming Huang1,2
  • Chen-Ya Du2

1Research Academy of Grand Health, Ningbo University, Ningbo City, Zhejiang, P. R. China

2Faculty of Sport Science, Ningbo University, Ningbo City, Zhejiang, P. R. China

DOI: 10.31083/jomh.2021.025

Online publish date: 31 March 2021

*Corresponding Author(s): Xiao-Guang Zhao E-mail:

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Background: Obesity is not only associated with cardiovascular diseases but also a primary cause of liver dysfunction and other related diseases. This study's aim was to determine the impact of a combination of dietary modification and aerobic exercise on liver function in overweight and obese adult males.

Methods: 45 overweight or obese men were randomly divided between the control group (n = 22) and intervention group (n = 23). Subjects in the intervention group were provided with dietary modification and aerobic exercise programmes. Dietary modification is a diet which restricts calorie intake and balances nutrients. Before and after 12 weeks of intervention, participants' anthropometric characteristics and biochemical parameters relating to liver function including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were measured.

Results: 12 weeks of aerobic exercise and dietary modification resulted in average weight loss of 10.6%, and body mass index, waist circumference and fat percentage decreased by 10.2%, 9.4% and 14.5% (P < 0.05). AST, ALT, GGT and ALP in the intervention group reduced by 20.6%, 18.1%, 37.7% and 6.1% (P < 0.05). Compared to the control group, AST, ALT, GGT and ALP in the intervention group were markedly lower (P < 0.05). Furthermore, there was a markedly positive relationship between the reduction rates of body weight and GGT (P < 0.05).

Conclusion: 12 weeks of aerobic exercise and dietary modification caused significant weight, waist circumference and body fat percentage reduction in overweight and obese men and their liver function was improved. The findings can provide a scientific reference for the improvement of liver function and prevention of liver diseases among overweight and obese people.


Aerobic exercise; Dietary modification; Liver function; Overweight and obesity; Weight reduction

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Xiao-Guang Zhao,Hui-Ming Huang,Chen-Ya Du. Effect of a combination of aerobic exercise and dietary modification on liver function in overweight and obese men. Journal of Men's Health. 2021.doi:10.31083/jomh.2021.025.


[1] Hruby A, Manson JE, Qi L, Malik VS, Rimm EB, Sun Q, et al. Determinants and consequences of obesity. American Journal of Public Health. 2016; 106: 1656-1662.

[2] Sorrie MB, Yesuf ME, GebreMichael TG. Overweight/Obesity and as-sociated factors among preschool children in Gondar City, Northwest Ethiopia: a cross-sectional study. PLoS ONE. 2017; 12: e0182511.

[3] Van Gaal LF, Mertens IL, De Block CE. Mechanisms linking obesity with cardiovascular disease. Nature. 2006; 444: 875-880.

[4] Nayyar M, Lastra G, Acevedo CM. Mineralocorticoids and Cardiovas-cular Disease in Females with Insulin Resistance and Obesity. Current Hypertension Reports. 2018; 20: 88.

[5] Nikolopoulou A, Kadoglou NPE. Obesity and metabolic syndrome as related to cardiovascular disease. Expert Review of Cardiovascular Therapy. 2012; 10: 933-939.

[6] Vimaleswaran KS, Cavadino A, Verweij N, Nolte IM, Leach IM; LifeLines Cohort Study, et al. Interactions between uncoupling protein 2 gene polymorphisms, obesity and alcohol intake on liver function: a large meta-analysed population-based study. European Journal of Endocrinology. 2015; 173: 863-872.

[7] Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: from pathophysiology to therapeutics. Metabolism: Clinical and Experimental. 2019; 92: 82-97.

[8] Ruiz JR, Lasa A, Simon E, Larrarte E, Labayen I. Lower plasma NAMPT/visfatin levels are associated with impaired hepatic mito-chondrial function in non-diabetic obese women: a potential link between obesity and non-alcoholic fatty liver disease. Nutrition, Metabolism, and Cardiovascular Diseases. 2012; 22: e1-e2.

[9] Goodman ZD. The impact of obesity on liver histology. Clinics in Liver Disease. 2014; 18: 33-40.

