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Determining the effect size of aerobic exercise training on the standard lipid profile in sedentary adults with three or more metabolic syndrome factors: a systematic review and meta-analysis of randomised controlled trials
  1. Gina Wood1,2,
  2. Emily Taylor2,
  3. Vanessa Ng3,
  4. Anna Murrell4,
  5. Aditya Patil2,
  6. Tom van der Touw2,
  7. Ronald Sigal5,
  8. Mitch Wolden6,
  9. Neil Smart2
  1. 1School of Physiotherapy and Exercise Science, Curtin University Faculty of Health Sciences, Perth, Western Australia, Australia
  2. 2School of Science and Technology, University of New England School of Science and Technology, Armidale, New South Wales, Australia
  3. 3School of Rural Medicine, Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
  4. 4School of Rural Medicine, University of New England, Armidale, New South Wales, Australia
  5. 5Division of Endocrinology and Metabolism, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  6. 6Physical Therapy, University of Jamestown, Jamestown, North Dakota, USA
  1. Correspondence to Dr Gina Wood, School of Physiotherapy and Exercise Science, Curtin University Faculty of Health Sciences, Perth, WA 6102, Australia; gina.wood{at}


Objectives To estimate the change in the standard lipid profile (SLP) of adults diagnosed with ≥3 metabolic syndrome (MetS) factors following aerobic exercise training (AET); and to investigate whether study/intervention covariates are associated with this change.

Design Systematic review with univariate meta-analysis and meta-regression.

Data sources English language searches of online databases from inception until July 2020.

Eligibility criteria (1) Published randomised controlled human trials with study population ≥10 per group; (2) sedentary adults with ≥3 MetS factors but otherwise free of chronic disease, not pregnant/lactating; (3) AET-only intervention with duration ≥12 weeks; and (4) reporting pre–post intervention SLP outcomes.

Results Various univariate meta-analyses pooled 48 data sets of 2990 participants. Aerobic exercise training significantly (P<.001) improved all lipids (mmol/L mean difference ranges, 95% CIs): total cholesterol, –0.19 (–0.26 to –0.12) to –0.29 (−0.36 to –0.21); triglycerides, −0.17 (–0.19 to –0.14) to –0.18 (−0.24 to –0.13); high-density lipoprotein-cholesterol (HDL-C), 0.05 (0.03 to 0.07) to 0.10 (0.05 to 0.15); and low-density lipoprotein-cholesterol (LDL-C), –0.12 (–0.16 to –0.9) to –0.20 (−0.25 to –0.14). Meta-regression showed that intensity may explain change in triglycerides and volume may explain change in HDL-C and LDL-C.

Conclusion Aerobic exercise training positively changes the SLP of sedentary and otherwise healthy adults with ≥3 MetS factors. Adjusting AET intervention training variables may increase the effects of AET on triglycerides and HDL-C.

PROSPERO registration number CRD42020151925.

  • lipids
  • cholesterol
  • exercise training
  • cardiovascular diseases
  • metabolism

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  • Contributors GW and NS designed the systematic review and meta-analysis. GW, ET, AP, VN and AM extracted data from included randomised controlled trials. GW, AM, NS and MW analysed data. GW drafted the manuscript and all co-authors provided feedback and revised the manuscript critically for important intellectual content. All authors gave final approval of the version to be published. All authors agreed to be accountable for all aspects of the work. All authors agreed to ensure that questions related to the accuracy or integrity of any part of the work have been appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests GW is supported by an Australian Government Research Training Program (RTP) Scholarship.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.