{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:15:43Z","timestamp":1792793743087,"version":"4.5.0"},"reference-count":58,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Biological Research For Nursing"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>Background: Physical exercises are the first step of therapy for people with non-alcoholic fatty liver disease (NAFLD). Objective: The purpose of this meta-analysis is to evaluate the efficacy of aerobic exercise training with or without diet to ameliorate liver function, insulin resistance, and lipids in adults. Data sources: We searched relevant databases up to 10 June 2021 for conducting a systematic review and meta-analysis of controlled trials lasting 4 or more weeks that investigated the effects of aerobic exercise alone or accompanied by diet on change in liver enzymes, intrahepatic fat (IHF), insulin resistance, and lipids. Results: Sixteen studies including 2255 participants were included. There was a significant pooled weighted mean differences (MD) for the comparison between aerobic exercise versus control in alanine aminotransferase (ALT; p = 0.003), aspartate aminotransferase (AST; p = 0.006), IHF ( p = 0.0004), body mass ( p = 0.0003), and body mass index ( p = 0.004). Moreover, there was a significant pooled MD for the comparison between aerobic exercise plus diet versus control in ALT ( p &lt; 0.0001), AST ( p = 0.01), IHF ( p = 0.02), GGT ( p &lt; 0.00001), insulin ( p &lt; 0.0001), HOMA-IR ( p &lt; 0.00001), body mass ( p &lt; 0.0001), and BMI ( p = 0.01). Conclusion: Our findings demonstrate a role for aerobic exercise with and without diet protocol as a therapeutic purpose, and suggest that evaluation of aerobic training levels and aerobic training prescription plus diet should be routine in NAFLD.<\/jats:p>","DOI":"10.1177\/10998004211068026","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T02:04:17Z","timestamp":1644285857000},"page":"259-276","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Effect of Aerobic Exercise Alone or in Conjunction With Diet on Liver Function, Insulin Resistance and Lipids in Non-Alcoholic Fatty Liver Disease"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8159-2065","authenticated-orcid":false,"given":"Gholam Rasul","family":"Mohammad Rahimi","sequence":"first","affiliation":[{"name":"Department of Exercise Physiology, Faculty of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyyed Reza","family":"Attarzadeh Hosseini","sequence":"additional","affiliation":[{"name":"Department of Exercise Physiology, Faculty of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"key":"bibr1-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019471"},{"issue":"3","key":"bibr2-10998004211068026","first-page":"667","volume":"13","author":"Al-Jiffri O","year":"2013","journal-title":"African Health Sciences"},{"key":"bibr3-10998004211068026","doi-asserted-by":"publisher","DOI":"10.3390\/nu13093135"},{"issue":"11","key":"bibr4-10998004211068026","first-page":"1961","volume":"73","author":"Bayard M","year":"2006","journal-title":"American Family Physician"},{"issue":"6","key":"bibr5-10998004211068026","first-page":"128","volume":"48","author":"Buzzetti E.","year":"2021","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"bibr6-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29367"},{"key":"bibr7-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.04.001"},{"key":"bibr8-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-16159-x"},{"key":"bibr9-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1016\/S1726-4901(08)70168-0"},{"key":"bibr56-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2012.08.002"},{"key":"bibr10-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-2033"},{"key":"bibr11-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1042\/CS20150447"},{"key":"bibr12-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1038\/srep36783"},{"key":"bibr57-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X13484078"},{"key":"bibr13-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"bibr14-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318213fefb"},{"issue":"1","key":"bibr15-10998004211068026","first-page":"64","volume":"31","author":"Gonzalez A","year":"2021","journal-title":"European Journal of Translational Myology"},{"key":"bibr16-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1042\/CS20150308"},{"key":"bibr17-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.08.023"},{"key":"bibr18-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"bibr19-10998004211068026","first-page":"128","volume":"437","author":"Houttu V.","year":"2021","journal-title":"Frontiers in Nutrition"},{"key":"bibr20-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1186\/1476-511X-12-171"},{"key":"bibr21-10998004211068026","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2011.00931.x"},{"issue":"25","key":"bibr22-10998004211068026","first-page":"S102","volume":"129","author":"Jensen MD","year":"2014","journal-title":"J Am Coll CardiolJournal of the American College of Cardiology"},{"key":"bibr23-10998004211068026","author":"Johnson N. 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