Prevention and Management of MASLD through Yogic Practices: A Clinical Review

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly referred to as non alcoholic fatty liver disease (NAFLD), is a common metabolic liver disorder strongly associated with obesity, insulin resistance, dyslipidemia, type 2 diabetes mellitus, and physical inactivity. Lifestyle modification, including diet, weight management, and regular physical activity, remains central to its management. Yoga and yogic practices may provide an additional mind–body approach by combining physical activity, breathing regulation, relaxation, and meditation. Objective: To clinically review the potential role of yoga and specific yogic practices in the prevention and management of NAFLD/MASLD, with particular emphasis on hepatic, biochemical, anthropometric, metabolic, and cardiometabolic outcomes. Methods: A systematic search of peer-reviewed literature was undertaken using PubMed, Scopus, Web of Science, and Google Scholar. Search terms included *yoga, yogic practices, NAFLD, MASLD, hepatic steatosis, insulin resistance,* and *lifestyle intervention*. Clinical trials and observational studies evaluating yoga-based interventions and hepatic, biochemical, or metabolic outcomes were considered. Relevant information regarding study characteristics, yoga interventions, duration, and outcomes was synthesized narratively. Results: The reviewed evidence suggests that yoga may have beneficial effects on several risk factors associated with NAFLD/MASLD. Evidence includes improvements in liver enzymes, body weight, BMI, waist circumference, glucose regulation, insulin resistance, lipid profile, and blood pressure. An 8-week randomized clinical trial involving women with type 2 diabetes and ultrasound-confirmed NAFLD reported improvements in ALT, AST, fatty-liver grade, anthropometric measures, glycemic control, and lipid parameters following cyclic yoga. However, NAFLD-specific evidence remains limited, with small sample sizes, short intervention periods, heterogeneous yoga protocols, and limited objective imaging evidence. Conclusion: Yoga and yogic practices may serve as a complementary lifestyle intervention in the prevention and management of NAFLD/MASLD by potentially improving metabolic health, body composition, cardiometabolic risk factors, and selected liver-related outcomes. Asanas, pranayama, Kapalbhati, meditation, and integrated yoga may act through interconnected pathways involving physical activity, insulin sensitivity, lipid metabolism, stress regulation, and cardiometabolic health. Nevertheless, yoga should not be considered a replacement for established medical, dietary, and exercise-based management. Larger, well-designed clinical trials using standardized yoga protocols and objective measures of hepatic fat and fibrosis are required to establish its clinical effectiveness.