Aerobic exercise, lipids and lipoproteins in overweight and obese adults: a meta-analysis of randomized controlled trials

• Published in: International Journal of Obesity 2005-08, Vol.29 (8), p.881-893
• Main Authors: Kelley, G A, Kelley, K S, Vu Tran, Z
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Body Weight; Cholesterol; Cholesterol - blood; Epidemiology; Exercise Therapy; Female; Health Promotion and Disease Prevention; Humans; Internal Medicine; Lipids; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Obesity; Obesity - blood; Obesity - therapy; Oxygen consumption; Public Health; Randomized Controlled Trials as Topic; Sensitivity analysis; Systematic review; Treatment Outcome; Triglycerides - blood
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0802959

OBJECTIVE: Use the meta-analytic approach to examine the effects of aerobic exercise on lipids and lipoproteins in overweight and obese adults. DATA SOURCES: (1) Computerized literature searches, (2) cross-referencing from review and original articles, (3) hand searching, and (4) expert review of reference list. STUDY SELECTION: (1) randomized controlled trials, (2) aerobic exercise ≥8 weeks, (3) adult humans ≥18 y of age, (4) all subjects overweight or obese (BMI ≥25 kg/m 2 ), (5) studies published in journal, dissertation, or master's thesis format, (6) studies published in the English-language, (7) studies published between 1 January 1955 and 1 January 2003, (8) assessment of one or more of the following lipid and/or lipoprotein variables: total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and triglycerides (TG). DATA ABSTRACTION: Dual-coding by the first two authors (inter-rater agreement=0.96). RESULTS: In total, 13 studies representing 31 groups (17 exercise, 14 control), 613 subjects (348 exercise, 265 control), and up to 17 outcomes were available for pooling. Across all categories, random-effects modeling resulted in statistically significant improvements for TC ( X̄ ±s.e.m., − 3.4±1.7 mg/dl, 95% CI, − 6.7 to − 0.2 mg/dl) and TG ( X̄ ±s.e.m., − 16.1±7.3 mg/dl, 95% CI, − 30.2 to − 2.1 mg/dl) but not HDL ( X̄ ±s.e.m., 1.6±0.8 mg/dl, 95% CI, − 0.02 to 3.2 mg/dl) or LDL ( X̄ ±s.e.m., − 0.5±1.3 mg/dl, 95% CI, − 3.0 to 2.0 mg/dl). Changes were equivalent to improvements of 2% (TC), 11% (TG), 3% (HDL), and 0.3% (LDL). After conducting sensitivity analyses (each study deleted from the model once), only decreases in TG remained statistically significant. Increases in HDL were associated with increases in maximum oxygen consumption ( V O 2 max in ml/kg/min, r =0.75, P =0.002) and decreases in body weight ( r =0.77, P