A new study shows that regular exercise can improve brain function and blood flow in people with fatty liver disease caused by obesity and metabolism problems. Researchers followed 40 overweight adults for 16 weeks—half did exercise plus diet changes, while the other half only changed their diet. The exercise group doubled their daily steps and did strength training. Results showed the exercise group had better blood vessel flexibility, improved thinking and memory skills, and better overall body composition. This suggests that getting moving isn’t just good for your liver and weight—it may also help your brain work better.

The Quick Take

  • What they studied: Whether a 16-week exercise program could improve brain blood flow and thinking skills in people with fatty liver disease
  • Who participated: 40 obese adults (60% women, average age 47 years) with metabolic dysfunction-associated fatty liver disease, split into two groups
  • Key finding: People who exercised showed a 5.9% improvement in memory and thinking tests, plus better blood vessel flexibility, while the diet-only group saw minimal brain improvements
  • What it means for you: If you have fatty liver disease, adding exercise to your routine may help your brain work better, not just your liver. However, this is one small study, so talk to your doctor before starting any new exercise program

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of research studies. Researchers randomly assigned 40 people with fatty liver disease into two groups. One group followed a calorie-controlled diet only, while the other group did the same diet plus a structured exercise program. The exercise program gradually increased daily walking steps and included resistance training (like weight lifting). Both groups also participated in monthly literature readings to keep their brains equally engaged in activities outside of exercise. The study lasted 16 weeks, and researchers measured brain blood flow using ultrasound technology and tested thinking skills using standard cognitive tests.

The researchers carefully tracked how well people stuck to the program (adherence was over 80%, which is very good). They measured brain health using transcranial doppler ultrasound, a safe imaging technique that measures blood flow in the brain. They also tested memory and thinking using two well-established cognitive tests: the Montreal Cognitive Assessment (MoCA) and the Addenbrooke’s test.

This design is strong because it randomly assigned people to groups, which helps reduce bias. The control group still received diet counseling, so researchers could see if exercise added extra benefits beyond just eating better.

Most research on fatty liver disease focuses on the liver itself, but the brain is also affected by this condition. This study is important because it looks at whether exercise helps the brain, not just the body. The researchers also measured blood vessel stiffness and flexibility, which are signs of overall cardiovascular health that affects the brain. By including a control group that got diet support but no exercise, they could prove that exercise itself—not just weight loss—provides brain benefits.

This study has several strengths: it’s a randomized controlled trial (the gold standard), it had good participant adherence (over 80%), and it measured multiple outcomes including brain blood flow and cognitive function. The sample size is relatively small (40 people), which means results should be interpreted cautiously. The study was published in a reputable peer-reviewed journal. However, the study only lasted 16 weeks, so we don’t know if benefits last longer. The participants were mostly obese adults around age 47, so results may not apply to younger or older people, or those with different body types.

What the Results Show

The exercise group showed impressive improvements in brain-related measures. Their cognitive test scores improved by about 5.9% on the MoCA test and 6.6% on the Addenbrooke’s test—both statistically significant improvements. These improvements suggest better memory, thinking speed, and mental clarity.

Brain blood vessel health also improved dramatically in the exercise group. Arterial stiffness (how flexible blood vessels are) decreased by 8.4%, which is important because stiff arteries reduce blood flow to the brain. The resistance index—a measure of how hard the heart has to work to push blood through vessels—dropped by 10.4%. The pulsatility index, another measure of blood vessel function, decreased by 19.2%. All of these changes mean blood was flowing more smoothly to the brain.

In contrast, the control group (diet only) showed no significant improvements in cognitive function or brain blood vessel measures. This is a crucial finding because it shows that diet alone didn’t improve brain health in this study—exercise was the key factor.

Both groups did lose weight and body fat, which is expected when eating fewer calories. The exercise group lost more weight (5.2% reduction in BMI) compared to the diet-only group (2.7% reduction). The exercise group also lost more body fat (10.5% vs. 3.8%).

Beyond brain health, the exercise group achieved better overall body composition improvements. They doubled their daily steps from about 5,178 to 10,161 steps per day, showing they successfully increased physical activity. The diet-only group’s step count didn’t change significantly. Liver disease markers improved more in the exercise group, though the abstract doesn’t specify exact numbers. These secondary findings suggest that exercise provides benefits across multiple body systems, not just the brain.

Previous research has shown that exercise improves liver health and body composition in people with fatty liver disease. This study builds on that knowledge by showing exercise also benefits the brain. The finding that exercise improves blood vessel flexibility is consistent with other research showing exercise strengthens cardiovascular health. However, this is one of the first studies to specifically measure how exercise affects brain blood flow and cognitive function in fatty liver disease patients, making it a novel contribution to the field.

The study included only 40 people, which is a relatively small sample size. Results might differ with a larger group. The study lasted only 16 weeks, so we don’t know if improvements continue or fade over time. Participants were mostly around age 47 and obese, so results may not apply to younger people, older people, or those with different body types. The study didn’t measure whether cognitive improvements were noticeable in daily life—the tests showed statistical improvements, but we don’t know if people felt sharper or had better memory in real situations. Finally, the study was conducted in a controlled setting with monitored exercise, so results might differ if people exercise on their own without supervision.

The Bottom Line

If you have fatty liver disease, adding regular exercise to your routine may help your brain function better. A reasonable goal based on this study would be to gradually increase daily steps and include resistance training 2-3 times per week. Start slowly and build up gradually—the study showed benefits from doubling daily steps over 16 weeks. Combine exercise with a healthy diet for the best results. Confidence level: Moderate—this is one solid study, but larger studies are needed to confirm these findings.

This research is most relevant for people with metabolic dysfunction-associated fatty liver disease who are overweight or obese. It’s also valuable for anyone with fatty liver disease who wants to improve brain health and thinking skills. People with cardiovascular disease or blood vessel problems may also benefit, since the study showed improvements in blood vessel flexibility. However, if you have severe liver disease, heart problems, or other serious health conditions, talk to your doctor before starting an exercise program. This study doesn’t apply to people without fatty liver disease.

Based on this study, you might expect to see improvements in thinking and memory within 16 weeks of regular exercise. However, benefits likely build gradually—you probably won’t notice changes after one week. Most participants in the study exercised consistently for the full 16 weeks before improvements were measured. For lasting benefits, exercise should become a permanent part of your routine, not just a temporary change.

Want to Apply This Research?

  • Track daily steps using your phone’s built-in step counter or a fitness app, aiming to gradually increase from your current baseline to 10,000+ steps daily over 16 weeks. Also log resistance training sessions (2-3 per week) with exercises like squats, push-ups, or weight lifting.
  • Set a specific, achievable weekly step goal that increases gradually (for example, add 500-1,000 steps per week). Schedule resistance training on specific days. Use app reminders to encourage movement throughout the day. Track your progress weekly to stay motivated and see improvements over time.
  • Use the app to monitor step count trends over weeks and months. Every 4 weeks, take a simple cognitive test (like online memory or reaction time games) to track mental improvements. Also monitor how you feel—do you notice better focus, clearer thinking, or improved memory in daily life? Share progress with your doctor at regular check-ups to discuss whether exercise is helping your overall health.

This research suggests exercise may improve brain function in people with fatty liver disease, but it is not medical advice. Before starting any new exercise program, especially if you have liver disease, heart problems, or other health conditions, consult with your healthcare provider. This study involved 40 people over 16 weeks, so results may not apply to everyone. Individual results vary based on age, overall health, genetics, and other factors. Always work with your doctor to develop a safe, personalized exercise plan appropriate for your specific health situation.