High cardiorespiratory fitness is an independent predictor of the reduction in liver fat during a lifestyle intervention in non-alcoholic fatty liver disease

Objective:Lifestyle intervention with diet modification and increase in physical activity is effective for reducing hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD). However, for a similar weight loss, there is a large variability in the change in liver fat. We hypothesised that cardiorespiratory fitness may predict the response to the intervention.Design:Longitudinal study with increase in physical activity and diet modification.Setting:University teaching hospital.Patients:50 adults with NAFLD and 120 controls at risk for metabolic diseases.Main outcome measures:Total-, subcutaneous abdominal- and visceral adipose tissue by magnetic resonance tomography, liver fat by 1HMR spectroscopy and cardiorespiratory fitness (VO2,max) by a maximal cycle exercise test at baseline and after 9 months of follow-up.Results:In all subjects total-, subcutaneous abdominal- and visceral adipose tissue decreased and fitness increased (all p