While exercise is good for the body and mind, it can have special benefits for the liver — a key organ that filters blood, breaks down food, stores energy, and keeps the human body in balance. In recent years, there has been a significant increase in young patients presenting with poor liver health and related conditions, such as fatty liver and liver fibrosis, among others. A recent study published in The Lancet Gastroenterology & Hepatology journal showed that the Metabolically Dysfunctional-Associated Steatotic Liver Disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), affected 1.3 billion people around the globe in 2023. India has also shown a sharp rise in MASLD prevalence, up 23.19 per cent from 1990 to 2023. India’s age-standardized MASLD prevalence rate rose from 10,191 per 100,000 in 1990 to 12,555 per 100,000 in 2023. The findings show that the spike is increasingly driven by rising metabolic risk factors, including high blood sugar and obesity. Amid the growing burden, hepatologist Dr Cyriac Abby Philips noted that “the best friend of the liver is muscle”. In a post on social media platform X, Dr Philips, popularly known as Liverdoc, added that “liver listens to your muscles” and shared nine exercises, all backed by clinical trials, that can be included in a daily routine to help boost liver health. Brisk walking: According to Dr Philips, brisk walking is the most accessible liver medicine. He noted that "150 min per week cuts liver fat by more than 30 per cent on MRI”. Citing a UK Biobank study of 91,000 people, he added that every extra 1,000 daily steps can lower the risk of developing fatty liver by about 12 per cent.Moderate-intensity cardio (MICT): This includes steady jogging, cycling, or swimming at a "can talk, can't sing" pace. Dr Philips stated that 30–45 minutes of MICT exercises for 3–5 days every week for 12 weeks can help reduce liver fat by 2–4 per cent (absolute). It can also significantly lower liver inflammation (enzyme levels), even without weight loss. High-intensity interval training (HIIT) This includes short hard bursts, like burpees, jumping jacks, etc. He recommended four minutes of these exercises “at 85–95 per cent max heart rate”. Repeating the exercise 4 times a day can “cut liver fat by 16–37 per cent, improve heart function,” in 12 weeks, the Liverdoc said. He added that the exercise regimen “matches steady cardio in half the time”. Sprint interval training (SIT) SITs are shorter and harder under 15-minute sessions of squat punches, knee hovers, and chair squats. “Six weeks of these can reduce intrahepatic triglycerides by 12 per cent and visceral fat by 17 per cent in men with fatty liver (MASLD),” said Dr Philips, adding that it gives the “biggest liver benefits for the smallest time spent”. Resistance/strength training This includes weights or bodyweight, such as squats, presses, rows, and pulldowns. Dr Philips recommended 3 sets of these exercises three times a week for about 40–45 min. It can “reduce liver fat independent of weight loss, uniquely lowers liver enzyme, and is the single most important exercise for cirrhosis patients to prevent muscle loss (sarcopenia),” he said. Combined aerobic + resistance The Liverdoc stated that this combination is the gold standard for exercises. He noted that “network meta-analyses rank this combination as the number one for improving triglycerides, LDL, and total cholesterol in patients with fatty liver (MASLD) - better than either alone”. Yoga (Hatha/ Surya Namaskar) Dr Philips noted that classical yoga is not useful for liver health as it is not aerobic and vouched for the modernized versions. “Eight to 12 weeks or 3 sessions/week of asanas like Surya Namaskar, Ardha Matsyendrasana, Paschimottanasana, Naukasana can help improve liver tests, insulin resistance, and fatty liver grade - especially in patients with type 2 diabetes plus fatty liver disease,” he said. Pilates and core work “Eight weeks of pilates can help reduce body weight, body fat, liver enzymes, and liver fat on ultrasound,” said Liverdoc. He called it a joint-friendly option for people who can't run or lift heavy. Tai Chi / Qigong The Chinese exercise is a low-impact mind-body movement. About 30–60 min of these three times a week can help “improve glucose control, insulin sensitivity, and balance/ stability, muscle tone," Dr. Philips said. He noted that this form of exercise is “gentle enough for older patients, those with early decompensated cirrhosis, or people with poor cardiorespiratory fitness”. Exercise In Cirrhosis Dr Philips said that even advanced liver disease can respond well to exercise treatment. Citing randomized trials, he stated that “combined aerobic plus resistance training cuts serious events (death, major complications) from 12.3 per cent to 5.6 per cent”. It also “prevents the muscle wasting that drives death events in cirrhosis patients”. “Make physical activity your number one preference to maintain liver health and reduce liver disease,” Dr Philips said.