Indoor cycling is one of the most practiced activities in fitness centers for most people regardless of their physical conditioning level. Several studies have analyzed the effect of indoor cycling on several parameters related to health, such as maximal oxygen consumption, blood pressure, body composition, as well as biochemical markers such as HDL or LDL. However, no study has synthesized all health benefits associated with the indoor cycling practice in the form of a systematic review and established guidelines or recommendations. Therefore, the aim of this manuscript was to conduct a systematic review of published studies about the benefits of indoor cycling training and to establish recommendations for coaches, researchers, and practitioners.The PRISMA guidelines were followed to conduct the current systematic review. A systematic search was performed to retrieve relevant published articles until January 2019 using the following keywords: 'indoor cycling', 'indoor bicycle', and 'spinning exercise'. Information about participants, intervention, comparisons, outcomes, and study design (PICOS) was extracted.A total of 300 studies were initially identified. After the revision process, 13 of them were included. The total sample size of the studies was 372 (306 women). Results revealed that indoor cycling may improve aerobic capacity, blood pressure, lipid profile, and body composition. These enhancements may be achieved as standalone intervention or combined with other physical exercises or diet.The combination of indoor cycling and diet is recommended to improve the lipid profile, lose weight, and reduce blood pressure. Furthermore, indoor cycling alone may also enhance aerobic capacity. Given the lack of randomized controlled trials, these conclusions should be taken with caution.

Low-fat diets, lipid-modifying nutraceuticals and a higher level of physical activity are often recommended to reduce dyslipidemia. A double-blind, randomized, crossover, controlled trial was designed to evaluate the independent and synergistic effects of()supplementation (4.5 g·day) with or without performing a physical exercise program (: aerobic exercise (3 days·week) + high-intensity interval training (2 days·week)) on blood lipids and BMI of 52 sedentary men with excess body weight. During six weeks, all participants were assigned to four intervention treatments (with PEP (SE), placebo with PEP (Ex),without PEP (Sm), placebo without PEP (C; control)) and plasma lipids were evaluated spectrophotometrically pre- vs. post intervention in stratified subgroups (overweight, obese and dyslipidemic subjects). Pre/post comparisons showed significant reductions in all plasma lipids in the SE group, particularly in those with dyslipidemia (≤ 0.043). Comparing the final vs. the initial values, BMI, total cholesterol, triglycerides and low-density lipoprotein cholesterol were decreased. High-density lipoprotein cholesterol increased in all treatment groups compared to C. Changes were observed mostly in SE interventions, particularly in dyslipidemic subjects (<0.05).supplementation enhances the hypolipidemic effect of a systematic PEP in men with excess body weight and dyslipidemia.

This study evaluates the relation of a Mediterranean dietary pattern and its individual components with the cardiovascular risk factors profile, plasma glucose and body mass index (BMI) in people with type 2 diabetes. We studied 2568 participants at 57 diabetes clinics. Diet was assessed with the EPIC (European Prospective Investigation into Cancer and Nutrition) questionnaire, adherence to the Mediterranean diet was evaluated with the relative Mediterranean diet score (rMED). A high compared to a low score was associated with a better quality of diet and a greater adherence to the nutritional recommendations for diabetes. However, even in the group achieving a high score, only a small proportion of participants met the recommendations for fiber and saturated fat (respectively 17% and 30%). Nonetheless, a high score was associated with lower values of plasma lipids, blood pressure, glycated hemoglobin, and BMI. The relationship of the single food items components of the rMED score with the achievement of treatment targets for plasma lipids, blood pressure, glucose, and BMI were also explored. The study findings support the Mediterranean dietary model as a suitable model for type 2 diabetes and the concept that the beneficial health effects of the Mediterranean diet lie primarily in its synergy among various nutrients and foods rather than on any individual component.

AIM:The study aimed to assess the effect of exercise intervention on the management of obese T2DM patients.

