TOPLINE

Combined aerobic and resistance training (AT + RT) ranked highest for reducing BMI, waist circumference (WC), low-density lipoprotein (LDL) cholesterol, and fasting blood glucose (FBG) in adults with metabolic syndrome. High-volume high-intensity interval training (HIIT) was most effective for reducing body fat percentage (FAT%), low-volume HIIT showed the greatest benefits for total cholesterol (TC), triglycerides, and diastolic blood pressure (DBP), and traditional Chinese exercise (TCE) ranked highest for increasing high-density lipoprotein (HDL) cholesterol and reducing systolic BP (SBP).

METHODOLOGY

• A network meta-analysis compared 10 different exercise interventions across metabolic syndrome outcomes in adults diagnosed according to the 2009 harmonized definition.
• A total of 53 randomized controlled trials involving 2948 participants were included, with mean ages ranging from approximately 36 to 73 years; 52 studies contributed to the network meta-analysis.
• Exercise modalities included low-intensity exercise training, moderate-intensity exercise training, moderate-to-vigorous intensity exercise training, low-volume HIIT, high-volume HIIT, RT, AT + RT, HIIT + RT, yoga, and TCE.
• Outcome measures included BMI, FAT%, WC, TC, triglycerides, HDL cholesterol, LDL cholesterol, SBP, DBP, and FBG.
• Intervention durations ranged from 8 to 80 weeks; most direct comparisons had durations between 8 and 16 weeks, while a few trials lasted 24-80 weeks.

TAKEAWAY

• Compared with control, AT + RT significantly reduced BMI (mean difference [MD], −1.43; 95% CI, −2.45 to −0.41), LDL cholesterol (MD, −0.22 mmol/L; 95% CI, −0.38 to −0.06), FBG (MD, −0.47 mmol/L; 95% CI, −0.76 to −0.17), and WC (MD, −3.60 cm; 95% CI, −6.14 to −1.06).
• High-volume HIIT was most effective for reducing FAT% (MD, −2.62; 95% CI, −3.96 to −1.28).
• TCE was the most effective exercise modality for increasing HDL cholesterol (MD, 0.31 mmol/L; 95% CI, 0.05 to 0.57) and reducing SBP (MD, −13.59 mmHg; 95% CI, −17.90 to −9.28).
• Low-volume HIIT showed the greatest reductions in TC (MD, −0.36 mmol/L; 95% CI, −0.61 to −0.11) and triglycerides (MD, −0.25 mmol/L; 95% CI, −0.38 to −0.11), and DBP (MD, −5.90 mmHg; 95% CI, −8.20 to −3.59).

IN PRACTICE

"These findings provide evidence-based guidance for clinicians to precisely prescribe individualized exercise regimens tailored to the differentiated cardiometabolic risk profiles of patients with MetS [metabolic syndrome]," the authors wrote.

SOURCE

The study was led by Xinyu Shen, College of Physical Education and Sports, Beijing Normal University, Beijing, China. It was published online on July 20 in iScience.

LIMITATIONS

Most evidence was rated as low or very low certainty, primarily due to risk of bias, imprecision, and heterogeneity. Comparisons for certain interventions were informed by a limited number of studies, with some estimates relying primarily on indirect evidence. The analysis did not explore the potential impact of intervention settings, session duration, exercise intensity, or training volume on outcomes.

DISCLOSURES

The study was supported by grants from the College Student Innovation Training Program Project. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.