Sports Medicine
Dose-Response Meta-Analysis: At Least 150 Weekly Minutes of Aerobic Exercise Needed for Significant Waist and Fat Reduction
2 Jan, 2025 | 09:30h | UTCBackground: Elevated body weight and adiposity remain major public health concerns worldwide, with overweight and obesity affecting nearly half of the adult population. Although various guidelines advocate for aerobic exercise as a core strategy in weight management, robust meta-analyses exploring dose-response relationships are scarce.
Objective: To clarify how different doses and intensities of supervised aerobic exercise affect body weight, waist circumference, and body fat in adults with overweight or obesity.
Methods: This systematic review and meta-analysis encompassed 116 randomized clinical trials (RCTs) including a total of 6880 participants (mean [SD] age, 46 [13] years). All studies involved supervised continuous aerobic interventions (e.g., walking or running) for at least 8 weeks. Comparisons were made against sedentary or usual-activity controls. Frequency, duration (minutes per week), and intensity (moderate, vigorous, or combined) of aerobic sessions were extracted.
Results: Across all trials, each additional 30 minutes per week of aerobic exercise was linked to a mean reduction of 0.52 kg in body weight (95% CI, −0.61 to −0.44), 0.56 cm in waist circumference, and 0.37 percentage points in body fat. Body weight and waist circumference showed largely linear decreases with increasing weekly exercise, whereas body fat percentage displayed a pattern suggesting that at least 150 minutes per week may be required to achieve clinically meaningful reductions (>2% reduction in body fat). Aerobic training was generally well tolerated, although a modest increase in mild musculoskeletal complaints was noted (risk difference, 2 more events per 100 participants).
Conclusions: Engaging in up to 300 minutes per week of aerobic exercise was associated with progressively greater benefits for weight control, waist circumference, and body fat. While even small doses yielded modest improvements, these findings suggest that an intensity of at least moderate level and a duration of at least 150 minutes per week may be necessary to achieve clinically important reductions in central obesity and fat percentage.
Implications for Practice: Clinicians managing patients with overweight or obesity can recommend a minimum of 150 minutes per week of moderate-to-vigorous aerobic training to achieve significant anthropometric changes. Gradual progression is essential to balance effectiveness and safety, especially in individuals with musculoskeletal constraints.
Study Strengths and Limitations: Strengths include the large number of RCTs, robust dose-response analyses, and consistent directions of effects. However, high heterogeneity, publication bias for certain fat measures, and limited data on medication use and health-related quality of life in longer trials were noted.
Future Research: Further trials should explore additional subgroup analyses (e.g., older adults, individuals with chronic comorbidities), longer durations of follow-up, and the integration of resistance training to optimize cardiometabolic outcomes.
Reference: Jayedi A, Soltani S, Emadi A, et al. Aerobic Exercise and Weight Loss in Adults: A Systematic Review and Dose-Response Meta-Analysis. JAMA Network Open. 2024;7(12):e2452185. DOI: http://doi.org/10.1001/jamanetworkopen.2024.52185
RCT: Effects of combined time-restricted eating and high-intensity functional training on body composition and cardiometabolic health in women with obesity – PLOS One
7 May, 2024 | 15:28h | UTCThis randomized clinical trial investigated the effects of time-restricted eating (TRE) and high-intensity functional training (HIFT), both separately and in combination, on body composition and cardiometabolic health in inactive women with obesity. Sixty-four participants were assigned to three groups: TRE alone, HIFT alone, and both TRE and HIFT (TRE-HIFT). Over 12 weeks, the TRE-HIFT group showed the most significant improvements in waist and hip circumference, fat mass, total cholesterol, triglyceride levels, insulin sensitivity, and blood glucose levels compared to the other groups. Weight and BMI reductions were also more substantial in the TRE-HIFT group than in the HIFT-only group. Furthermore, while all groups exhibited improvements, those combining both interventions experienced more pronounced changes in cardiometabolic parameters, suggesting the potential of integrated lifestyle interventions for enhancing health outcomes in this population.
Reference (link to free full-text):
Meta-Analysis: Efficacy of exercise modalities in major depressive disorder treatment
20 Mar, 2024 | 17:54h | UTCStudy Design and Population: This article presents a systematic review and network meta-analysis of randomized controlled trials to assess the optimal dose and modality of exercise for treating major depressive disorder, comparing its effects to psychotherapy, antidepressants, and control conditions such as usual care or placebo. The review included 218 unique studies encompassing 495 arms with a total of 14,170 participants who met the clinical cutoffs for major depression.