METHODS:The literature retrieval was conducted in relevant databases from their inception to 2015, with predefined searching strategy and selection criteria. The Cochrane Collaboration's tool was utilized to assess the quality of included studies. Weighted mean difference (WMD) with its corresponding 95% CI (confidence interval) was used as the effect size.

RESULTS:A subset of 13 eligible studies was selected. Exercise significantly reduced the concentration of high sensitivity C reactive protein (4 months: WMD=-1.03, 95% CI: -1.77 to -0.29, P<0.01), triglyceride (6 months: WMD=-24.75, 95% CI: -27.67 to -21.83, P<0.01), diastolic blood pressure (6 months: WMD=-2.70, 95% CI: -4.12 to -1.28, P=0.0002), systolic blood pressure (WMD=-7.98, 95% CI: -9.87 to -6.08, P<0.01)), HbA1c (4 months: WMD=-0.25, 95% CI: -0.49 to -0.02, P=0.04) and homeostasis model assessment-insulin resistance (3 months: WMD=-0.19, 95% CI: -0.37 to -0.01, P=0.04); and a pronounced increase of HDL-C (12 months: WMD=3.57, 95% CI: 1.92 to 5.21, P<0.01).

CONCLUSION:Exercise was beneficial to obese T2DM patients.

Background and objectives:Nonalcoholic steatohepatitis (NASH) is strongly associated with obesity. A weight loss of≥10% is necessary to improve NASH severity, but this goal has rarely been achieved in published studies using different diet protocols. The effect of a ketogenic, hypocaloric, commercial diet ("Ideal Protein,"IP) on body weight, metabolic markers, and liver tests in a group of NASH patients is evaluated in this study. Daily calorie intake was tailored to achieve a weight loss of≥10%.

Methods:We analyzed 38 patients with NASH who were placed on the IP diet between 2014 and 2018 and compared their outcomes with 6 control patients who declined the diet. All patients were evaluated by a trained health coach in weekly intervals throughout the study period. Clinical and laboratory data obtained before and at 6.5 months after intervention were compared using paired t-testing.

Results:The patients on the IP diet experienced a significant weight reduction (217± 8 lb. 194± 7 lb; mean ± S.E.M.), corresponding to an average weight loss of 9.7% ± 1.6%. Significant changes in systolic blood pressure (133 ± 3 mmHg. 123± 3 mmHg), triglycerides (200 ± 21 mmol/L. 132± 11 mmol/L), hemoglobin A1c (6.71% ± 0.29%. 5.74%± 0.19%), SGPT (97.3 ± 11.1 IU/L. 44.2± 5.9 IU/L), SGOT (82.4 ± 10.5 IU/L. 32.8± 5.2 IU/L), and Fib-4 scores (2.25 ± 0.23. 1.40± 0.13) were also observed (<0.05 in all cases). In the IP group, 50.5% of patients lost≥10% body weight. In contrast, no significant changes were observed in the control group. The IP diet was well tolerated, and no safety signals were noticed.

Conclusions:A ketogenic, hypocaloric resulted in striking weight loss and significant improvements in metabolic parameters and liver tests, suggesting that this approach carries promise for the dietary management of patients with NASH.

AIMS:The purpose of the present study was to compare different modes of exercise in chronic modification of cardiovascular diseases risk factors.

METHODS:A total of 48 healthy elderly men were randomly assigned to an aerobic training group (n = 15, aged 71.7± 4.7 years), a combined (aerobic and resistance) training group (n = 16, aged 68.5 ± 3.5 years) and a control group (n = 17, aged 67.0 ± 5.8 years). Both training programs were of moderate-to-vigorous intensity, 3 days per week for 9 months. Primary outcome measures included body composition, blood pressure and lipid profile. Odds ratios (OR) between hypertension, obesity and dyslipidemia were calculated. The independence between risk factors, aggregation and group factor was tested (baseline vs post-test).

