Metabolic-associated fatty liver disease (MAFLD) affects one in four adults globally and is linked with type 2 diabetes, cardiovascular disease and lifestyle-related cancers, as well as progressive liver disease and liver cancer.

This position statement collates evidence on the role of exercise in the management of MAFLD including referral pathways, assessment and management priorities, exercise prescription recommendations, action planning and considerations for clinicians working with people with MAFLD. The information in this statement is relevant and appropriate for people living with the condition historically termed non-alcoholic fatty liver disease (NAFLD), regardless of terminology.

The majority of research evidence indicates that 150–240 min per week of at least moderate-intensity aerobic exercise can reduce liver fat by ~ 2–4%, but as little as 135 min/week has been shown to be effective. This dose of exercise is likely to improve central adiposity, cardiorespiratory fitness and cardiometabolic health, irrespective of weight loss.