{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:02:50Z","timestamp":1790283770697,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH 109\u2010A149"],"award-info":[{"award-number":["NTUH 109\u2010A149"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Med Sci Sports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Exercise is recommended for metabolic dysfunction\u2010associated steatotic liver disease (MASLD, previously known as nonalcoholic fatty liver disease [NAFLD]), but the optimal exercise mode remains unclear. We compared high\u2010intensity interval training (HIIT) versus moderate\u2010intensity continuous training (MCT) on cardiorespiratory fitness in patients with MASLD. This randomized trial assigned patients with ultrasonography\u2010confirmed NAFLD\/MASLD to HIIT (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200946) or MCT (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200949) for 24\u2009weeks; a non\u2010randomized observation group (OBS;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200920) was also recruited. Both exercise groups performed self\u2010directed treadmill training thrice weekly in free\u2010living settings (home, residential gyms, or community fitness facilities). HIIT: 5\u2009cycles of 4\u2010min intervals at 80%\u201390% peak oxygen consumption (V\u0307O\n                    <jats:sub>2peak<\/jats:sub>\n                    ) with 3\u2010min recovery at 50% V\u0307O\n                    <jats:sub>2peak<\/jats:sub>\n                    . MCT: 30\u201340\u2009min at 60% V\u0307O\n                    <jats:sub>2peak<\/jats:sub>\n                    . Outcomes were assessed at baseline and week 24. Both HIIT and MCT significantly reduced hepatic steatosis versus OBS (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), with no between\u2010group difference. HIIT achieved greater V\u0307O\n                    <jats:sub>2peak<\/jats:sub>\n                    improvements than MCT and OBS (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Both exercise groups increased minute ventilation and carbohydrate utilization at moderate\u2010to\u2010high intensities versus OBS (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). HIIT and MCT equally reduce hepatic steatosis in patients with MASLD, suggesting exercise participation matters more than intensity for liver fat reduction. Importantly, HIIT provides superior cardiorespiratory benefits.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    (NCT04463667)\n                  <\/jats:p>","DOI":"10.1111\/sms.70252","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T05:07:35Z","timestamp":1773205655000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Self\u2010Directed High\u2010Intensity Interval Versus Moderate Continuous Training on Cardiometabolic Health in Metabolic Dysfunction\u2010Associated Steatotic Liver Disease: A Randomized Controlled Trial"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1427-7460","authenticated-orcid":false,"given":"Ping\u2010Lun","family":"Hsieh","sequence":"first","affiliation":[{"name":"School and Graduate Institute of Physical Therapy, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Physical Therapy Center National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6202-0993","authenticated-orcid":false,"given":"Chun\u2010Jen","family":"Liu","sequence":"additional","affiliation":[{"name":"Hepatitis Research Center National Taiwan University Hospital  Taipei Taiwan"},{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7498-4183","authenticated-orcid":false,"given":"Chih\u2010Horng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9476-8998","authenticated-orcid":false,"given":"Wei\u2010Kai","family":"Wu","sequence":"additional","affiliation":[{"name":"Bachelor Program of Biotechnology and Food Nutrition National Taiwan University  Taipei Taiwan"},{"name":"Department of Medical Research National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3075-6872","authenticated-orcid":false,"given":"Li\u2010Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"School and Graduate Institute of Physical Therapy, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Physical Therapy Center National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000539371"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2025.01.001"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010025\u201008893\u20104"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab795"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.08.023"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000033147"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0022\u20104707.22.13801\u20106"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.660818"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0022\u20104707.24.16206\u20108"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2017.08.012"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep43029"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019471"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/381251"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2040\u20101124.2011.00113.x"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102004\u2010830512"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e31821ece12"},{"key":"e_1_2_15_19_1","volume-title":"2018 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