The Effects of Physical Activity on Functional Dyspepsia: A Mendelian Randomization and Randomized Controlled Study

Background/Aims: The relationship between physical activity (PA) and functional dyspepsia (FD) remains unclear due to a lack of robust evidence. We conducted a Mendelian randomization (MR) analysis to assess potential genetic associations, followed by a randomized controlled trial (RCT) assessing the therapeutic effects of moderate-intensity exercise in FD patients. Methods: In the MR analysis, genetic variants associated with PA traits from genome-wide association studies were analyzed. For the RCT, 260 FD patients were randomized to moderate-intensity exercise intervention or a control group. The primary endpoint was the adequate relief rate of dyspeptic symptoms. Results: Using MR, a potential inverse association of strenuous sports activity against the development of FD was estimated (inverse variance weight OR = 0.92, 95% CI = 0.88-0.98, P = 0.0047). Additionally, a suggestive inverse association was observed between other exercises (eg, swimming, cycling, keep fit, and fishing) (inverse variance weight OR = 0.964; 95% CI, 0.937-0.993; P = 0.013) and FD risk. In the previous high-quality study, other exercises (eg, swimming, cycling, keep fit, and fishing) were considered moderate intensity exercise. Therefore, the MR study suggest that moderate intensity exercise may reduce the occurrence of FD. In the subsequent RCT, 114 participants in the exercise intervention group and 113 in the control group completed the study. The exercise group demonstrated a significantly higher adequate relief rate (46.9% vs 30.8%, P = 0.008) and greater reductions in symptom scores (all P < 0.05) versus controls. Conclusions: PA, particularly moderate-intensity exercise, may reduce the risk of FD.