RESULTS:There was significant aggregation between hypertension and obesity (OR 2.57, 95% CI 1.24-5.33). After 32 weeks, there was a significant change in the number of hypertensive (χ(2) = 8.1, P = 0.004) and dyslipidemic (χ(2) = 3.9, P = 0.049) participants, and also a favorable modification in the risk factors aggregation (χ(2) = 7.9, P = 0.019), but only in the combined training group.

CONCLUSIONS:Combined aerobic and resistance training is more effective in the chronic modification of blood pressure and lipid profile, and in the reduction of total risk factors aggregated.

AIMS:The purpose of the present study was to compare different modes of exercise in chronic modification of cardiovascular diseases risk factors.

METHODS:A total of 48 healthy elderly men were randomly assigned to an aerobic training group (n = 15, aged 71.7± 4.7 years), a combined (aerobic and resistance) training group (n = 16, aged 68.5 ± 3.5 years) and a control group (n = 17, aged 67.0 ± 5.8 years). Both training programs were of moderate-to-vigorous intensity, 3 days per week for 9 months. Primary outcome measures included body composition, blood pressure and lipid profile. Odds ratios (OR) between hypertension, obesity and dyslipidemia were calculated. The independence between risk factors, aggregation and group factor was tested (baseline vs post-test).

RESULTS:There was significant aggregation between hypertension and obesity (OR 2.57, 95% CI 1.24-5.33). After 32 weeks, there was a significant change in the number of hypertensive (χ(2) = 8.1, P = 0.004) and dyslipidemic (χ(2) = 3.9, P = 0.049) participants, and also a favorable modification in the risk factors aggregation (χ(2) = 7.9, P = 0.019), but only in the combined training group.

CONCLUSIONS:Combined aerobic and resistance training is more effective in the chronic modification of blood pressure and lipid profile, and in the reduction of total risk factors aggregated.

-Only a few randomized dietary intervention studies that investigated the effects of lacto-ovo vegetarian diet (VD) in clinically healthy omnivorous subjects are available.-We randomly assigned to overweight omnivores with a low-to-moderate cardiovascular risk profile a low-calorie VD compared with a low-calorie Mediterranean diet (MD), each lasting 3 months, with a crossover design. The primary outcome was the difference in body weight, body mass index, and fat mass changes between the 2 groups. Secondary outcomes were differences in circulating cardiovascular disease risk parameters changes between the 2 groups.-One hundred eighteen subjects (mean age: 51.1 years, females: 78%) were enrolled. The total participation rate at the end of the study was 84.7%. No differences between the 2 diets in body weight were observed, as reported by similar and significant reductions obtained by both VD (‒1.88 kg) and MD (‒1.77 kg). Similar results were observed for body mass index and fat mass. In contrast, significant differences between the 2 interventions were obtained for low-density lipoprotein cholesterol, triglycerides, and vitamin Blevels. The difference between the VD and MD groups, in terms of end-of-diet values, was recorded at 9.10 mg/dL for low-density lipoprotein cholesterol (=0.01), 12.70 mg/dL for triglycerides (<0.01), and 32.32 pg/mL for vitamin B(<0.01). Finally, no significant difference was found between VD and MD interventions in oxidative stress markers and inflammatory cytokines, except for interleukin-17, which improved only in the MD group. Forty-six participants during the VD period and 35 during the MD period reached the target values for≥1 cardiovascular risk factor.-Both VD and MD were effective in reducing body weight, body mass index, and fat mass, with no significant differences between them. However, VD was more effective in reducing low-density lipoprotein cholesterol levels, whereas MD led to a greater reduction in triglyceride levels.-URL: https://www.clinicaltrials.gov. Unique identifier: NCT02641834.

