BACKGROUND: Lifestyle intervention is considered first-line therapy for Nonalcoholic Fatty Liver Disease (NAFL). OBJECTIVE(S): Here, we aimed to compare the effect of combined Aerobic Training (AT) and Vitamin D (Vit D) supplementation on NAFLD in elderly women with Vit D deficiency. METHODS: We recruited 40 women (60 to 65 years) with NAFLD (second or third grade) and Vit D deficiency. Then, using simple randomization, the subjects were assigned to four groups including aerobic training (AT; 60% to 75%, 20 to 40 min/day, 3 days/wk running and walking), vitamin D supplementation (Vit D; 50,000 IU one day/week), aerobic training plus vitamin D supplementation (AT plus Vit D), and sedentary control (C; placebo). The data were analyzed using paired t-test and one-way analysis of variance and Tukey's post hoc test with SPSS21 at a significance level of p < 0.05. RESULTS: After eight weeks of intervention, fatty liver grade markedly reduced in the AT plus Vit D, AT, and Vit D groups (60%, 38.88%, and 22% respectively). However, it increased by 17.60% in the control group. The combination of AT plus Vit D significantly reduced liver enzymes, anthropometric indices, and glycemic indices and improved lipid profile. All groups demonstrated a significant inverse correlation between vitamin D and fatty liver grade. CONCLUSIONS: A sedentary lifestyle and Vit D deficiency accelerate the NAFLD probably by deteriorating hepatic risk factors. Additionally, adequate levels of plasma vitamin D are necessary to achieve the beneficial metabolic effects of aerobic training.

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