Background: Reduced brain‐derived neurotrophic factor (BDNF) levels have been linked to increased depression risk. While physical exercise is known to alleviate depressive symptoms and elevate BDNF levels, the effects of different exercise modalities and doses, along with their dose–response relationships, remain unclear.Objective: This study aims to systematically evaluate the effects of various exercise types and doses on BDNF levels in patients with depression through pairwise meta‐analysis, network meta‐analysis (NMA), and dose–response NMA and to provide personalized exercise prescription recommendations.Methods: A comprehensive search identified randomized controlled trials (RCTs) examining exercise’s impact on BDNF levels in depression. Pairwise and NMA compared six exercise modalities: continuous aerobic exercise (CAE), resistance exercise (RE), combined aerobic and resistance exercise (AERE), yoga, Qigong, and mindfulness. Dose–response NMA was used to assess the relationships between exercise dose and BDNF levels.Results: Thirty‐six RCTs with 2515 participants were included. The pairwise meta‐analysis indicated that all exercise interventions significantly elevated BDNF levels in patients with depression, with AERE, RE, and yoga demonstrating the most substantial effects. NMA rankings suggested that AERE was the most effective intervention, followed by RE, yoga, Qigong, mindfulness, and CAE. Dose–response NMA revealed a positive nonlinear dose–response relationship between total exercise volume and BDNF levels, with an optimal effective dose identified at ~610 METs‐min/week. Beyond 1000 metabolic equivalent of tasks (METs)‐min/week, increases in BDNF levels appeared to plateau. Moreover, each exercise type had distinct dose–response patterns, with RE and AERE having relatively higher optimal effective dose ranges, while CAE, yoga, Qigong, and mindfulness exhibited lower optimal ranges.Conclusions: AERE, RE, and yoga are effective interventions for enhancing BDNF levels in patients with depression, with Qigong, mindfulness, and CAE being comparatively less effective. A positive nonlinear dose–response relationship between exercise volume and BDNF levels was observed. Further research is needed to refine dose–response relationships in this population.

Objective: The gut microbiota plays a critical role in regulating human health and athletic performance. Probiotic supplementation has been shown to modulate gut microbiota composition and improve exercise performance. This study aimed to investigate the effect of probiotic yogurt supplementation on gut microbiota and its relationship with exercise-related psychological fatigue in female taekwondo athletes. Methods: Twenty female taekwondo athletes were randomly assigned to either a dietary intervention group (DK) or a control group (CK). The athletes’ exercise-related psychological fatigue was measured using the Athlete Burnout Questionnaire (ABQ) before and after an 8-week intervention. High-throughput sequencing was used to profile the gut microbiota, and functional prediction of the microbial community was performed. The effect of the dietary intervention on the athletes’ exercise-related psychological fatigue clearance rate and its relationship with the gut microbiota were explored. Results: (1) The probiotic supplementation of Bifidobacterium animalis ssp. lactis BB-12 for 8 weeks significantly increased the ABQ scores of the DK group compared to the CK group (p < 0.05). (2) The abundances of Bifidobacterium, Bacteroides, Lachnospiraceae, family _Lactobacillaceae, and genus _Lactobacillus were significantly higher in the DK group than in the CK group after probiotic supplementation, while Escherichia coli was significantly lower in the DK group than in the CK group. (3) The ABQa scores were positively correlated with Proteus; ABQb scores were positively correlated with Streptococcus and Enterococcus; and ABQc scores were positively correlated with Klebsiella, Bacteroides, and Streptomyces. (4) The DK group had significantly higher levels of L-arginine biosynthesis I (via L-ornithine), fatty acid biosynthesis and oxidation, and L-isoleucine biosynthesis III pathways compared to the CK group. Tyrosine degradation I (via 2,3-dihydroxyphenylpropionate) was significantly lower in the DK group than in the CK group. Conclusions: Probiotic yogurt supplementation of Bifidobacterium animalis ssp. lactis can promote the clearance of exercise-related psychological fatigue in female taekwondo athletes by upregulating beneficial gut microbiota, inhibiting harmful gut microbiota, and regulating relevant metabolic pathways.

