Table 4: Changes in primary and secondary outcomes (study level).

VariableStudies (#)Participants (#)ES (#) 𝑋 (95% CI) 𝑄 ( 𝑃 ) 𝐼 2 (%)95% PI

Primary outcomes
 TC (mg/dL)1182011−12.6 (−20.1, −5.1)*60.5 (<0.001)*83.5−38.8, 13.6
 HDL-C (mg/dL)1182011−0.8 (−2.8, 1.2)53.0 (<0.001)*81.1−21.3, 19.7
 TC : HDL-C63836−0.5 (−0.7, −0.3)*9.1 (0.11)45.0−1.1, 0.1
 LDL-C (mg/dL)1078310−6.8 (−11.8, −1.8)*30.4 (<0.001)*70.4−22.6, 9.1
 TG (mg/dL)1182011−10.6 (−18.8, −2.4)*48.1 (<0.001)*79.2−35.4, 14.3
Secondary outcomes
 Body weight (kg)1042310−4.3 (−6.6, −2.0)*125.3 (<0.001)*92.8−12.7, 4.0
 BMI (kg/m2)81978−1.4 (−1.7, −1.0)*10.7 (0.2)34.4−2.2, −0.53*
V O 2 m a x (mL kg−1 min−1)518253.6 (0.3, 7.0)*121.4 (<0.001)*96.7−9.4, 16.6
 Kilocalories (total)63896−405 (−512, −298)*7.3 (0.2)32.0−660, −150*
 Carbohydrates (%)524052.8 (0.8, 4.7)*88.1 (<0.001)*95.5−4.3, 9.9
 Total fat (%)73437−3.5 (−5.8, −1.1)*284.7 (<0.001)*97.9−11.9, 4.9
 Saturated fat (%)41604−3.5 (−6.4, −0.5)*245.8 (<0.001)*98.8−17.9, 11.0
 Cholesterol (mg)41534−127 (−153, −101)*1.1 (0.8)0−185, −69*

Notes. ES, effect sizes; #, number for which data were available; 𝑋 (95% CI), mean and 95% confidence interval; 𝑄 ( 𝑃 ) , Cochran’s Q statistic for heterogeneity and alpha value; 𝐼 2 (%), percent inconsistency statistic; 95% PI, 95% prediction intervals for a new study; *, statistically significant; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; TC : HDL-C, TC : HDL-C ratio; LDL-C, low-density lipoprotein cholesterol; TG, triglycerides; BMI, body mass index; V O 2 m a x , maximum oxygen consumption; %, percentage of total kilocalorie intake. To convert TC, HDL-C, and LDL-C from mg/dL to mmol, divide by 38.46; to convert TG from mg/dL to mmol, divide by 87.7.