[10] Chitturi S, Farrell GC. Etiopathogenesis of nonalcoholic steatohepati-tis. Seminars in Liver Disease. 2001; 21: 27-41.

[11] Dobrosielski DA, Papandreou C, Patil SP, Salas-Salvadó J. Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk. European Respiratory Review. 2017; 26: 160110.

[12] Fock KM, Khoo J. Diet and exercise in management of obesity and overweight. Journal of Gastroenterology and Hepatology. 2013; 28: 59-63.

[13] Ho SS, Dhaliwal SS, Hills AP, Pal S. The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial. BMC Public Health. 2012; 12: 704.

[14] Weiss EP, Albert SG, Reeds DN, Kress KS, McDaniel JL, Klein S, et al. Effects of matched weight loss from calorie restriction, exercise, or both on cardiovascular disease risk factors: a randomized intervention trial. The American Journal of Clinical Nutrition. 2016; 104: 576-586.

[15] Skrypnik D, Ratajczak M, Karolkiewicz J, Mądry E, Pupek-Musialik D, Hansdorfer-Korzon R, et al. Effects of endurance and endurance-strength exercise on biochemical parameters of liver function in women with abdominal obesity. Biomedicine & Pharmacotherapy. 2016; 80: 1-7.

[16] Katsagoni CN, Georgoulis M, Papatheodoridis GV, Panagiotakos DB, Kontogianni MD. Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: a meta-analysis. Metabolism: Clinical and Experimental. 2017; 68: 119-132.

[17] Sreenivasa Baba C, Alexander G, Kalyani B, Pandey R, Rastogi S, Pandey A, et al. Effect of exercise and dietary modification on serum aminotransferase levels in patients with nonalcoholic steatohepatitis. Journal of Gastroenterology and Hepatology. 2006; 21: 191-198.

[18] Hann H, Wan S, Myers RE, Hann RS, Xing J, Chen B, et al. Com-prehensive analysis of common serum liver enzymes as prospective predictors of hepatocellular carcinoma in HBV patients. PLoS ONE. 2012; 7: e47687.

[19] Liu C, Zhou W, Lu Z, Wang X, Qiu Z. The associations between liver enzymes and the risk of metabolic syndrome in the elderly. Experimental Gerontology. 2018; 106: 132-136.

[20] Zhou B. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults–study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomedical and Environmental Sciences. 2002; 15: 83-96.

[21] Ramírez-Vélez R, Rodrigues-Bezerra D, Correa-Bautista JE, Izquierdo M, Lobelo F. Reliability of health-related physical fitness tests among colombian children and adolescents: the FUPRECOL study. PLoS ONE. 2015; 10: e0140875.

[22] Jacobs PL, Klose KJ, Guest R, Needham-Shropshire B, Broton JG, Green BA. Relationships of oxygen uptake, heart rate, and ratings of perceived exertion in persons with paraplegia during functional neuromuscular stimulation assisted ambulation. Spinal Cord. 1997; 35: 292-298.

[23] Zhao X, Tsujimoto T, Kim B, Katayama Y, Ogiso K, Takenaka M, et al. Does weight reduction affect foot structure and the strength of the muscles that move the ankle in obese Japanese adults? The Journal of Foot and Ankle Surgery. 2018; 57: 281-284.

[24] World Health Organization. Obesity and overweight. 2020. Available at:

detail/obesity-and-overweight (Accessed: 27 September 2020).

[25] van Dijk SJ, Tellam RL, Morrison JL, Muhlhausler BS, Molloy PL. Recent developments on the role of epigenetics in obesity and metabolic disease. Clinical Epigenetics. 2015; 7: 66.

[26] Esser N, Legrand-Poels S, Piette J, Scheen AJ, Paquot N. Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Research and Clinical Practice. 2014; 105: 141-150.

[27] Zeyda M, Stulnig TM. Obesity, inflammation, and insulin resistance-a mini-review. Gerontology. 2009; 55: 379-386.

[28] Westerterp-Plantenga MS, Nieuwenhuizen A, Tomé D, Soenen S, Westerterp KR. Dietary protein, weight loss, and weight maintenance. Annual Review of Nutrition. 2009; 29: 21-41.