The health consequences associated with exercising in polluted air are not fully understood. Therefore, we synthesized controlled trials that compared exercise performed under higher air-pollution exposure with a corresponding lower-exposure condition (e.g., filtered air or a lower concentration) in healthy participants, and explored potential effect modifiers. We searched PubMed, Embase, the Cochrane Library, Web of Science Core Collection, and Scopus for studies published between 2000 and 2024, and included 35 eligible controlled trials. Risk of bias was assessed using RoB 2 for randomized crossover trials and ROBINS-E for non-randomized studies, and the overall certainty of evidence using the GRADE framework. Random-effects meta-analyses using Hedges' g as a pooled effect size were conducted, with subgroup and meta-regression analyses exploring moderators. Results for pulmonary function showed that FEF_25-75 declined significantly (g = -0.323, 95% CI -0.633 to -0.014, I² = 19%, k = 5, certainty of evidence (CoE)), with smaller reductions in FEV₁ (g = -0.183, 95% CI -0.334 to -0.032, I² = 0%, k = 15, high CoE) and FVC (g = -0.131, 95% CI -0.280 to 0.018, I² = 0%, k = 14, moderate CoE). For cardiovascular function, there was a modest rise in systolic blood pressure (g = 0.279, 95% CI 0.093 to 0.464, I² = 0%, k = 9, high CoE), while diastolic pressure and heart rate were largely unaffected. Results for hematological outcomes showed that white blood cells (g = 0.479, 95% CI -0.002 to 0.960, I² = 73%, k = 6, very low CoE) increased, and red blood cells (g = -0.791, 95% CI -1.353 to -0.230, I² = 74%, k = 5, very low CoE) decreased, whereas results for inflammatory cytokines were inconsistent. Findings for hematological and inflammatory markers should be interpreted cautiously given heterogeneity and generally low certainty of evidence. Overall, these modest but consistent changes suggest that repeated exposure during exercise may accumulate respiratory and cardiovascular risks, underscoring the need to promote activity in cleaner environments to safeguard health benefits.

Early-life maternal separation (MS) in rodents has been associated with long-term disruptions in psychological development, potentially increasing susceptibility to mood and anxiety disorders. Exercise has been proposed as a non-pharmacologic intervention capable of mitigating behavioral disturbances induced by early-life stress. However, the efficacy of exercise across various behavioral domains and experimental paradigms in MS models remains incompletely characterized.We performed a systematic review and meta-analysis of preclinical studies evaluating the effects of exercise on depression- and anxiety-like behaviors in rodent models of maternal separation. Behavioral assessments included the Forced Swim Test (FST) and Open Field Test (OFT) for depressive phenotypes, and the Elevated Plus Maze (EPM) for anxiety-related outcomes. Fourteen studies comprising 18 independent datasets met inclusion criteria. Of these, 11 reported FST outcomes, 3 reported OFT data, and 4 included EPM measures.Exercise significantly reduced immobility time in the FST among MS-exposed rodents (mean difference, −63.64 seconds; 95% CI, −84.21 to −43.06; P < 0.00001), indicating attenuation of depression-like behavior. In the OFT, exercise was associated with increased exploratory activity (mean difference, 44.32 units; 95% CI, 30.86 to 57.78; P < 0.00001). A nonsignificant trend toward reduced anxiety-like behavior was observed in the EPM (mean difference,26.23,95% CI, 16.14to36.32, P < 0.00001). Substantial heterogeneity was observed, likely reflecting variation in MS protocols and exercise regimens.In rodent models of maternal separation, physical exercise is associated with significant reductions in depression-like behavior and increased exploratory activity, with a potential—though inconclusive—benefit for anxiety-related outcomes. These findings support the therapeutic potential of exercise in mitigating the long-term behavioral sequelae of early-life stress.

To systematically evaluate the effects of exercise interventions on plasma fibrinogen levels in patients with type 2 diabetes and to provide evidence to support the use of exercise prescription in the management of diabetes-related thrombotic risk. PubMed, Web of Science, Scopus, and Embase were systematically searched for randomized controlled trials investigating the effects of exercise or lifestyle interventions incorporating an exercise component on plasma fibrinogen levels. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes were expressed as Cohen’s d with 95% confidence intervals and pooled using a random-effects model. Subgroup analyses were conducted According to intervention type and intervention duration. Publication bias and the robustness of the findings were examined using Egger’s regression test and sensitivity analyses involving the exclusion of individual studies. Eight randomized controlled trials involving 2,371 participants were included. The pooled analysis indicated that exercise interventions were associated with improvements plasma fibrinogen levels (Cohen’s d=0.38, 95% CI: 0.09 to 0.67, I² = 75.2%). Subgroup analysis by intervention type showed a larger beneficial effect for exercise-only interventions, whereas the effect of combined exercise and dietary interventions was smaller; the between-subgroup difference was statistically significant (P16 weeks) was close to the null. These findings suggest that shorter-term structured exercise programs may be associated with larger observed effect estimates. Exercise interventions may improve plasma fibrinogen levels in patients with type 2 diabetes, with exercise-only and shorter-duration interventions showing comparatively larger effects. However, given the limited number of included studies, substantial between-study heterogeneity, and variation in intervention protocols, these findings should be confirmed in further high-quality, large-scale randomized controlled trials.