Mechanisms by which exercise regulates gut microbiota in the prevention and treatment of non-alcoholic fatty liver disease

• Gut microbiota dysbiosis in NAFLD is characterized by increased pro-inflammatory bacteria and decreased anti-inflammatory bacteria, contributing to disease progression via the gut-liver axis. • Modulating gut microbiota through probiotics or fecal microbiota transplantation reduces transaminase levels and inflammation, highlighting gut microbiota as a therapeutic target. • Exercise modulates gut microbiota composition and function, increasing beneficial bacteria and reducing pro-inflammatory species, thereby improving host metabolic health. • Exercise exerts beneficial effects on NAFLD through multiple mechanisms involving short-chain fatty acids, bile acid metabolism, lipopolysaccharide reduction, and indole derivatives.