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    Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis
    (Bmc, 2023) Al-Mhanna, Sameer Badri; Rocha-Rodriguesc, Silvia; Mohamed, Mahaneem; Batrakoulis, Alexios; Aldhahi, Monira I.; Afolabi, Hafeez Abiola; Yagin, Fatma Hilal
    Background Lifestyle modifications involving diet and exercise are recommended for patients diagnosed with obesity and type 2 diabetes mellitus (T2DM). The purpose of this review was to systematically evaluate the effects of combined aerobic exercise and diet (AEDT) on various cardiometabolic health-related indicators among individuals with obesity and T2DM.Methodology A comprehensive search of the PubMed/Medline, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases was conducted for this meta-analysis. The Cochrane risk of bias tool was used to evaluate eligible studies, and the GRADE tool was used to rate the certainty of evidence. A random-effects model for continuous variables was used, and the results were presented as mean differences or standardised mean differences with 95% confidence intervals.Results A total of 16,129 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants. The findings revealed significant improvements in body mass index, body weight, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, fasting blood glucose, fasting plasma insulin, glycated hemoglobin, leptin, interleukin-6, C-reactive protein, and adiponectin (p < 0.05) compared to the standard treatment (ST) group. No significant differences were observed between the AEDT and ST groups in fat mass, hip circumference, waist-to-hip ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and tumor necrosis factor-alpha. The present findings are based on low- to moderate-quality evidence.Conclusions AEDT may be a critical behavior for holistic cardiometabolic health-related benefits as a contemporary anti-obesity medication due to its significant positive impact on patients with obesity and T2DM. Nevertheless, further robust evidence is necessary to determine whether AEDT is an effective intervention for lowering cardiovascular and metabolic risk factors among individuals with obesity and T2DM.
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    Impact of Exercise on High-Density Lipoprotein Cholesterol in Adults with Overweight and Obesity: A Narrative Review
    (Annals Applied Sport Science, 2024) Al-mhanna, Sameer Badri; Leao, Cesar; Ghazali, Wan Syaheedah Wan; Mohamed, Mahaneem; Batrakoulis, Alexios; Afolabi, Hafeez Abiola; Abubakar, Bishir Daku
    Background. Sedentary lifestyles and insufficient physical activity contribute significantly to the rising global epidemic of obesity, fostering an environment where excess calories are stored as adipose tissue. Lack of regular physical activity and diminished cardiorespiratory fitness are key factors in the emergence of obesity-related illnesses, leading to cardiovascular and metabolic complications. However, the extent to which low levels of physical activity and obesity directly cause low HDL-C levels is uncertain, and the specific impact of obesity on reducing HDL-C as well as the associated risks are not well clarified. The influence of different types of exercise on HDL function is intricate and depends on various factors, including exercise intensity and individual characteristics. Objectives. This study aims to investigate the effect of exercise on HDL-C levels in overweight and obese adults, as well as review the mechanisms and pathways by which various exercise types influence HDL-C metabolism in this population. Methods. A literature search was conducted using the PubMed, Scopus, and Google Scholar databases. Studies were included if they were published in English. Results. A sequential moderate-tohigh-intensity exercise regimen resulted in sustained or gradual improvements in HDL-C levels. For increased HDL-C levels, frequent moderate-to-high-intensity, long-duration exercise at an aerobic threshold in conjunction with body mass reduction and dietary modification is observed from the reviewed studies. Conclusion. Regular exercise can improve HDL-C levels in overweight and obese individuals. A combination of moderate-to-high-intensity, long-duration exercise at an aerobic threshold with body mass reduction and dietary modification is most effective. Overweight and obese individuals should engage in regular exercise to improve their HDL-C levels and overall health.