Abstract
SummaryThis systematic review examined the impact of exercise intervention programs on selected cardiometabolic health indicators in adults with overweight or obesity. Three electronic databases were explored for randomized controlled trials (RCTs) that included adults with overweight or obesity and provided exercise‐training interventions. Effects on blood pressure, insulin resistance (homeostasis model of insulin resistance, HOMA‐IR), and magnetic resonance measures of intrahepatic fat in exercise versus control groups were analyzed using random effects meta‐analyses. Fifty‐four articles matched inclusion criteria. Exercise training reduced systolic and diastolic blood pressure (mean difference, MD = −2.95 mmHg [95% CI −4.22, −1.68], p < 0.00001, I 2 = 63% and MD = −1.93 mmHg [95% CI −2.73, −1.13], p < 0.00001, I 2 = 54%, 60 and 58 study arms, respectively). Systolic and diastolic blood pressure decreased also when considering only subjects with hypertension. Exercise training significantly decreased HOMA‐IR (standardized mean difference, SMD = −0.34 [−0.49, −0.18], p < 0.0001, I 2 = 48%, 37 study arms), with higher effect size in subgroup of patients with type 2 diabetes (SMD = −0.50 [95% CI: −0.83, −0.17], p = 0.003, I 2 = 39%). Intrahepatic fat decreased significantly after exercise interventions (SMD = −0.59 [95% CI: −0.78, −0.41], p < 0.00001, I 2 = 0%), with a larger effect size after high‐intensity interval training. In conclusion, exercise training is effective in improving cardiometabolic health in adults with overweight or obesity also when living with comorbitidies.
Highlights
Obesity is a global and growing multifactorial disease as well as a public health issue.[1]
In 2006, a Cochrane review based on a very limited number of randomized controlled trials (RCTs) available showed that groups of adults with overweight or obesity participating in physical exercise intervention programs experienced advantages for cardiometabolic health, if involved in higher-intensity exercise training.[7]
Four studies were performed on subjects affected by hypertension and nonalcoholic fatty liver disease (NAFLD),[41,51,55,78] three studies included subjects affected by NAFLD and type 2 diabetes,[28,29,50] and two included patients with dyslipidaemia.[18,52]
Summary
Obesity is a global and growing multifactorial disease as well as a public health issue.[1]. In 2006, a Cochrane review based on a very limited number of randomized controlled trials (RCTs) available showed that groups of adults with overweight or obesity participating in physical exercise intervention programs experienced advantages for cardiometabolic health (i.e., blood pressure lowering and improved lipid profile), if involved in higher-intensity exercise training.[7] In 2013, Pattyn et al.,[8] focusing on subjects with metabolic syndrome, displayed the efficacy of aerobic training in improving cardiovascular risk factors. In 2012, Cornelissen et al.[9] described the significant effect of resistance training in reducing systolic and diastolic blood pressure, but this meta-analysis did not address individuals with overweight or obesity. Previous systematic reviews and meta-analysis outlined significant effect of regular exercise in improving insulin sensitivity in patients with type 2 diabetes, but limited data are available in patients with overweight and obesity with or without type 2 diabetes.[10,11]
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