Diabetes Mellitus type 2 (DM2) is a metabolic disease that develops by a decrease in sensitivity of insulin receptors as an effect of the disruption certain metabolic functions in the processing of glucose. DM2 patients have, uncontrolled glucose levels, and commonly have problems with obesity and cardiovascular disease. Patients are treated with standard diet, insulin, diabetic oral agents and antihypertensive drugs, but this approach does not completely stops tissue deterioration since it does not address the metabolic root of the disease. Metabolic correction is proposed as a suitable adjunct treatment to improve clinical outcomes. Metabolic correction is based on diet modification, proper hydration and scientific supplementation directed to improve cellular biochemistry and metabolic efficiency. In addition, other possible benefits may include reduction in medication use, disease complications and medical costs. To test the results of a metabolic correction program, 25 patients with DM2 participated in an education program about adequate food consumption that promoted control of blood glucose levels. Anthropometric measurements and blood tests were performed during a 13 week program based on a low carbohydrate diet, proper hydration and magnesium supplementation. The metabolic correction program implemented by a proprietary educational system resulted in significant reductions in glucose, triglycerides, cholesterol, weight and waist circumference. Improvements in these values could represent an important reduction of coronary heart disease risk factors as well as other chronic degenerative diseases. In addition there was medication dosage reduction in one or more medications in 21 of the 25 participating patients, which suggest that the program has the potential to improve health outcomes and reduce health care costs.

BACKGROUND:Cardiovascular Diseases (CVD) are, currently, the major contributor to global mortality and will continue to dominate mortality rates in the future. Hyperlipidemia refers to the elevated levels of lipids and cholesterol in the blood, and is also identified as dyslipidemia, manifesting in the form of different disorders of lipoprotein metabolism. These abnormalities may lead to the development of atherosclerosis, which can lead to coronary artery disease and stroke. In recent years, there is a growing interest in the quest for alternative therapeutic treatments based on natural products, offering better recovery and the avoidance of side effects. Recent technological advances have further improved our understanding of the role of epigenetic mechanisms in hyperlipidemic disorders and dietary prevention strategies.

OBJECTIVE:This is a comprehensive overview of the anti-hyperlipidemic effects of plant extracts, vegetables, fruits and isolated compounds thereof, with a focus on natural products from the Mediterranean region as well as the possible epigenetic changes in gene expression or cardiometabolic signaling pathways.

METHODS:For the purpose of this study, we searched the PubMed, Scopus and Google Scholar databases for eligible articles and publications over the last five years. The keywords included:"hyperlipidemia","plant extract","herbs","natural products","vegetables","cholesterol"and others. We initially included all relevant articles referring to in vitro studies, animal studies, Randomized Controlled Trials (RCTs) and previous reviews.

CONCLUSION:Many natural products found in the Mediterranean diet have been studied for the treatment of hyperlipidemia. The antihyperlipidemic effect seems to be dose and/or consumption frequency related, which highlights the fact that a healthy diet can only be effective in reversing disease markers if it is consistent and within the framework of a healthy lifestyle. Finally, epigenetic biomarkers are increasingly recognized as new lifestyle management tools to monitor a healthy dietary lifestyle for the prevention of hyperlipidaemic disorders and comorbidities to promote a healthy life.

