Do we really need another reason to exercise? We know that regular physical activity reduces risk of heart disease, stroke, diabetes, Alzheimer’s, depression, and so on. Exercise is an essential component for the smooth running of a healthy liver.

Although my hepatitis C is cured, I continue to take care of my liver. At this point, my biggest liver-related risk is fatty liver disease (medically called nonalcoholic fatty liver disease (NAFLD). In the March 2018 World Journal of Gastroenterology, Mazen Noureddin and team reported that nearly half the patients with hepatitis C who achieved a sustained virologic response after treatment with direct-acting antivirals (DAAs) had NAFLD. (Fatty Liver Prevalence in Hepatitis C patients after Sustained Virological Response with Direct-Acting Antivirals )

Adding more weight to why I need to be concerned, the prevalence of NAFLD is increasing. (Healthcare Cost and Utilization in Nonalcoholic Fatty Liver Disease: Real‐World Data from a Large US Claims Database - Alina M. Allen, et al. Hepatology May 18, 2018)

In short, NAFLD is the liver disease that many of us are at risk for simply because of the American diet and lifestyle. Add in a history of hepatitis C, and you have another risk factor. Liver specialists are acutely aware of this, as evidenced by the title of an editorial in the May 2018 issue of Hepatology, ‘Nonalcoholic fatty liver disease, metabolic syndrome, and the fight that will define clinical practice for a generation of hepatologists.’  

Let’s stop here for a moment. If you don’t know what NAFLD is, you can learn about it here. Basically, NAFLD is a condition caused when excess fat accumulates around the liver. The liver becomes inflamed and damaged, and can become cirrhotic. Exercise, weight loss, and a healthy diet can reduce the risk, and are also essential tools for treating NAFLD.

Research shows that physical activity makes a huge difference in treating NAFLD. I was curious about this, and had my curiosity somewhat satisfied by another article in the May 2018 issue of Hepatology ‘Exercise alters the hepatic immunophenotype to protect against inflammatory liver disease’ by Kathleen Corey and Harmeet Mahli.  

I say ‘somewhat satisfied’ because in truth, we don’t completely know why exercise has such a beneficial effect on the liver, in particular NAFLD. However, we have data, and although not all of it is from human studies, we have enough to think that exercise stimulates the immune system, which reduces inflammation in the liver. Macrophages play an important role. These are a type of white blood cell which basically consume cellular debris, foreign substances, microbes, cancer cells, and so on. Macrophages devour unwanted stuff, kind of like Pac Man. 

So, if you are need a reason to exercise, think about your macrophages. Want more specific guidance such as how much exercise and how often? This link can answer that and has information about how to treat and prevent NAFLD.