Effects of Nonlinear Resistance Training with Curcumin Supplement on Liver Enzymes in Men with Non- Alcoholic Fatty Liver Disease

Document Type : Original Article


1 Department of Sport Physiology, Sama Technical and Vocational Training College, Islamic Azad University, Esfahan (Khorasgan) Branch, Esfahan, Iran

2 Department of Sport Physiology, Najafabad Branch, Islamic Azad University, Najafabad, Iran

3 Faculty of Sciences, Qom University of Technology, Qom, Iran


Introduction: Non-alcoholic fatty liver disease (NAFLD) has been recently very common; however, there is no definitive treatment for it. The present study aimed to investigate the effects of nonlinear resistance training with curcumin supplement on liver enzymes in men with non- alcoholic fatty liver disease. Methods: Forty-eight men with obesity and non-alcoholic fatty liver disease (mean age: 38.24 ± 6.59 years and BMI: 29.27 ± 4.43 kg.m-2) were selected and randomly divided into 4 groups including resistance training (RT), resistance training with curcumin supplement (RTCS), curcumin supplement (CS) and placebo (P). Before and after the protocol blood samples were taken to investigate the alanine aminotransferase (ALT), aspartate aminotransferase (AST) and Alkaline phosphatase (ALP) levels. One-way analysis of variance (ANOVA), paired sample t- test and Tukey post hoc test were used to analyze the data (p<0.05). Results: The results indicated significant difference between groups in ALT (p=0.0001) and AST (p=0.0001) levels following 12 weeks of exercise and supplement interventions. Post-hoc multiple comparison of ALT and AST was significant between RT and RTCS groups with CS and P groups (p=0.0001). ALP levels was not significantly different between groups (p=0.05). Conclusion: It seems that nonlinear resistance training with curcumin supplement improves the liver enzymes in men with non-alcoholic fatty liver disease.


