Nonalcoholic Fatty Liver Disease (NAFLD) is a growing health epidemic in developed countries with increased prevalence in obese and diabetic populations. Exercise is an established and essential component of lifestyle modification for NAFLD disease management. Despite numerous studies reporting exercise-mediated improvements in NAFLD, there remains a large gap in our knowledge of how to optimize exercise prescriptions and whether the benefits of exercise extend beyond improvements in liver fat. In this review, we summarize studies that have investigated the independent effects of exercise training on liver enzymes, hepatic fat, and histologic markers in NAFLD. Overall, 12-weeks of aerobic, resistance, the combination of aerobic and resistance, and novel training modalities, including acceleration and hybrid training, significantly improve liver enzymes and hepatic fat. The greatest benefits in NAFLD may occur through the combination of aerobic and resistance training that targets both cardiorespiratory fitness, and mediators of skeletal muscle, known as myokines. Understanding the role of myokines in the beneficial effects of exercise in NAFLD may identify future therapeutic targets that can be modified with tailored exercise prescriptions.

Background: Oral cavity is prone for myriad of changes with advancing age as well result of environmental and life style related factors like consumption of tobacco (smoke or smokeless) and alcohol. Aim: The aim of this study was to quantify and compare the association of oral mucosal changes (OMC) with nonsmoked tobacco over smoked tobacco and alcohol. Methods: Data of 11,145 subjects from 106 health screening camps, organized in Uttar Pradesh and Rajasthan between April 2015 to June 2017 was analyzed to unveil and determine the mode of addiction and prevalence of OMC. Bivariate and multivariable models were tested for comparison and identification of factors associated with an increasing risk of developing OMC. Results: The primary symptoms were mouth ulcer in 5.6% and trismus (1.0%). The overall proportions of tobacco chewing, smoking and alcohol addiction were 12.5%, 10.7% and 2.5% respectively. The highest prevalence of smoking noted in the age-group 55-64 years (14.4%), for tobacco chewing and alcohol consumption in the age-group 25-34 years was 15.6% and 4.2% respectively ( P < 0.001). The prevalence of mouth ulcers were 20.7% among smokers and 27.8% among tobacco chewers ( P < 0.001) while the percentage of trismus 26.1% among smokers and 53.0% among tobacco chewers ( P < 0.001). Conclusion: Results of this study can be used for creating awareness among the population regarding the hazards of tobacco use. More number of studies needs to be conducted all over India to understand the prevalence and the biologic behavior of these oral premalignant lesions and its progression to invasive diseases.

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