The Effects of Exercise on Fluorosis: A Comprehensive Multisystem Review

Fluorosis, a systemic condition caused by chronic excessive fluoride intake, poses significant threats to livestock health and agricultural productivity worldwide. This systematic review synthesizes current evidence on the modulatory effects of exercise against fluorosis, integrating human studies, animal experiments, and methodological considerations. Human studies indicate negative associations between fluoride exposure and cognitive development, muscle function, and exercise capacity, with exercise influencing fluoride pharmacokinetics in an exercise-intensity-dependent manner. Animal experiments consistently demonstrate that regular moderate-intensity exercise attenuates fluoride-induced damage across multiple organ systems through activation of the Nrf2/ARE antioxidant pathway, modulation of BMP-2/Smads and OPG/RANKL/RANK signaling, suppression of inflammatory responses, and preservation of intestinal barrier integrity. Substantial heterogeneity exists among current fluorosis models regarding exposure dosages, durations, and exercise protocols, underscoring the need for standardization and consideration of genetic background. Overall, exercise shows promise for mitigating fluorosis-induced multi-organ damage, although human evidence remains limited. Future research should prioritize model optimization, elucidation of molecular targets, and exploration of synergistic interventions to provide a foundation for veterinary clinical management.