The effects of high- intensity interval training with and without intermittent fasting on body composition and markers of cardiometabolic risk in patients with metabolic-associated fatty liver disease
الموضوعات : Exercise Physiology and PerformanceSaber Rezanejad 1 , Mohammad Sharifi 2 , Mahtab Enteshari 3 , Akram khani Rozveh 4
1 - Faculty of Sport Sciences, University of Almahdi mehr, Isfahan, Iran.
2 - Faculty of Sport Sciences, University of Agig, Isfahan, Iran
3 - Faculty of Sport Sciences, University of Almahdi mehr, Isfahan, Iran.
4 - Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran.
الکلمات المفتاحية: Fasting glucose, Insulin, TC, TG, HIIT, IF, MAFLD,
ملخص المقالة :
Background and aim: The combined effects of high-intensity interval training (HIIT) and intermittent fasting (IF) have been poorly studied, especially on cardiometabolic risk factors in patients with MAFLD. Therefore, the aim of the present study was to study the effects of 12 weeks of high-intensity interval training with and without intermittent fasting on body composition and cardiometabolic risk markers in patients with metabolic-related fatty liver disease.
Materials and Methods: is study, 48 men with MAFLD were divided into 3 groups: high-intensity interval training or HIIT (n = 15), intermittent fasting or IF (n = 17), and a combination of HIIT + IF (n = 16). The high-intensity interval training program was performed in the two intervention groups, three times a week at an intensity of 80-95% of peak heart rate, 14 minutes per session for 12 weeks. Serum levels of fasting glucose, insulin, insulin resistance, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, and anthropometric measurements were measured before and after the study.
Results: Analysis of covariance showed a significant decrease in weight, body mass index, total cholesterol, triglycerides, low-density lipoprotein, HIIT+IF and IF groups compared to the HIIT alone group and a significant increase in high-density lipoprotein in the HIIT+IF and HIIT alone groups compared to the IF group (p>0.05). However, a significant decrease in serum levels of fasting glucose, insulin, and insulin resistance was observed in all three groups after the study compared to baseline (p>0.05).
Conclusion: The results of the present study indicate that HIIT combined with IF can help improve body composition and cardiometabolic risk markers in patients with MAFLD.
1. Pavlides, M.; Cobbold, J. Non-Alcoholic Fatty Liver Disease. Medicine 2019, 47, 728–733.
2. Younossi, Z.M. Non-Alcoholic Fatty Liver Disease—A Global Public Health Perspective. J. Hepatol. 2019, 70, 531–544.
3. Kumar, R.; Priyadarshi, R.N.; Anand, U. Non-Alcoholic Fatty Liver Disease: Growing Burden, Adverse Outcomes and Associations. J. Clin. Transl. Hepatol. 2020, 8, 76–86.
4. Vanni, E.; Bugianesi, E.; Kotronen, A.; De Minicis, S.; Yki-Järvinen, H.; Svegliati-Baroni, G. From the Metabolic Syndrome to NAFLD or Vice Versa? Dig. Liver Dis. 2010, 42, 320–330.
5. Mantovani, A.; Byrne, C.D.; Bonora, E.; Targher, G. Nonalcoholic Fatty Liver Disease and Risk of Incident Type 2 Diabetes: A Meta-Analysis. Diabetes Care 2018, 41, 372–382.
6. Papandreou, D.; Andreou, E. Role of Diet on Non-Alcoholic Fatty Liver Disease: An Updated Narrative Review. World J. Hepatol 2015, 7, 575–582.
7. Buzzetti, E.; Pinzani, M.; Tsochatzis, E.A. The Multiple-Hit Pathogenesis of Non-Alcoholic Fatty Liver Disease (NAFLD). Metabolism 2016, 65, 1038–1048.
8. Targher, G.; Day, C.P.; Bonora, E. Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease. N. Engl. J. Med. 2010, 363, 1341–1350.
9. Puri P, Fuchs M. Population management of nonalcoholic fatty liver disease. Fed Pract Health care Professionals VA DoD PHS. 2019;36(2):72–82.
10. Anania C, Perla FM, Olivero F, Pacifico L, Chiesa C. Mediterranean diet and nonalcoholic fatty liver disease. World J Gastroenterol. 2018;24(19):2083–94.
11. Kasper Ter Horst; Serlie, M. Fructose Consumption, Lipogenesis, and Non-Alcoholic Fatty Liv-er Disease. Nutrients 2017, 9, 981.
12. Romero-Gómez, M.; Zelber-Sagi, S.; Trenell, M. Treatment of NAFLD with Diet, Physical Ac-tivity and Exercise. J. Hepatol. 2017, 67, 829–846.
13. Perumpail, B.J.; Cholankeril, R.; Yoo, E.R.; Kim, D.; Ahmed, A. An Overview of Dietary In-terventions and Strategies to Optimize the Management of Non-Alcoholic Fatty Liver Disease. Diseases 2017, 5, 23.
