Exercise Training Reduces Liver Fat and Increases Rates of VLDL Clearance, but not VLDL Production in NAFLD

Context Randomised controlled trials in non-alcoholic fatty liver disease (NAFLD) have shown that regular exercise, even without calorie restriction, reduces liver steatosis. A previous study has shown that 16 weeks supervised exercise training in NAFLD did not affect total VLDL kinetics. Objective To determine the effect of exercise training on intrahepatocellular fat (IHCL) and the kinetics of large triglyceride-(TG)-rich VLDL1 and smaller denser VLDL2 which has a lower TG content. Design A 16 week randomised controlled trial. Patients 27 sedentary patients with NAFLD. Intervention Supervised exercise with moderate-intensity aerobic exercise or conventional lifestyle advice (control). Main outcome Very low density lipoprotein1 (VLDL1) and VLDL2-TG and apolipoproteinB (apoB) kinetics investigated using stable isotopes before and after the intervention. Results In the exercise group VO2max increased by 31±6% (mean±SEM) and IHCL decreased from 19.6% (14.8, 30.0) to 8.9% (5.4, 17.3) (median (IQR)) with no significant change in VO2max or IHCL in the control group (change between groups p<0.001 and p=0.02, respectively). Exercise training increased VLDL1-TG and apoB fractional catabolic rates, a measure of clearance, (change between groups p=0.02 and p=0.01, respectively), and VLDL1-apoB production rate (change between groups p=0.006), with no change in VLDL1 -TG production rate. Plasma TG did not change in either group. Conclusion An increased clearance of VLDL1 may contribute to the significant decrease in liver fat following 16 weeks of exercise in NAFLD. A longer duration or higher intensity exercise interventions may be needed to lower plasma TG and VLDL production rate.

City dweller aspirations for cities of the future: How do environmental and personal wellbeing feature?

This paper explores city dweller aspirations for cities of the future in the context of global commitments to radically reduce carbon emissions by 2050; cities contribute the vast majority of these emissions and a growing bulk of theworld's population lives in cities. The particular challenge of creating a carbon reduced future in democratic countries is that the measures proposed must be acceptable to the electorate. Such acceptability is fostered if carbon reduced ways of living are also felt to bewellbeing maximising. Thus the objective of the paper is to explore what kinds of cities people aspire to live in, to ascertain whether these aspirations align with or undermine carbon reduced ways of living, as well as personal wellbeing. Using a novel free associative technique, city aspirations are found to cluster around seven themes, encompassing physical and social aspects. Physically, people aspire to a city with a range of services and facilities, green and blue spaces, efficient transport, beauty and good design. Socially, people aspire to a sense of community and a safe environment. An exploration of these themes reveals that only a minority of the participants' aspirations for cities relate to lowering carbon or environmental wellbeing. Far more consensual is emphasis on, and a particular vision of, aspirations that will bring personal wellbeing. Furthermore, city dweller aspirations align with evidence concerning factors that maximise personal wellbeing but, far less, with those that produce lowcarbonways of living. In order to shape a lower carbon future that city dwellers accept the potential convergence between environmental and personal wellbeing will need to be capitalised on: primarily aversion to pollution and enjoyment of communal green space.