Vol. 11, Issue 9, Part A (2025)

Non-alcoholic fatty liver disease (NAFLD) is a growing public health concern globally which is estimated around 32.4%.The lifestyle interventions emerging as a primary management strategy which offer potential to mitigate NAFLD and its progression. Thus, this study aimed to evaluate the effect of lifestyle interventions including dietary modifications, physical activity, and weight management in metabolic health indicators associated with NAFLD. Eligible studies meeting the inclusion criteria were considered, evaluated the impact of intervention on anthropometry (BMI, WC), Liver enzymes (ALT, AST, GGT), Lipid Profile and HOMA-IR A random effect meta-analysis was conducted and pooled effect sizes with 95% confidence interval (CI) and heterogeneity (I2) was calculated. Fourteen studies comprising 1494 participants were included in the study. Subgroup analysis revealed that the Mediterranean diet and physical activity (aerobic and resistance training) significantly improved liver enzymes (ALT: SMD= -0.80; AST: SMD= -0.79; p<0.05), lipid profiles (TG, LDL, HDL), HOMA-IR (SMD= -0.52, p<0.05) and BMI. The combination of dietary and exercise interventions showed greater effectiveness in reducing intrahepatic fat and improving metabolic outcomes than either intervention alone. Though heterogeneity across studies was high (i2 > 80). In conclusion, dietary interventions, especially the Mediterranean diet, combined with aerobic and resistance training, provide the most effective approach for improving liver health and metabolic outcomes in NAFLD. However, individual responses vary, emphasizing the need for personalized treatment plans. Future research should focus on long-term effects to better understand their impact on NAFLD progression and liver health.