Nutrient levels in buckwheats that were maximized in day 8 sprouts (D8SP) included total phenolics, quercetin, and l-ascorbic acid, whereas those of oxalic, malic, tartaric, and citric acids, rutin, and gamma-aminobutyric acid (GABA) were found to reach maximum levels on day 10. Ethanolic extract of D8SP (2.5 mg/mL) revealed potent free-radical scavenging (FRS) and antioxidative (ANO) capabilities. However, its Fe2+-chelating capability was only moderate. To further study the hypolipidemic activity of D8SP, 36 Syrian hamsters were grouped into six groups and fed for 28 days, respectively, with (i) control meal, (ii) high fat plus high cholesterol meal, (iii) high fat plus high cholesterol plus 2.5% of buckwheat seeds, (iv) high fat plus high cholesterol plus 25% of buckwheat seeds, (v) high fat plus high cholesterol plus 2.5% of D8SP, and (vi) high fat plus high cholesterol plus 25% of D8SP. High seed meal prominently enhanced body weight gain, whereas high sprout meal exhibited the highest feed efficiency. Ratios of liver/body weight (L/B) were significantly lowered by all BS meals. Although low seed meal reduced serum total cholesterol (TC) levels (p<0.05), its effect was still inferior to the high seed and sprout meals (p<0.01). In contrast, serum triglyceride (TG) levels were lowered only by the high seed and sprout meals (p<0.05). Alternatively, levels of serum low-density lipoprotein cholesterol (LDL-C) were significantly suppressed by all buckwheat meals (p<0.01). Serum high-density lipoprotein cholesterol (HDL-C) levels were increased, however, insignificantly. Nutraceutically more meaningful is that both LDL-C/HDL-C and TC/HDL-C ratios were significantly lowered (p<0.01). Apparently, hepatic TC levels were significantly reduced, whereas hepatic TG levels were totally unaffected. Conclusively, sprouting triggers a variety of nutritional changes in buckwheats. Day 8 sprouts, consisting of high polyphenolic and moderate quercetin contents, are nutraceutically maximized when hypocholesterolemic, hypotriglyceridemic, and antioxidative activities are concerned.

Cardiovascular diseases (CVDs) are disorders of the heart and blood vessels and include coronary heart diseases, cerebrovascular diseases, rheumatic heart diseases, and other conditions. CVDs are one of the most major causes of morbidity and mortality around the world, taking the lives of 17.9 million people every year. Several investigations have shown the influence of Ganoderma lucidum (G. lucidum, Lingzhi) on some metabolic markers, such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), blood pressure, and oxidative damage. G. lucidum potentially reduces the risk of suffering cardiovascular diseases. Some studies found that G. lucidum prevented from heart damage in a variety of disease models, such as streptozotocin (STZ)-induced diabetic, high-fat-diet-induced diabetic, isoprenaline (ISO)-induced myocardial hypertrophy, acute ethanol-induced heart toxicity, and transverse aortic constriction (TAC) models. This chapter summarizes putative preventive and therapeutic effects of G. lucidum on cardiovascular diseases and the potential clinical use of G. lucidum involved in these effects.

The aim of this study was to investigate the responses of atherosclerosis plaque biomarkers to purslane seed consumption and aerobic training in women with T2D. 196 women with T2D were assigned into; (1) placebo (PL), (2) aerobic training+placebo (AT + PL), 3) purslane seeds (PS), aerobic training+purslane seeds (AT + PS). The training program and purslane seeds consumption (2.5 g lunch and 5 g dinner) were carried out for 16 weeks. The components of purslane seed were identified and quantified by GC-MS. Blood samples were withdrawnvia venipuncture to examine blood glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol, triglycerides (TG), creatinine, urea, uric acid, NF-κB, GLP1, GLP1R, TIMP-1, MMP2, MMP9, CRP, CST3, and CTSS expressions. Blood glucose, LDL, cholesterol, TG, creatinine, urea, and uric acid levels in the (P), (AT), and (AT + PS) groups were significantly decreased compared to the pre-experimental levels or the placebo group, while HDL, significantly increased. Furthermore, the protein and mRNA levels of NF-κB, TIMP-1, MMP2&9, CRP, CST3, and CTSS in the (P), (AT), (AT + PS) significantly decreased compared to pre-experimental or the placebo group, while level of GLP1 and GLP1-R increased drastically. Findings suggest that purslane seed consumption alongside exercising could improve atherosclerosis plaque biomarkers through synergistically mechanisms in T2D.

BACKGROUND:Raisins are a significant source of dietary fiber and polyphenols, which may reduce cardiovascular disease (CVD) risk by affecting lipoprotein metabolism and inflammation. Walking represents a low intensity exercise intervention that may also reduce CVD risk. The purpose of this study was to determine the effects of consuming raisins, increasing steps walked, or a combination of these interventions on blood pressure, plasma lipids, glucose, insulin and inflammatory cytokines.

