Comparative effects of two exercise training programs on health-related quality of life in middle-aged women with non-alcoholic fatty liver disease

Introduction
Insufficient research exists on the effectiveness of exercise therapy in nonalcoholic fatty liver disease (NAFLD), particularly regarding the health-related quality of life (HRQoL) outcome. Therefore, this study aimed to assess the effects of high-intensity interval training (HIIT) compared to moderate-intensity combined resistance and aerobic training (RT/AT) on HRQoL in NAFLD patients

Material and methods
Twenty-three middle-aged obese women with NAFLD were enrolled in 3-month exercise interventions of either HIIT (n1 = 12, 46.3 ± 5 years, 40.5 ± 4.1 kg / m2 ) or moderate-intensity combined RT/AT (n2 = 11, 45.6 ± 4.4 years, 43.5 ± 5.4 kg / m2 ). Secondary hepatic steatosis, liver cirrhosis, or virus C hepatitis were excluded. HIIT was prescribed as 4 sets x 4 min at 80-85 % HRmax with 3 min active recovery. Combined RT/AT was prescribed as 10 min low to moderate cycling exercises followed by 8 resistance exercises at 50-75 % 1-RM. The outcomes were HRQoL, as assessed by the Chronic Liver Disease Questionnaire (CLDQ), and the percentage of body weight change ( % ∆BW)

Results
CLDQ domains were significantly improved in both HIIT & RT/AT groups compared to baselines; the emotional function & worry domains and the total CLDQ score were significantly higher in the HIIT group (p< 0.05)compared to the other group. Body weight was reduced by 13 % & 8 % in HIIT and combined RT/AT groups, respectively, with a significant difference in the % ∆ BW between the two groups in favor of HIIT.

Conclusions
Both HIIT and moderate-intensity combined RT/AT could be suggested to improve the HRQoL and reduce body weight in middle-aged obese women with NAFLD, however, HIIT could be superior to the combined RT/AT in improving overall HRQoL, especially the emotional aspects, and reducing body weight.