14. Mirizzi, A.; Franco, I.; Leone, C.M.; Bonfiglio, C.; Cozzolongo, R.; Notarnicola, M.; Giannuzzi, V.; Tutino, V.; De Nunzio, V.; Bruno, I.; et al. Effects of Some Food Components on Non-Alcoholic Fatty Liver Disease Severity: Results from a Cross-Sectional Study. Nutrients 2019, 11, 2744.
15. Arnason TG, Bowen MW, Mansell KD. Effects of intermittent fasting on health markers in those with type 2 diabetes: a pilot study. World J Diabetes. 2017;8(4):154–64.
16. Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease pro-cesses. Ageing Res Rev. 2017;39:46–58.
17. 23. Allaf, M.; Elghazaly, H.; Mohamed, O.G.; Fareen, M.F.K.; Zaman, S.; Salmasi, A.-M.; Tsi-lidis, K.; Dehghan, A. Intermittent Fasting for the Prevention of Cardiovascular Disease. Cochrane Database Syst. Rev. 2021, 2021.
18. Batacan, R.B., Jr.; Duncan, M.J.; Dalbo, V.J.; Tucker, P.S.; Fenning, A.S. Effects of high-intensity interval training on cardiometabolic health: A systematic review and meta-analysis of intervention studies. Br. J. Sports Med. 2017, 51, 494–503.
19. Zhao, L., Dong, X., Gao, Y., Jia, Z., Han, S., Zhang, J., & Gao, Y. (2022). Effects of exercise combined with diet intervention on body composition and serum biochemical markers in ado-lescents with obesity: a systematic review and meta-analysis. Journal of Pediatric Endocrinology and Metabolism, 35(11), 1319-1336.
20. An N, Gao Y, Si Z, Zhang H, Wang L, Tian C, et al. Regulatory Mechanisms of the NLRP3 In-flammasome, a Novel Immune-Inflammatory Marker in Cardiovascular Diseases. Front Immu-nol. (2019) 10:1592.
21. Nichols GA, Horberg M, Koebnick C, Young DR, Waitzfelder B, Sherwood NE, et al. Cardi-ometabolic risk factors among 1.3 million adults with overweight or obesity, but not diabetes, in 10 geographically diverse regions of the United States, 2012-2013. Prev Chronic Dis. (2017) 14:E22.
22. Guo Y, Luo S, Ye Y, Yin S, Fan J, Xia M. Intermittent fasting improves cardiometabolic risk factors and alters gut microbiota in metabolic syndrome patients. J Clin Endocrinol Metab. (2021) 106:64–79.
23. Haluzík M, Mráz M. Intermittent fasting and prevention of diabetic retinopathy: where do we go from here? Diabetes. (2018) 67:1745–7.
24. Lamos EM, Malek R, Munir KM. Effects of intermittent fasting on health, aging, and disease. N Engl J Med. (2020) 382:1771.
25. Janaswamy, R. and Yelne, P., 2022. A Narrative Review on Intermittent Fasting as an Ap-proachable Measure for Weight Reduction and Obesity Management. Cureus, 14(10).
26. Paahoo, A., Tadibi, V. and Behpoor, N., 2021. Effectiveness of continuous aerobic versus high-intensity interval training on atherosclerotic and inflammatory markers in boys with over-weight/obesity. Pediatric exercise science, 33(3), pp.132-138.
27. Darvish Damavandi R, Shidfar F, Najafi M, Janani L, Masoodi M, Akbari-Fakhrabadi M, et al. Effect of Portulaca Oleracea (purslane) extract on liver enzymes, lipid profile, and glycemic sta-tus in nonalcoholic fatty liver disease: A randomized, double-blind clinical trial. Phytother Res. 2021;35(6):3145-3156.
28. Hajighasem A, Farzanegi P, Mazaheri Z. Effects of combined therapy with resveratrol, continu-ous and interval exercises on apoptosis, oxidative stress, and inflammatory biomarkers in the liver of old rats with non-alcoholic fatty liver disease. Arch Physiol Biochem. 2019;125(2):142-149.
29. Khaleghzadeh H, Afzalpour ME, Ahmadi MM, Nematy M, Sardar MA. Effect of high intensity interval training along with Oligopin supplementation on some inflammatory indices and liver enzymes in obese male Wistar rats with non-alcoholic fatty liver disease. Obesit Med. 2020;17:100177.
30. Gheflati A, Adelnia E, Nadjarzadeh A. The clinical effects of purslane (Portulaca oleracea) seeds on metabolic profiles in patients with nonalcoholic fatty liver disease: A randomized controlled clinical trial. Phytother Res. 2019;33(5):1501-1509.
31. Lin HY, Yang YL, Wang PW, Wang FS, Huang YH. The Emerging Role of MicroRNAs in NAFLD: Highlight of MicroRNA-29a in Modulating Oxidative Stress, Inflammation, and Be-yond. Cells. 2020;9(4).
