Soltani Sepideh, Yazdanpanah Zeinab, Razmpoosh Elham, Vasmehjani Azam Ahmadi, Rostampour Kimia, Lotfi Mahshid, Kaviani Mojtaba, Forbes Scott C, Baker Julien Steven, Salehi-Abargouei Amin
Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Nutr Rev. 2025 Jun 4. doi: 10.1093/nutrit/nuaf065.
Individual studies examining the combined effects of exercise and a low-calorie diet on cardiometabolic factors have yielded inconsistent results.
In this systematic review and meta-analysis of randomized controlled trials we aimed to determine whether adding exercise to a low-calorie diet has impacts on glucose homeostasis, lipid profiles, and blood pressure in adults with overweight and obesity.
We searched the PubMed/MEDLINE, EMBASE, Web of Sciences, and Scopus databases from their inception to August 2024 to identify trials comparing the effects of exercise plus diet versus a low-calorie diet on cardiometabolic factors in adults with overweight and obesity.
Six reviewers independently performed title/abstract screening, data extraction, and quality assessment in duplicate. Meta-analyses were conducted using random-effects models to calculate summary estimates.
Ninety-seven eligible studies were included. Our findings demonstrated that incorporating exercise into a weight-loss diet significantly improved serum glucose, insulin levels, homeostatic model of insulin resistance, triglycerides, high-density lipoprotein cholesterol, and both systolic and diastolic blood pressure compared to diet alone. The analysis results highlighted the primary association of these benefits with aerobic exercise, rather than resistance training or combined aerobic and resistance exercises. Most improvements in cardiovascular risk factors were observed in supervised, high-intensity exercise programs, particularly cycling. The combination of aerobic exercise and a weight-loss diet was especially effective for metabolically healthy obese individuals.
The moderate to low certainty of evidence found in this review suggests that to mitigate metabolic risk in individuals with overweight or obesity, dietary intervention combined with high-intensity aerobic exercise, particularly cycling, may offer greater benefits than resistance training.
PROSPERO registration number: CRD42020173434.
个别研究探讨运动与低热量饮食对心脏代谢因素的综合影响，结果并不一致。
在这项对随机对照试验的系统评价和荟萃分析中，我们旨在确定在低热量饮食中加入运动是否会对超重和肥胖成年人的血糖稳态、血脂谱和血压产生影响。
我们检索了PubMed/MEDLINE、EMBASE、Web of Sciences和Scopus数据库，从其创建到2024年8月，以识别比较运动加饮食与低热量饮食对超重和肥胖成年人心脏代谢因素影响的试验。
六位评审员独立进行标题/摘要筛选、数据提取和质量评估，均进行两次。使用随机效应模型进行荟萃分析以计算汇总估计值。
纳入了97项符合条件的研究。我们的研究结果表明，与单纯饮食相比，将运动纳入减肥饮食可显著改善血清葡萄糖、胰岛素水平、胰岛素抵抗稳态模型、甘油三酯、高密度脂蛋白胆固醇以及收缩压和舒张压。分析结果突出了这些益处与有氧运动的主要关联，而非抗阻训练或有氧与抗阻联合运动。在有监督的高强度运动项目中，尤其是骑自行车，心血管危险因素的改善最为明显。有氧运动与减肥饮食相结合对代谢健康的肥胖个体尤其有效。
本评价中发现的证据确定性为中到低，这表明为减轻超重或肥胖个体的代谢风险，饮食干预结合高强度有氧运动，尤其是骑自行车，可能比抗阻训练带来更大益处。
PROSPERO注册号：CRD42020173434。
