A metanalysis from 2019 looking at 5025 adults with obesity across 64 studies showed that exercise interventions had a medium-to-large benefit on total cholesterol (standard mean difference (SMD) 0.721, 95% CI 0.228 – 1.214, 906 participants, 35 studies), triglycerides (SMD 0.603, 95% CI 0.257 – 0.949, 2226 participants, 56 studies) and a small-to-medium benefit for LDL (SMD 0.406, 95% CI 0.238 – 0.573, 1994 participants, 49 studies) (1). The authors found that effects on lipid profiles were greater if more than 120 minutes of exercise were done per week and if the duration of an exercise intervention lasted 12 weeks or more. The authors judged the quality of the studies included to be good.
Another metanalysis from 2019 looking at 620 adults with obesity showed that both high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) have beneficial effects on total cholesterol (HIIT: SMD 0.467, 95% CI 0.157 – 0.777, 12 studies; MICT: SMD 0.488, 95% CI 0.176 – 0.800, 12 studies). There was no difference in reduction in total cholesterol between HIIT and MICT but HIIT also showed a beneficial effect on LDL levels (SMD 0.445, 95% CI 0.092 – 0.797) (2).
These data are also supported by two metanalyses and one systematic review suggesting that combined exercise and dietary interventions have a greater beneficial effect on lipid profiles when compared with dietary interventions on their own (3-5).
Quality of Evidence
A – High Quality: consistent evidence from multiple meta-analyses and systematic reviews
Strength of Recommendation
1 – Strong Recommendation: a medium-to-large effect size is seen.
Physical activity improves lipid profiles in adults with obesity with a medium-to-large effect size and so should be strongly encouraged in all patients alongside dietary modification.
1. Kim KB, Kim K, Kim C, Kang SJ, Kim HJ, Yoon S, et al. Effects of Exercise on the Body Composition and Lipid Profile of Individuals with Obesity: A Systematic Review and Meta-Analysis. J Obes Metab Syndr. 2019;28(4):278-94.
2. Su L, Fu J, Sun S, Zhao G, Cheng W, Dou C, et al. Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: A meta-analysis. PLoS One. 2019;14(1):e0210644.
3. Gobbo S, Bullo V, Roma E, Duregon F, Bocalini DS, Rica RL, et al. Nordic Walking Promoted Weight Loss in Overweight and Obese People: A Systematic Review for Future Exercise Prescription. J Funct Morphol Kinesiol. 2019;4(2).
4. Clark JE. Diet, exercise or diet with exercise: comparing the effectiveness of treatment options for weight-loss and changes in fitness for adults (18-65 years old) who are overfat, or obese; systematic review and meta-analysis. J Diabetes Metab Disord. 2015;14:31.
5. Schwingshackl L, Dias S, Hoffmann G. Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight/obese participants: a systematic review and network meta-analysis. Syst Rev. 2014;3:130.