32. Kumar R, Porwal YC, Dev N, Kumar P, Chakravarthy S, Kumawat A. Association of high-sensitivity C-reactive protein (hs-CRP) with non-alcoholic fatty liver disease (NAFLD) in Asian Indians: A cross-sectional study. J Family Med Prim Care. 2020;9(1):390-394.
33. Aliniya N, Elmieh A, Fadaei Chafy M. The Effect of Combined Training and Portulaca Oleracea Supplementation on Plasma Lipid Profile and Liver Ultrasound in Obese Females With Nonal-coholic Fatty Liver Disease. J Arak Univ Med Sci. 2020;23(1):92-107.
34. Lowe DA, Wu N, Rohdin-Bibby L, Moore AH, Kelly N, Liu YE, et al. Effects of time-restricted eating on weight loss and other metabolic parameters in women and men with overweight and obesity: the TREAT randomized clinical trial. JAMA Intern Med. (2020) 180:1491–9.
35. Eslam, M.; Newsome, P.N.; Sarin, S.K.; Anstee, Q.M.; Targher, G.; Romero-Gomez, M.; Shira Zelber-Sagi, S.;Wai-SunWong, V.; Dufour, J.F.; Schattenberg, J.M.; et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus state-ment. J. Hepatol. 2020, 73, 202–209.
36. Keating, S.E.; Adams, L.A. Exercise in NAFLD: Just do it. J. Hepatol. 2016, 65, 671–673.
37. Bull, F.C.; Al-Ansari, S.S.; Biddle, S.; Borodulin, K.; Buman, M.P.; Cardon, G.; Carty, C.; Chaput, J.-P.; Chastin, S.; Chou, R.; et al. World Health Organization 2020 guidelines on phys-ical activity and sedentary behaviour. Br. J. Sports Med. 2020, 54, 1451–1462.
38. Wasfy, M.; Baggish, A.L. Exercise dose in clinical practice. Circulation 2016, 133, 2297–2313.
39. Colberg Colberg, S.R.; Sigal, R.J.; Fernhall, B.; Regensteiner, J.G.; Blissmer, B.J.; Rubin, R.R.; Chasan-Taber, L.; Albright, A.L.;. Braun, B. Exercise and type 2 diabetes: The American Col-lege of Sports Medicine and the American Diabetes Association: Joint position statement. Dia-betes Care 2010, 33, e147–e167.
40. Słomko, J., Zalewska, M., Niemiro, W., Kujawski, S., Słupski, M., Januszko-Giergielewicz, B., Zawadka-Kunikowska, M., Newton, J., Hodges, L., Kubica, J. and Zalewski, P., 2021. Evi-dence-based aerobic exercise training in metabolic-associated fatty liver disease: systematic re-view with meta-analysis. Journal of Clinical Medicine, 10(8), p.1659.
41. Smart, N.A.; King, N.; McFarlane, J.R.; Graham, P.L.; Dieberg, G. Effect of exercise training on liver function in adults who are overweight or exhibit fatty liver disease: A systematic re-view and meta-analysis. Br. J. Sports Med. 2018, 52, 834–843.
42. Pellegrini M, Cioffi I, Evangelista A, Ponzo V, Goitre I, Ciccone G, et al. Effects of time-restricted feeding on body weight and metabolism. A systematic review and meta-analysis. Rev EndocrMetab Disord. (2020) 21:17–33.
43. Harris L, Hamilton S, Azevedo LB, Olajide J, De Brun C, Waller G, et al. Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis. JBI Database System Rev Implement Rep. (2018) 16:507–47.
44. Fernando H, Zibellini J, Harris R, Seimon R, Sainsbury A. Effect of ramadan fasting on weight and body composition in healthy nonathlete adults: a systematic review and meta-analysis. Nu-trients. (2019) 11:478.
45. Park J, Seo YG, Paek YJ, Song HJ, Park KH, Noh HM. Effect of alternate-day fasting on obesi-ty and cardiometabolic risk: a systematic review and metaanalysis. Metabolism. (2020) 111:154336
46. Cho AR, Moon JY, Kim S, An KY, Oh M, Jeon JY, et al. Effects of alternate day fasting and exercise on cholesterol metabolism in overweight or obese adults: a pilot randomized controlled trial. Metabolism. (2019) 93:52–60.
47. Meng H, Zhu L, Kord-Varkaneh H, H OS, Tinsley GM, Fu P. Effects of intermittent fasting and energy-restricted diets on lipid profile: a systematic review and meta-analysis. Nutrition. (2020) 77:110801.
48. Moro T, Tinsley G, Bianco A, Marcolin G, Pacelli Q, Battaglia G, et al. Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, in-flammation, and cardiovascular risk factors in resistance-trained males. J Transl Med. (2016) 14:290.
