Additional effects of exercise to hypocaloric diet on body weight, body composition, glycaemic control, and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes: a systematic review and meta-analysis

BACKGROUND<br/>This systematic review and meta-analysis evaluates the additional effects of exercise to hypocaloric diet on body weight, body composition, glycaemic control, and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes.<br/><br/>METHODS<br/>Embase, Medline, Web of Science, and Cochrane Central databases were evaluated and 11 studies were included. Random-effects meta-analysis was performed on body weight and measures of body composition and glycaemic control, to compare the effect of hypocaloric diet plus exercise with hypocaloric diet alone.<br/><br/>RESULTS<br/>Exercise interventions consisted of walking or jogging, cycle ergometer training, football training, or resistance training, and duration varied from 2 to 52!weeks. Body weight and measures of body composition and glycemic control decreased during both the combined intervention and hypocaloric diet alone. Mean difference in change of body weight (0.77 kg [95% CI: 2.03; 0.50]), BMI (0.34 kg/m2 [95% CI 0.73; 0.05]), waist circumference (1.42 cm [95% CI: 3.84; 1.00]), fat-free mass (0.18 kg [95% CI 0.52; 0.17]), fat mass (1.61 kg [95% CI 4.42; 1.19]), fasting glucose (+0.14 mmol/l [95% CI 0.02; 0.30]), HbA1c (0.06 % [95% CI 0.25; 0.13]), and HOMA-IR (+0.01 [95% CI: 0.40; 0.42]) was not statistically different between the combined intervention and hypocaloric diet alone. Two studies reported VO2max and showed significant increases upon addition of exercise to hypocaloric diet.<br/><br/>CONCLUSION<br/>Additional effects of exercise to hypocaloric diet in adults with overweight or obesity and type 2 diabetes were not shown for body weight, body composition, or glycaemic control, while cardio-respiratory fitness improves.<br/><br/>