Background: The coronavirus disease 2019 (COVID-19) pandemic has created challenges that have caused profound changes in health behaviors. This study aimed to explore how COVID-19 is affecting the health-related quality of life (QoL) among Chinese adults. Methods: The data of health-related behaviors and QoL were collected via online surveys from 2289 adults (mean age = 27.8 ± 12 years) who had been isolated at home for an average of 77 days. Results: More than 50% of the respondents reported that their time engaged in daily physical activity (PA) decreased, while sedentary behavior (SB) time increased compared with that before the lockdown. Only 20% of the respondents reported engaging in moderate-to-vigorous PA, 23% of adults reported changed their diets to be healthier, and 30% reported consuming more vegetables, fruits, and milk products than before home-isolation. During home-isolation, 75.2% of the adults rated their sleep quality as very good, and 65% reported that they were satisfied with their QoL. Sleep quality mediated the relationship between PA and QoL. Conclusion: The two-to-three-month home-isolation has had mixed effects on adult health behaviors in China. The participants were found to have focused more on their eating quality and patterns, which had a positive influence on their QoL. However, people should be encouraged to exercise at home with limited space to maintain a generally healthy lifestyle during a prolonged quarantine.

Exercise and diet are treatments for nonalcoholic fatty liver disease (NAFLD) and prediabetes, however, how exercise and diet interventions impact gut microbiota in patients is incompletely understood. We previously reported a 8.6-month, four-arm (Aerobic exercise, n = 29; Diet, n = 28; Aerobic exercise + Diet, n = 29; No intervention, n = 29) randomized, singe blinded (for researchers), and controlled intervention in patients with NAFLD and prediabetes to assess the effect of interventions on the primary outcomes of liver fat content and glucose metabolism. Here we report the third primary outcome of the trial—gut microbiota composition—in participants who completed the trial (22 in Aerobic exercise, 22 in Diet, 23 in Aerobic exercise + Diet, 18 in No Intervention). We show that combined aerobic exercise and diet intervention are associated with diversified and stabilized keystone taxa, while exercise and diet interventions alone increase network connectivity and robustness between taxa. No adverse effects were observed with the interventions. In addition, in exploratory ad-hoc analyses we find that not all subjects responded to the intervention in a similar manner, when using differentially altered gut microbe amplicon sequence variants abundance to classify the responders and low/non-responders. A personalized gut microbial network at baseline could predict the individual responses in liver fat to exercise intervention. Our findings suggest an avenue for developing personalized intervention strategies for treatment of NAFLD based on host-gut microbiome ecosystem interactions, however, future studies with large sample size are needed to validate these discoveries. The Trial Registration Number is ISRCTN 42622771.

The study aimed to assess whether aerobic exercise (AEx) training and a fibre-enriched diet can reduce hepatic fat content (HFC) and increase glycaemic control in pre-diabetic patients with non-alcoholic fatty liver disease (NAFLD). Six-hundred-and-three patients from seven clinics in Yangpu district, Shanghai, China were recruited. Of them 115 individuals aged 50–65-year fulfilled the inclusion criteria (NAFLD with impaired fasting glucose or impaired glucose tolerance) and were randomly assigned into exercise (AEx n = 29), diet (Diet n = 28), exercise plus diet (AED n = 29), or no-intervention (NI n = 29) groups. Progressive supervised AEx training (60–75% VO2max intensity) was given 2-3 times/week in 30–60 min/sessions, and the diet intervention was provided as lunch with 38% carbohydrate and diet fibre of 12 g/day for 8.6-month. HFC was assessed by ¹H MRS. We found that HFC was significantly reduced in the AEx (−24.4%), diet (−23.2%), and AED (−47.9%) groups by contrast to the 20.9% increase in the NI group (p = 0.001 for all) after intervention. However, only AED group significantly decreased HbA_1c (−4.4%, p = 0.01) compared with the NI group (−0.6%). Aerobic exercise training combined with fibre-enriched diet can reduce HFC more effectively than either exercise or increased fibre-intake alone in pre-diabetic patients with NAFLD.

The primary aim of this study was to examine the associations of normal weight obesity (NWO) with physical fitness in Chinese university students. As a secondary aim, we assessed whether possible differences in physical fitness between students classified as NWO and normal weight non-obese (NWNO) were mediated by skeletal muscles mass. A total of 383 students (205 males and 178 females, aged 18–24 years) from two universities volunteered to participate in this study. Body height and weight were measured by standard procedures and body composition was assessed by bio-impedance analysis (InBody 720). NWO was defined by a BMI of 18.5–23.9 kg/m2 and a body fat percentage of > 20% or > 30% in male and female students, respectively. Physical fitness was measured using a 10-min intermittent endurance running test (Andersen test), countermovement jumps (CMJ) and a 5 × 5 m shuttle run test (5mSR). The level of leisure time physical activity (PA) was assessed by a questionnaire. 13.7% of male and 27.5% of female students were classified as NWO. Compared to NWNO, students classified as NWO showed a significantly poorer performance in the Andersen test (males: 1146 ± 70 m vs. 1046 ± 95 m, females: 968 ± 61 m vs. 907 ± 67 m, p < 0.001), CMJ (males: 55.0 ± 7.6 cm vs. 44.9 ± 7.5 cm, females: 39.8 ± 8.0 cm vs. 33.7 ± 5.9 cm, p < 0.001) and 5mSR (males: 18.7 ± 1.0 s vs. 20.0 ± 0.9 s, females: 21.1 ± 1.1 s vs. 22.4 ± 1.3 s, p < 0.001), respectively. The lower levels of physical fitness in NWO were partially explained by lower skeletal muscle mass (p < 0.001) both in male and female students. NWO was associated with poorer physical fitness and the relationship was partially mediated by lower skeletal muscle mass. The study indicated that attention should be paid for the potential hidden health risk in university students with normal body mass index but excessive fat mass.

Fatty liver is a major cause of obesity-related morbidity and mortality. The aim of this study was to identify early metabolic alterations associated with liver fat accumulation in 50- to 55-year-old men (n = 49) and women (n = 52) with and without NAFLD. Hepatic fat content was measured using proton magnetic resonance spectroscopy (¹H MRS). Serum samples were analyzed using a nuclear magnetic resonance (NMR) metabolomics platform. Global gene expression profiles of adipose tissues and skeletal muscle were analyzed using Affymetrix microarrays and quantitative PCR. Muscle protein expression was analyzed by Western blot. Increased branched-chain amino acid (BCAA), aromatic amino acid (AAA) and orosomucoid were associated with liver fat accumulation already in its early stage, independent of sex, obesity or insulin resistance (p<0.05 for all). Significant down-regulation of BCAA catabolism and fatty acid and energy metabolism was observed in the adipose tissue of the NAFLD group (p<0.001for all), whereas no aberrant gene expression in the skeletal muscle was found. Reduced BCAA catabolic activity was inversely associated with serum BCAA and liver fat content (p<0.05 for all). Liver fat accumulation, already in its early stage, is associated with increased serum branched-chain and aromatic amino acids. The observed associations of decreased BCAA catabolism activity, mitochondrial energy metabolism and serum BCAA concentration with liver fat content suggest that adipose tissue dysfunction may have a key role in the systemic nature of NAFLD pathogenesis.