Effects of Combined Exercise and Low Carbohydrate Ketogenic Diet Interventions on Waist Circumference and Triglycerides in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis.

(1) : The purpose of this meta-analysis was to investigate the effects of combined exercise and low carbohydrate ketogenic diet interventions (CELCKD) for overweight and obese individuals. (2) : Relevant studies were searched by using the MEDLINE and EMBASE databases up to October 2020. Study Inclusion and Exclusion Criteria: Inclusion criteria were reporting effects of the CELCKD for overweight and obese individuals from randomized controlled trials. Studies that did not match the inclusion criteria were excluded. The methods for CELCKD and outcomes of selected studies were extracted. The effect sizes for interventions that included cardiorespiratory fitness, body composition, fasting glucose, and lipid profiles were calculated by using the standardized mean difference statistic. (3) : A total of seven studies and 278 overweight and obese individuals were included. The average intervention of selected studies consisted of moderate to vigorous intensity, 4 times per week for 9.2 weeks. Participating in CELCKD interventions was decreased triglycerides ( = -0.34, CI; -0.68--0.01, = 0.04) and waist circumference ( = -0.74, 95% confidence interval [CI]; -1.28--1.20, = 0.01), while cardiovascular fitness, body composition, fasting glucose, total cholesterol, high density lipoprotein (HDL) cholesterol, and low density lipoprotein (LDL) cholesterol were not statistically different after the interventions. No adverse side effects were reported. (4) : Participation in interventions by overweight and obese individuals had beneficial effects including decreased waist circumference and triglycerides. Longer term intervention studies with homogenous control groups may be needed.