RESULTS:Thirty-four men and postmenopausal women were matched for weight and gender and randomly assigned to consume 1 cup raisins/d (RAISIN), increase the amount of steps walked/d (WALK) or a combination of both interventions (RAISINS + WALK). The subjects completed a 2 wk run-in period, followed by a 6 wk intervention. Systolic blood pressure was reduced for all subjects (P = 0.008). Plasma total cholesterol was decreased by 9.4% for all subjects (P<0.005), which was explained by a 13.7% reduction in plasma LDL cholesterol (LDL-C) (P<0.001). Plasma triglycerides (TG) concentrations were decreased by 19.5% for WALK (P<0.05 for group effect). Plasma TNF-alpha was decreased from 3.5 ng/L to 2.1 ng/L for RAISIN (P<0.025 for time and group x time effect). All subjects had a reduction in plasma sICAM-1 (P<0.01).

CONCLUSION:This research shows that simple lifestyle modifications such as adding raisins to the diet or increasing steps walked have distinct beneficial effects on CVD risk.

INTRODUCTION AND OBJECTIVES:Consumption of a Western diet during the perinatal period is associated with development of cardiovascular disease. Resistance training (RT) has been used to treat cardiovascular disorders. The aim of this work was to assess the effect of RT on cardiometabolic disorders in rats exposed to a Western diet in the perinatal period.

METHODS:Female Wistar rats were fed with control or Western diet during pregnancy and lactation. The pups were divided into three groups: Control (C), Western Diet Sedentary (WDS) and Western Diet + RT (WDRT). At 60 days of age, all animals started the RT protocol (five times a week for four weeks). At the end, blood pressure was recorded for analysis of heart rate variability and baroreflex sensitivity (BRS). Blood samples were collected for biochemical analysis.

RESULTS:RT reduced blood pressure and vascular sympathetic modulation and increased BRS. There were improvements in biochemical profile, with reductions in fasting blood glucose, total cholesterol and low-density lipoprotein, and an increase in high-density lipoprotein.

CONCLUSION:RT led to beneficial adaptations in the cardiovascular system, mediated by changes in the mechanisms of autonomic control and biochemical profile of animals exposed to a Western diet in the perinatal period.

BACKGROUND:Yoga is a science practiced in India over thousands of years. It produces constituent physiological changes and has sound scientific basis.

AIM:Since exam stress modifies lipid profile and hematological parameters, we conducted an investigation on the effect of sudarshan kriya (SK and P) program on these parameters.

MATERIALS AND METHODS:Blood samples of 43 engineering students were collected at four intervals namely baseline (BL), exam stress (ES), three and six weeks practice of SK and P during exam stress. Lipid profile and hematological parameters were measured at all four intervals.

RESULTS:ES elevated total cholesterol (TC), triglycerides (TGL) and very low density lipoprotein (VLDL) levels. Hematological parameters affected by ES included neutrophil, lymphocytes, platelet count, packed cell volume (PCV) and mean cell volume (MCV). Three and six weeks practice of SK and P reduced the elevated lipid profile, hematological parameters and improved lymphocyte levels.

CONCLUSION:Our study indicates that SK and P practice has the potential to overcome ES by improving lipid profile and hematological parameters.

BACKGROUND:Yoga is a science practiced in India over thousands of years. It produces constituent physiological changes and has sound scientific basis.

AIM:Since exam stress modifies lipid profile and hematological parameters, we conducted an investigation on the effect of sudarshan kriya (SK and P) program on these parameters.

MATERIALS AND METHODS:Blood samples of 43 engineering students were collected at four intervals namely baseline (BL), exam stress (ES), three and six weeks practice of SK and P during exam stress. Lipid profile and hematological parameters were measured at all four intervals.

RESULTS:ES elevated total cholesterol (TC), triglycerides (TGL) and very low density lipoprotein (VLDL) levels. Hematological parameters affected by ES included neutrophil, lymphocytes, platelet count, packed cell volume (PCV) and mean cell volume (MCV). Three and six weeks practice of SK and P reduced the elevated lipid profile, hematological parameters and improved lymphocyte levels.