1. Giannini EG, Testa R, Savarion V. Review: Liver enzyme alteration: a guide for clinicians. CMA. 2005; 172 (3): 367- 79.
2. Moeini Z, Rahmaninia F, Rajabi H, Aghaalinejad H, Salami F. Physiology of sport of and exercise. Mobtakeran Pub. 4th ed. Tehran. 2003; 201.
3. Argo CK, Caldwell SH. Epidemiology and natural history of non-alcoholic steatohepatitis. Clin Liver Dis. 2009; 13 (4): 511- 531.
4. Adibi A, Kelishadi R, Beyhaghi A, Salehi H, Talaei M. Study of the prevalence of fatty liver in overweight and obese children in comparison with the natural group (A cross sectional study in Isfahan). Shaheed Sadoughi Univ Med Sci J. 2009; 17 (4): 270- 278.
5. Fauci AS. Harrison's principles of internal medicine. New York: McGraw-Hill Medical. 2008.
6. Johnson NA, George J. Fitness versus fatness: Moving beyond weight loss in nonalcoholic fatty liver disease. Hepatology. 2010; 52 (1): 370- 381.
7. Alavian SM, Mohammad- Alizadeh AH, Esna- Ashari F, Ardalan G, Hajarizadeh B. Nonalcoholic fatty liver disease prevalence among school-aged children and adolescents in Iran and its association with biochemical and anthropometric measures. Liver Int. 2009; 29 (2): 159- 163.
8. Eslami L, Rahmani-Nia F, Nakhostin-Roohi B. The effect of 12 week vitamin E supplementation and regular physical activity on selected liver enzymes of non- alcoholic fatty liver patients. Sport Physiol. 2014; (22): 69- 82.
9. Chitturi S, Wong VW, Farrell G. Nonalcoholic fatty liver in Asia: Firmly entrenched and rapidly gaining ground. J Gastrone Hepatol. 2011; 26 (1): 163- 172.
10. Tolman KG, Dalpiaz AS. Treatment of non-alcoholic fatty liver disease. Ther Clin Risk Manag. 2007; 3 (6): 1153- 1163.
11. Johnson N A, Sachinwalla T, Walton D W, Smith K, Armstrong A, Thompson M W, et al. Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology. 2009; 50 (4): 1105- 1112.
12. Ayonrinde OT, Olynyk JK, Beilin LJ, Mori TA, Pennell CE, de Klerk N, et al. Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease. Hepatology. 2011; 53 (3): 800- 809.
13. St George A, Bauman A, Johnston A, Farrell G, Chey T, George J. Independent effects of physical activity in patients with nonalcoholic fatty liver disease. Hepatology. 2009; 50 (1): 68- 76.
14. Romijn JA, Pijl H. The muscle-liver axis: does aerobic fitness induce intrahepatic protection against non-alcoholic fatty liver disease?. J Physiol. 2009; 587 (8): 1637- 1641.
15. Kistler KD, Brunt EM, Clark JM, Diehl AM, Sallis JF, Schwimmer JB, et al. Physical activity recommendations, exercise intensity, and histological severity of nonalcoholic fatty liver disease. Am J Gastroenterol. 2011; 106 (3): 460- 468.
16. Damor K, Mittal K, Bhalla AS, Sood R, Pandey RM, Guleria R, et al. Effect of progressive resistance exercise training on hepatic fat in asian indians with non-alcoholic fatty liver disease. Br J Med Med Res. 2014; 4 (1): 114- 124.
17. Aggarwal BB, Sung B. Pharmacological basis for the role of curcumin in chronic diseases: an age-old spice with modern
targets. Trends Pharmacol Sci. 2009; 30 (2): 85- 94.
18. Shishodia S, Sethi G, Aggarwal BB. Curcumin: getting back to the roots. Ann N Y Acad Sci. 2005; 1056: 206- 217.
19. Kim HY, Park EJ, Joe EH and Jou I. Curcumin suppresses janus kinase-STAT inflammatory signaling through activation of Src homology 2 domain-containing tyrosine phosphatase2 in brain microglia. J Immunol. 2003; 171: 6072- 6079.
20. Zelber- Sagi S, Nitzan- Kaluski D, Goldsmith R, Webb M, Zvibel I, Goldiner I, et al. Role of leisure-time physical activity in nonalcoholic fatty liver disease: a population-based study. Hepatology. 2008; 48 (6): 1791- 1798.
21. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28 (7): 412- 419.
22. Kraemer WJ, Fleck SJ. Optimizing strength training: designing nonlinear periodization workouts. champaign, illinois: Human Kinetics Pub. 2007.
23. Nikseresht M, Agha-Alinejad H, Azarbayjani MA, AND Ebrahim Kh. Effects of nonlinear resistance and aerobic interval training on cytokines and insulin resistance in sedentary men who are obese. J Strength Cond Res. 2014; 28 (9): 2560- 2568.
24. Brzycki M. Strength testing- predicting a one- rep max from rep- to- fatigue. JOPERD. 1993; 68: 88- 90.Jackson AS, Pollock ML. Generalized equations for predicting body density of men. Br J Nutr. 1978; 40 (3): 497- 504.
26. Hallsworth K, Fattakhova G, Hollingsworth KG, Thoma C, Moore S, Taylor R, et al. Resistance exercise reduces liver fat and its mediators in non-alcoholic fatty liver disease independent of weight loss. Gut. 2011; 60 (9): 1278- 1283.
27. De Piano A, de Mello MT, Sanches Pde L, da Silva PL, Campos RM, Carnier J, et al. Long term effects of aerobic plus resistance training on the adipokins and neuropeptides in nonalcoholic fatty liver disease obese adolescents. Eur J Gastrone Hepat. 2012; 24 (11): 1313- 1324.
28. Alie M, Matinhommaee H, Azarbayjani MA, Peeri M. The effect of resistance training intensity on enzymatic and nonenzymatic markers of liver function in obese males. JLS. 2015; 5 (2): 101- 110.
29. Moradi Kelardeh B, Azarbayjani MA, Peeri M, matin homaee H. Effect of curcumin supplementation and resistance training in patients with nonalcoholic fatty liver disease. J Med Plants. 2016; 4 (60): 161- 172.
30. Slentz CA, Bateman LA, Willis LH, Shields AT, Tanner CJ, Piner LW, et al. Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT. Am J Physiol Endocrinol Meta. 2011; 301 (5): 1033- 1039.
31. Bacchi E, Negri C, Targher G, Faccioli N, Lanza M, Zoppini G, et al. Both resistance
training and aerobic training reduce hepatic fat content in type 2 diabetic subjects with nonalcoholic fatty liver disease (the RAED2 Randomized Trial). Hepatology. 2013; 58 (4): 1287- 1295.
32. Kumar A, Dhawan S, Hardegen NJ, Aggarwal BB. Curcumin (Diferulogylmethane) inhibition of tumor necrosis factor (TNF)-mediated adhesion of monocytes to endothelial cells by suppression of cell surface expression of adhesion molecules and of nuclear factor-kappa B activation. Biochem Pharmacol, 1998; 55:775- 783.
33. Abe Y, Hashimoto S, Horie T. Curcumin inhibition of inflammatory cytokine production by human peripheral blood monocytes and alveolar macrophages. Pharmacol Res. 1999; 39: 41- 47.
34. DiSilvestro RA, Joseph E, Zhao Sh, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. J. Nutr. 2012; 11: 79- 83.
35. Bhat G, Baba CS, Pandey A, Kumari N, Choudhuri G. Life style modification improves insulin resistance and liver histology in patients with nonalcoholic fatty liver disease. World J Hepatol. 2012; 4 (7): 209- 217.