Effects of Broccoli Sprout Supplementation and Pilates Training on Liver Enzymes in Women with Nonalcoholic Fatty Liver Disease: A Double-Blind, Randomized Controlled Trial

Nonalcoholic fatty liver disease is a prevalent metabolic disorder linked to lifestyle factors. This study aimed to evaluate the effects of Pilates exercise and broccoli sprout supplementation, individually and combined, on liver enzyme levels in women with nonalcoholic fatty liver disease. In this double-blind, randomized controlled trial, 32 women aged 30-45 years from Mashhad were allocated into four groups: Pilates plus broccoli sprout supplement(SP), Pilates plus placebo(PP), supplement only(S), and placebo control(P). The Pilates training was performed three times per week for 8weeks at intensities progressing from 54 to 75% of maximum heart rate. Participants in supplementation groups received two 500 mg tablets daily (total 1,000 mg/day) of standardized broccoli sprout extract produced under good manufacturing practice guidelines. Serum liver enzyme levels, including aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase, were measured before and after the intervention. Data normality was assessed using the Kolmogorov-Smirnov test. Paired t-tests were applied for between-group comparisons, while one-way analysis of variance and analysis of covariance adjusted for baseline values were used for between-group comparisons. Tukey's post-hoc test was employed for pairwise analyses with p < 0.05 considered statistically significant. After 8 weeks, no statistically significant differences were observed in enzyme levels among the groups. Pilates exercise and broccoli sprout supplementation, alone or in combination, did not significantly alter hepatic enzyme levels in this population The modest exercise intensity and supplement dosage may have been insufficient to elicit measurable hepatic effects. Future studies should consider higher exercise intensities, longer intervention periods, and more diverse participant characteristics to better clarify potential synergistic effects in nonalcoholic fatty liver disease management.