CONCLUSION:Our study indicates that SK and P practice has the potential to overcome ES by improving lipid profile and hematological parameters.

Cardiovascular diseases are part of the highly preventable chronic diseases associated with changes in lifestyle. Within them, physical activity, low-fat and high-fiber diets are distinguished as the main support for prevention, even when supplementation with nutraceuticals has become a very common practice. Fifty-two young sedentary men with excess body weight (body mass index (BMI)≥ 25 kg·m) were enrolled in a randomized-crossover controlled trial [six weeks of a systematic physical exercise withor placebo supplementation (4.5 g·day)]. Body composition, blood lipid profile, and maximal oxygen uptake were determined pre/post intervention. Pairwise comparisons showed a significant improvement (<0.01) on blood lipid profile in the group of exercise plus. Moreover, correlations of absolute changes of BMI, body fat percentage, blood lipids and maximal oxygen uptake were statistically significant (<0.01). These results indicate that thesupplementation could be acting in a synergistic way with exercise due to the enhanced effects on body composition, cardiorespiratory fitness, and blood lipid profile. This phenomenon should be considered to reduce risk of cardiovascular disorders. Trial registration: Clinical Trials, NCT02837666 (July 19, 2016).

BACKGROUND:Purpose: to establish if exercise training improves clinical outcomes in people with metabolic syndrome (MetS). Registered with PROSPERO international prospective register of systematic reviews ( https://www.crd.york.ac.uk/PROSPERO/Identifier:CRD42017055491 ).

DATA SOURCES:studies were identified through a MEDLINE search strategy (1985 to Jan 12, 2017), Cochrane controlled trials registry, CINAHL and SPORTDiscus.

STUDY SELECTION:prospective randomized or controlled trials of exercise training in humans with metabolic syndrome, lasting 12 weeks or more.

RESULTS:We included 16 studies with 23 intervention groups; 77,000 patient-hours of exercise training. In analyses of aerobic exercise studies versus control: body mass index was significantly reduced, mean difference (MD) -0.29 (kg m(-2)) (95% CI -0.44, -0.15, p < 0.0001); body mass was significantly reduced, MD -1.16 kg (95% CI -1.83, -0.48, p = 0.0008); waist circumference was significantly reduced MD -1.37 cm (95% CI -2.02, -0.71, p < 0.0001), peak VO2 was significantly improved MD 3.00 mL kg(-1) min(-1) (95% CI 1.92, 4.08, p < 0.000001); systolic blood pressure and diastolic blood pressure were significantly reduced, MD -2.54 mmHg (95% CI -4.34, -0.75, p = 0.006), and, MD -2.27 mmHg (95% CI -3.47, -1.06, p = 0.0002) respectively; fasting blood glucose was significantly reduced MD -0.16 mmol L(-1) (95% CI -0.32,-0.01, p = 0.04); triglycerides were significantly reduced MD -0.21 mmol L(-1) (95% CI -0.29, -0.13, p < 0.00001); and low density lipoprotein was significantly reduced MD -0.03 mmol L(-1) (95% CI -0.05, -0.00, p = 0.02). In analyses of combined exercise versus control: waist circumference, MD -3.80 cm (95% CI -5.65, -1.95, p < 0.0001); peak VO2 MD 4.64 mL kg(-1) min(-1) (95% CI 2.42, 6.87, p < 0.0001); systolic blood pressure MD -3.79 mmHg (95% CI -6.18, -1.40, p = 0.002); and high density lipoprotein (HDL) MD 0.14 (95% CI 0.04, 0.25, p = 0.009) were all significantly improved. We found no significant differences between outcome measures between the two exercise interventions.

CONCLUSIONS:Exercise training improves body composition, cardiovascular, and, metabolic outcomes in people with metabolic syndrome. For some outcome measures, isolated aerobic exercise appears optimal.