Combined Effects of Aerobic Exercise and Diet on Lipids and Lipoproteins in Overweight and Obese Adults: A Meta-Analysis

Table 1

General characteristics of studies.

Study	Country	Group characteristics*	Exercise intervention	Diet intervention	Lipid assessment
Agurs-Collins; et al. (1997) [6]	USA	64 overweight African-American men and women with type 2 diabetes, 55–79 yrs age, assigned to an exercise and diet (𝑛=32) or usual care (𝑛=32) group	12 wks of 20 min of supervised low-impact aerobic exercise 1x wk; encouraged to exercise 2x wk and increase physical activity in daily routines	Carbohydrate, 55%–60% of kcals; protein 12–20%; fat, <30%; weight loss of 4.5 kg at ≤0.9 kg per week using the Exchange Lists for Meal Planning program	TC, HDL, TC/HDL, LDL, TG after a 12 hr overnight fast; LDL estimated using the Friedwald formula
Anderssen et al. (2005) [7]	Norway	285 drug-treated, sedentary, overweight hypertensive men, 40–75 yrs of age, assigned to a placebo and lifestyle intervention (𝑛=142) or placebo and usual care (𝑛=143) group	209 wks of supervised aerobic exercise 2x wk; home-based individualized aerobic activity program	Individualized to reduce caloric intake, saturated fat and sugar, and to increase intake of fruit, vegetables, complex carbohydrates, fish, and fish products	TC, HDL, LDL, TG in the morning after an overnight fast
Arciero et al. (2006) [8]	USA	36 sedentary, overweight/obese men and women, 26 to 60 yrs of age, assigned to an exercise and diet (𝑛=19) or nonintervention control group (𝑛=17)	12 wks of supervised aerobic exercise, 4–6x wk, 30–60 min/d, 50%–75% MHR	Carbohydrate, 55%–60% of kcals; protein 10–15%; fat, <30%	TC, HDL, TC/HDL, LDL, TG in the morning after a 12 hr overnight fast; LDL estimated using the Friedwald formula
Avila and Hovell (1994) [9]	USA	44 overweight Latino women 18 yrs of age and older assigned to an exercise and diet (𝑛=22) or control (𝑛=22) group	8 wks of supervised walking, 1x per wk, 20-min/d; participants also encouraged to walk an additional 15–20 min/d, every d	Carbohydrate, 58% of kcals; protein, 12%; fat, <30%; 1200–1500 kcals/d	TC
Hagan et al. (1986) [10]	USA	24 sedentary, overweight men and women assigned to an exercise and diet (𝑛=12) or control (𝑛=12) group	12 wks of supervised walking and/or running, 30 min/d, 5x per wk	1200 kcals/d	TC, HDL, LDL, TG after a 14 hr fast and 30 min of supine rest; LDL estimated using the Friedwald formula
Hirose et al. (2002) [11]	Japan	35 overweight women >30 yrs of age assigned to either a diet and exercise (𝑛=23) or control (𝑛=12) group	12 wks of unsupervised walking, at least 2x wk, 30 min/d; given a pedometer and asked to walk 10,000 steps/d	1600 kcals/d, <25% fat	TC, HDL, TG
Hopewell (1989) [12]	USA	21 sedentary, overweight, nonsmoking, premenopausal women, 20–51 yrs of age, assigned to an exercise and diet (𝑛=11) or control (𝑛=10) group	24 wks supervised walking, 3x wk, 50 min/d	1200 kcals/d, 60% carbohydrates, 20% protein, 20% fat, 25 g fiber/d	TC, HDL,TC/HDL, LDL, TG after a 12 hr fast and avoiding exercise for at least 24 hr; LDL estimated using the Friedwald formula
McAuley et al. (2002) [13]	New Zealand	54 sedentary, overweight/obese men and women 30–68 yrs of age assigned to a modest exercise and diet (𝑛=31) or control (𝑛=23) group	16 wks supervised & unsupervised aerobic exercise, 5x wk, 30 min/d	<32% of total kcals from fat, ≤11% of total kcals from saturated fat, 14% from monounsaturated fat, 7% from polyunsaturated fat, 50% from carbohydrates, 18% from protein, <200 mg cholesterol and >25 g fiber per/d	Fasting TC, HDL, LDL, TG
Miller et al. (2002) [14]	USA	44 hypertensive, overweight adults, 22 to 70 yrs of age, assigned to either an exercise and diet (𝑛=22) or control (𝑛=23) group	9 wks of supervised aerobic exercise (walking or cycle ergometry), 3x wk, 30–45 min/d, 50%–75% MHR	Hypocaloric version (2100 kcals) of DASH diet (18% kcals from protein, 55% from carbohydrate, 6% saturated fat, 13% monounsaturated fat, 8% polyunsaturated fat, 500 mg/d magnesium, 1240 mg/d calcium, 4700 mg/d potassium, 31 g/d fiber, 150 mg/d cholesterol, 100 mmol/d sodium)	TC, HDL, LDL, TG after fasting; LDL estimated using the Friedwald formula
Nieman et al. (2002) [15]	USA	44 sedentary obese women, 25–75 yrs of age, assigned to either an exercise and diet (𝑛=22) or attention control stretching (𝑛=22) group	12 wks walking, 5x wk (4 supervised, 1 unsupervised), 45 min/d, 60% to 80% MHR	1200–1300 kcal, NCEP Step  1 diet (55% carbohydrate, 30% total fat, ≤10% saturated fat, <300 mg/d of cholesterol)	TC, HDL, TC/HDL, LDL, TG
Wing et al. (1998) [16]	USA	77 overweight men and women, 40–55 yrs of age, assigned to either an exercise and diet (𝑛=37) or control (𝑛=40) group	104 wks supervised and unsupervised brisk walking, increasing to 3 miles per/d, 5x week	800–1,500 kcal/d, 20% of kcals from fat	Fasting TC, HDL, LDL, TG
Wood et al. (1991) [17]	USA	160 sedentary, overweight men and women 25 to 49 yrs of age assigned to either an exercise and diet (𝑛=81) or control (𝑛=79) group	52 wks supervised brisk walking and jogging, 25–45 min/d, 3x wk, 60% to 80% MHR	NCEP Step  1 diet (55% carbohydrate, 30% total fat, ≤10% saturated fat, <300 mg/d of cholesterol)	TC, HDL, LDL, TG in the morning after a 12 to 16 hr overnight fast and avoiding vigorous physical activity for at least 12 hr

Notes. Description of groups and all other variables limited to those that met the criteria for inclusion. *Number of participants include those that began the study but not necessarily included in the final analysis. USA, United States of America; yrs, years; wk, week; wks, weeks; min, minutes; kcals, kilocalories; kg, kilograms; TC, total cholesterol; HDL, high-density lipoprotein cholesterol; LDL, low-density lipoprotein cholesterol; TG, triglycerides; TC/HDL, ratio of total cholesterol to high-density lipoprotein cholesterol; hr, hour; MHR, maximum heart rate; kcals/d, kilocalories per day; min/d, minutes per day; NCEP, National Cholesterol Education Program; mg/d, milligrams per day; VO_2max, maximum oxygen consumption; DASH, Dietary Approaches to Stop Hypertension; AHA, American Heart Association; MWC, maximal work capacity.