[29] Palmer BF, Clegg DJ. Strategies to Counter Weight Loss-Induced Reductions in Metabolic Rate. Current Sports Medicine Reports. 2019; 18: 258-265.

[30] Alves-Bezerra M, Cohen DE. Triglyceride metabolism in the liver. Comprehensive Physiology. 2017; 8: 1-8.

[31] Ponziani FR, Pecere S, Gasbarrini A, Ojetti V. Physiology and pathophysiology of liver lipid metabolism. Expert Review of Gastroen-terology & Hepatology. 2015; 9: 1055-1067.

[32] Verrijken A, Francque S, Mertens I, Talloen M, Peiffer F, Van Gaal L. Visceral adipose tissue and inflammation correlate with elevated liver tests in a cohort of overweight and obese patients. International Journal of Obesity. 2010; 34: 899-907.

[33] Angulo P, Keach JC, Batts KP, Lindor KD. Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis. Hepatology. 1999; 30: 1356-1362.

[34] Hossain N, Afendy A, Stepanova M, Nader F, Srishord M, Rafiq N, et al. Independent predictors of fibrosis in patients with nonalcoholic fatty liver disease. Clinical Gastroenterology and Hepatology. 2009; 7: 1224-1229.

[35] Yang SQ, Lin HZ, Lane MD, Clemens M, Diehl AM. Obesity increases sensitivity to endotoxin liver injury: implications for the pathogenesis of steatohepatitis. Proceedings of the National Academy of Sciences of the United States of America. 1997; 94: 2557-2562.

[36] Hannah WN, Harrison SA. Effect of Weight Loss, Diet, Exercise, and Bariatric Surgery on Nonalcoholic Fatty Liver Disease. Clinics in Liver Disease. 2016; 20: 339-350.

[37] van der Heijden G, Wang ZJ, Chu ZD, Sauer PJJ, Haymond MW, Rodriguez LM, et al. A 12-week aerobic exercise program reduces hepatic fat accumulation and insulin resistance in obese, Hispanic adolescents. Obesity. 2010; 18: 384-390.

[38] Lee S, Deldin AR, White D, Kim Y, Libman I, Rivera-Vega M, et al. Aerobic exercise but not resistance exercise reduces intrahepatic lipid content and visceral fat and improves insulin sensitivity in obese adolescent girls: a randomized controlled trial. The American Journal of Physiology-Endocrinology and Metabolism. 2014; 305: E1222-E1229.

[39] Keating SE, George J, Johnson NA. The benefits of exercise for patients with non-alcoholic fatty liver disease. Expert Review of Gastroenterology & Hepatology. 2015; 9: 1247-1250.

[40] Huang MA, Greenson JK, Chao C, Anderson L, Peterman D, Jacobson J, et al. One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study. the American Journal of Gastroenterology. 2005; 100: 1072-1081.

[41] Mei Y, Chen L, Zeng P, Peng C, Wang J, Li W, et al. Combination of serum gamma-glutamyltransferase and alkaline phosphatase in pre-dicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis. World Journal of Clinical Cases. 2019; 7: 137-144.

[42] Shephard RJ, Johnson N. Effects of physical activity upon the liver. European Journal of Applied Physiology. 2015; 115: 1-46.

[43] Smart NA, King N, McFarlane JR, Graham PL, Dieberg G. Effect of exercise training on liver function in adults who are overweight or exhibit fatty liver disease: a systematic review and meta-analysis. British Journal of Sports Medicine. 2018; 52: 834-843.

[44] Arase Y, Suzuki F, Ikeda K, Kumada H, Tsuji H, Kobayashi T. Multi-variate analysis of risk factors for the development of type 2 diabetes in nonalcoholic fatty liver disease. Journal of Gastroenterology. 2009; 44: 1064-1070.

[45] Chen S, Liu C, Li S, Huang H, Tsai C, Jou H. Effects of therapeutic lifestyle program on ultrasound-diagnosed nonalcoholic fatty liver disease. Journal of the Chinese Medical Association. 2008; 71: 551-558.

[46] Ohno H, Yahata T, Yamashita K, Yamamura K, Sato Y, Yamamoto C, et al. Effect of physical training on immunoreactive gamma-glutamyltransferase in human plasma. Enzyme. 1988; 39: 110-114.

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