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Review
. 2022 Aug 5;9(8):1174.
doi: 10.3390/children9081174.

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

Valeria Calcaterra  1   2 , Vittoria Carlotta Magenes  2 , Matteo Vandoni  3 , Clarissa Berardo  4 , Luca Marin  5   6 , Alice Bianchi  2 , Erika Cordaro  1 , Giustino Simone Silvestro  2 , Dario Silvestri  5 , Vittoria Carnevale Pellino  3   7 , Cristina Cereda  8 , Gianvincenzo Zuccotti  2   4
Affiliations
Review

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

Valeria Calcaterra et al. Children (Basel). .

Abstract

Non-alcoholic fatty liver disease (NAFLD) is an important health concern during childhood; indeed, it is the most frequent cause of chronic liver diseases in obese children. No valid pharmacological therapies for children affected by this condition are available, and the recommended treatment is lifestyle modification, usually including nutrition and exercise interventions. In this narrative review, we summarized up-to-date information on the benefits of physical exercise on NAFLD in children and adolescents with obesity. The role of exercise as non-pharmacological treatment was emphasized in order to provide recent advances on this topic for clinicians not deeply involved in the field. Several studies on obese children and adults confirm the positive role of physical activity (PA) in the treatment of NAFLD, but to date, there are no pediatric randomized clinical trials on exercise versus usual care. Among the pathogenic mechanisms involved in the PA effects on NAFLD, the main players seem to be insulin resistance and related inflammation, oxidative stress, and gut dysbiosis, but further evaluations are necessary to deeply understand whether these factors are correlated and how they synergistically act. Thus, a deeper research on this theme is needed, and it would be extremely interesting.

Keywords: exercise; obesity; pediatrics; physical activity; prevention; steatosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Multiorgan complications related to obesity in children and adolescents (created with BioRender.com, accessed on 1 July 2022).
Figure 2
Figure 2
Nonalcoholic fatty liver disease in children and adolescents (created with BioRender.com, accessed on 1 July 2022).
Figure 3
Figure 3
Benefits of exercise on NAFLD (created with BioRender.com, accessed on 1 July 2022). NAFLD, non-alcoholic fatty liver disease; HFF, hepatic fat fraction; IHTG, intrahepatic triglycerides; AST, aspartate aminotransferase; ALT, alanine aminotransferase; gGT, gamma-glutamyl transferase; TC, total cholesterol; TG, triglycerides; LDL, low-density lipoprotein; VLDL, very-low-density lipoprotein; IR, insulin resistance.
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