Non-Alcoholic Fatty Liver Disease is a chronic condition marked by excessive fat accumulation in the liver, not linked to alcohol consumption. Globally, it affects 25–29% of the population, with prevalence in Asia, including India, ranging from 9% to 53%, influenced by demographics and socioeconomic factors. NAFLD can progress to severe liver conditions like NASH, fibrosis, cirrhosis, or liver cancer. It also increases the risk of cardiovascular diseases, metabolic syndrome, diabetes, and kidney disorders. The healthcare costs associated with NAFLD have risen significantly and each one-unit increase in FIB-4 scores correlates with a 3.4% rise in overall healthcare expenses. So, early intervention in terms od diet and lifestyle modification is crucial to curb these escalating costs.

Lifestyle modifications, including dietary changes and physical activity, are pivotal in NAFLD management. Calorie-restricted diets, such as low-carbohydrate, Mediterranean, and ketogenic approaches, have shown promise in reducing hepatic fat and improving metabolic health.

                   Different type of exercise like aerobic and resistance training offers unique and complementary benefits to individuals but, resistance training has additional benefits in terms of building and maintaining lean muscle mass, reducing risk of injury, feasibility in cardiopulmonary compromised and obese patients. So, it is important to make use of this modality in NAFLD management.

Although resistance exercise is promising for NAFLD management but, significant research gaps exist regarding its optimal application, standardized protocols, duration and clinical outcomes. So, we hypothesized that a calorie-restricted diet combined with structured resistance training (150 minutes/week) will be feasible and effective.