Exploring the gut-exercise link: A systematic review of gastrointestinal disorders in physical activity

Table 4 Summary of studies on physical activity and gallbladder health

Ref.	Type of article	Age of patients	Summary of study characteristics	Outcome
Shanmugam et al[128]	Review		Examined PA’s effects on lipid metabolism, gallbladder motor function, bile acids, and gallstone risk. Focused on hepatobiliary-gut axis and metabolic inflammation	PA positively influences lipid metabolism, reduces gallstone risk, and improves gallbladder motility
Ye et al[129]	Narrative review		Reviewed 15 articles on PA and cholelithiasis. Included cohort studies and Mendelian randomization analyses. Highlighted protective effects of PA and knowledge gaps	Regular PA has a protective effect on gallstone formation and is independently associated with lower cholelithiasis risk
Molina-Molina et al[130]	Review		Discussed PA effects on the hepatobiliary-gut axis, including bile acids, gut microbiota, and inflammatory responses. Focused on NAFLD and gallstone disease	PA benefits metabolic disorders like NAFLD and gallstone disease by improving bile acid circulation and reducing inflammation
Franczyk et al[131]	Narrative review		Reviewed aerobic exercise’s impact on HDL levels, lipid profiles, and antioxidant properties. Analyzed PA types, intensities, and durations	Aerobic exercise improves HDL quality and functionality, reduces LDL, and lowers triglycerides, benefiting lipid metabolism
Shephard[132]	Systematic review		Analyzed 67 articles on PA and gallbladder health, including gallstone risk and cancer. Examined acute and chronic PA effects on gallbladder motility	PA reduces gallstone risk and may lower gallbladder cancer risk. Effects on gallbladder motility remain unclear
Bulut and Karabulut[133]	Comparative study	Mean age: 45 years	Investigated effects of breathing exercises on recovery quality, anxiety, and sleep in patients undergoing laparoscopic cholecystectomy	Breathing exercises improved sleep quality, reduced anxiety, and enhanced recovery quality after gallbladder surgery
Misciagna et al[134]	Case-control study	Mean age: 49 years	Population-based study with 100 gallstone cases and 290 controls. Analyzed diet, PA, and gallstone risk using logistic regression	PA is inversely associated with gallstone risk. A diet rich in animal fats and refined sugars increases gallstone formation risk

PA: Physical activity; NAFLD: Non-alcoholic fatty liver disease; HDL: High-density lipoprotein; LDL: Low-density lipoprotein.