Effect of Exercise Training on Body Composition and Inflammatory Cytokine Levels in Overweight and Obese Individuals: A Systematic Review and Network Meta-Analysis

Abstract

ObjectiveThis study aimed to compare and rank the effectiveness of aerobic exercise (AE), resistance training (RT), combined aerobic and resistance training (CT), and high-intensity interval training (HIIT) on body composition and inflammatory cytokine levels in overweight and obese individuals by using network meta-analysis (NMA).MethodsWe searched the PubMed, Cochrane, Embase, Web of Science, and EBSCO databases to identify randomized controlled trials investigating the effects of exercise training on inflammatory cytokines in overweight and obese patients. The retrieval period was from inception to November 2021. Two reviewers independently screened the retrieved articles, extracted the pertinent data, and assessed the risk of bias of the included studies; then, they used Stata 16.0 and Review Manager 5.3 to perform an NMA.ResultsA total of 38 studies involving 1317 patients were included in this study. The results of the NMA indicated that AE had the greatest effect on weight loss (SUCRA=78.3; SMD=−0.51, 95% CI: −0.70, −0.33); CT had the greatest effect on reducing body mass index (SUCRA=70.7; SMD=−0.46, 95% CI: −0.81, −0.10), waist circumference (SUCRA=93.4; SMD=−1.86, 95% CI: −2.80, −0.93), percentage body fat (SUCRA=79.6; SMD=−1.38, 95% CI: −2.29, −0.48), interleukin-6 level (SUCRA=86.4; SMD=−1.98, 95% CI: −3.87, −0.09), and tumor necrosis factor-α level (SUCRA=79.4; SMD=−2.08, 95% CI: −3.75, −0.42); AE (SMD=0.51, 95% CI: −1.68, 2.69), RT (SMD=0.15, 95% CI: −3.01, 3.32), CT (SMD=1.78, 95% CI: −1.35, 4.92), and HIIT (SMD=2.29, 95% CI: −1.27, 5.86) did not significantly increase the adiponectin level.ConclusionThe current results suggest that CT is the best exercise modality for improving body composition and inflammatory status in overweight and obese individuals. More rigorous randomized control trials are needed for further validation.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022303165.

Phase angle (PhA) in overweight and obesity: evidence of applicability from diagnosis to weight changes in obesity treatment

“…This finding is probably reflected in the increase in muscle mass, a tissue that holds a large amount of ICW, resulting in better electrical conductivity and, thus, a concomitant increase in PhA. Others cellular mechanisms might be involved if we considering that exercise results in a greater reduction in CRP, IL-6, and TNF-a when accompanied by a reduction in BMI or FM% in overweight/obese individuals [ 80 ]. Furthermore, studies have shown that PhA increases after a training period or is higher in active subjects compared to less active ones, suggesting that many of the exercise-induced systemic adaptations can impact cell integrity and functionality [ 78 , 81 , 82 ].…”

Effects of various exercise types on visceral adipose tissue in individuals with overweight and obesity: A systematic review and network meta‐analysis of 84 randomized controlled trials

“…Combined exercise programs (AE + RT) have recently emerged as one of the most efficient strategies not only to improve body composition 28,50 but also as the most effective training mode for improving metabolic inflammatory markers. 30,51,52 The current NMA showed that AE 53 In addition, several meta-analyses have found that AE + RT is the best exercise mode for improving inflammation in obesity. 30,53,54 Therefore, AE + RT is recommended as the most appropriate treatment for the simultaneous improvement of VAT, inflammation, and muscle mass and strength.…”

“…Increased muscle and bone mass and decreased VAT were observed only with the AE + RT regimen 53 . In addition, several meta‐analyses have found that AE + RT is the best exercise mode for improving inflammation in obesity 30,53,54 . Therefore, AE + RT is recommended as the most appropriate treatment for the simultaneous improvement of VAT, inflammation, and muscle mass and strength.…”

The ‘Behavioral Balance Model’: A new perspective on the aetiology and therapy of obesity

“…64 In addition, regular exercise, optimally a combination of endurance other important obesity-related health parameters. [65][66][67][68] However, it should be considered that many people with obesity show orthopaedic impairments that preclude a high level of physical activity. In addition, there is evidence that habitual physical activity is to a great extent biologically determined and remains relatively stable at an individual level even after relevant changes in body weight.…”

“…While it has been shown to be not very effective in reducing body weight, it is well documented that increasing physical activity helps to maintain body weight at a lower level 64 . In addition, regular exercise, optimally a combination of endurance and resistance training, clearly improves body composition by increasing muscle mass and decreasing fat mass and by ameliorating many other important obesity‐related health parameters 65–68 . However, it should be considered that many people with obesity show orthopaedic impairments that preclude a high level of physical activity.…”