European Journal of Applied Physiology

, Volume 115, Issue 1, pp 1–46 | Cite as

Effects of physical activity upon the liver

  • Roy J. Shephard
  • Nathan Johnson
Invited Review



To review the responses of the liver to acute and chronic physical activity and to summarize relationships between physical activity and liver health.


A systematic search of HealthStar/Ovid from 1975 through June of 2013, supplemented by articles from other sources.


351 of 8,010 articles identified by HealthStar/Ovid were supplemented by 92 other papers; after focussing, the review was reduced to 435 citations. Prolonged acute exercise reduces hepatic blood flow, stimulating hepatic glycogenolysis, gluconeogenesis and synthesis of some proteins; however, lipid metabolism shows little change. Glutathione depletion suggests oxidative stress. Enzymes affecting carbohydrate metabolism are up-regulated, and lipogenic enzymes are down-regulated. The main triggers are humoral, but hepatic afferent nerves, cytokines, reactive oxygen species, and changes in hepatic blood flow may all play some role. Regular aerobic exercise training improves blood glucose control during exercise by increasing glycogen stores and up-regulating enzymes involved in gluconeogenesis and carbohydrate metabolism. Resistance to oxidant stress is generally increased by training. Lipogenic enzymes are down-regulated, and lipid metabolism is augmented. Modulations of insulin, insulin-like growth factor, glucagon and interleukin-6 may trigger the adaptive responses to training. Cross-sectional and longitudinal studies show that regular exercise can reduce hepatic fat, but the effect on circulating aminotransferases is unclear and the modality and dose of physical activity optimizing health benefits need clarification.


Regular moderate physical activity enhances liver health. Adverse functional changes can develop if habitual activity is inadequate, and extremely prolonged competitive exercise may also be harmful, particularly under harsh environmental conditions.


Diabetes mellitus Fatty liver Hepatic blood flow Hepatic clearance Metabolic syndrome Obesity Oxidative stress Steatosis Steato-hepatitis Ultra-marathons 



Acetyl-coa carboxylase


Adenosine diphosphate


Protein kinase B


Alanine transaminase


Adenosine monophosphate


Adenosine monophosphate kinase


ADP-ribosylation factor-related protein 1


Aspartate transaminase


Adenosine triphosphate


Branched-chain alpha-ketoacid dehydrogenase


Cyclic adenosine monophosphate




Coenzyme A


Computerized tomography


Desoxyribonucleic acid


Eukaryotic initiation factor 2


Extracellular signal-regulated kinase


Free fatty acid


Gamma glutamyl transferase



G protein

Guanine-nucleotide binding protein


Guanosine triphosphate




High-density lipoprotein cholesterol


Hepatic insulin sensitizing substance




Heat shock protein


Insulin-like growth factor-1


Insulin-like growth factor binding protein




Intramyocellular triglyceride


Janus kinase


c-jun N-terminal kinase


Lactate dehydrogenase


Mitogen-activated protein kinase




Messenger ribonucleic acid


Non-alcoholic fatty liver disease


Nuclear factor kappa-B


Mononitrogen oxides


Phosphoenolpyruvate carboxykinase


Protein-kinase like endoplasmic reticular kinase


Stearoyl-CoA desaturase-1


Soluble Fas ligand


Regulatory element-binding protein-1c


Signal transducer and activator of transcription


Tribbles-related protein 3


Very low density lipoprotein triglycerides


Maximal oxygen intake


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Faculty of Kinesiology and Physical EducationUniversity of TorontoTorontoCanada
  2. 2.Faculty of Health SciencesUniversity of SydneySydneyAustralia
  3. 3.Boden Institute of Obesity, Nutrition, Exercise and Eating DisordersUniversity of SydneySydneyAustralia
  4. 4.BrackendaleCanada

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