Main Findings: The findings revealed moderate reductions in depression symptoms for several exercise modalities when compared to active controls. Notably, walking or jogging, yoga, and strength training demonstrated the most significant effects. The effectiveness of exercise was found to be proportional to the intensity of the activity prescribed. Among these, yoga and strength training were identified as the most acceptable modalities for participants. However, the overall confidence in these results is low due to the high risk of bias in the included studies, with only one study meeting the criteria for a low risk of bias.
Implications for Practice: The study concludes that exercise, particularly walking or jogging, yoga, and strength training at sufficient intensities, can be an effective treatment for major depressive disorder. These modalities could be recommended alongside traditional treatments such as psychotherapy and antidepressants. Future research should focus on blinding participants and staff to mitigate expectancy effects and improve the reliability of findings. The inclusivity of exercise as a core treatment for depression could significantly impact treatment strategies and patient outcomes.
Reference: Noetel, M., et al. (2024). Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ, 384, e075847. DOI: https://doi.org/10.1136/bmj-2023-075847. Access the study here: [Link]
RCT – 2ry analysis | Aerobic exercise intervention shows potential to reduce chemotherapy-induced peripheral neuropathy
11 Aug, 2023 | 15:17h | UTCSee also: Visual Abstract
Commentary: Aerobic Exercise Cuts Chemotherapy-Induced Peripheral Neuropathy Symptoms – HealthDay
Commentary on Twitter
Aerobic exercise improves chemotherapy-induced peripheral neuropathy (CIPN) in women who were treated for ovarian cancer. Incorporating referral to exercise programs as a part of standard of oncology care is recommended. https://t.co/lp9C9seyM6 @anlan_cao
— JAMA Network Open (@JAMANetworkOpen) August 1, 2023
Study | Frequent soccer heading linked to cognitive impairment risk in retired players
3 Aug, 2023 | 13:12h | UTCInvited Commentary: Heading Frequency and Risk of Cognitive Impairment in Retired Male Professional Soccer Players – JAMA Network Open
Related:
Dementia risk in former professional footballers is related to player position and career length.
Study: Neurodegenerative Disease Mortality Increased Among Former Professional Soccer Players
Commentary on Twitter
In retired professional UK soccer players, repetitive heading was linked to an increased risk of cognitive impairment later in life by >2x (6-15/match) and >3x (>15x/match). https://t.co/lV2xNa1TTR
— JAMA Network Open (@JAMANetworkOpen) July 17, 2023
RCT | Platelet-rich plasma injections lack efficacy in 52-week ankle osteoarthritis study
2 Aug, 2023 | 13:43h | UTC
Study | Only 11% of sports supplements listing botanical ingredients accurately declare contents, 12% contain FDA-prohibited stimulants
28 Jul, 2023 | 14:21h | UTCCommentaries:
Ensuring the Safety and Value of Supplements – JAMA Network Open
Prospective Study | Intelligence likely remains intact after pediatric concussion
20 Jul, 2023 | 11:06h | UTCIQ After Pediatric Concussion – Pediatrics (free for a limited period)
Commentaries:
IQ After Pediatric Concussion: Clinical Considerations – Pediatrics
No Evidence Seen for Differences in IQ After Pediatric Concussion – HealthDay
Concussions do not affect IQ in children, study finds – News Medical
Changes to breast structure and function across a woman’s lifespan: implications for managing and modeling female breast injuries
19 Jul, 2023 | 14:29h | UTC
Cohort study | High-risk patent foramen ovale associated with increased decompression illness in scuba divers
18 Jul, 2023 | 13:43h | UTCDecompression Illness in Divers With or Without Patent Foramen Ovale: A Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
News Release: SCUBA divers with PFO at higher risk for decompression illness than previously thought – American College of Physicians
Commentary on Twitter
A study of #ScubaDivers found presence of high-risk PFO was associated with increased risk of decompression illness. Authors recommend divers with PFO should consider not diving or adhering to more conservative protocol: https://t.co/5Glt9B8Xup pic.twitter.com/AYbrDxiL0p
— Annals of Int Med (@AnnalsofIM) July 11, 2023
RCT| Exercise during hemodialysis improves physical function in chronic kidney failure patients
13 Jul, 2023 | 13:01h | UTCExercise during Hemodialysis in Patients with Chronic Kidney Failure – NEJM Evidence
Podcast | Overuse injuries in pediatrics
11 Jul, 2023 | 13:52h | UTC#86: Overuse Injuries – The Leg Bone’s Connected to the Foot Bone! – The Cribsiders
M-A | Comparing the efficacy of different types of exercise for the treatment and prevention of depression in youths
30 Jun, 2023 | 14:40h | UTC
M-A | Effect of resistance exercise dose components for tendinopathy management
26 Jun, 2023 | 00:22h | UTC
Consensus Statement | Concussion in sport
15 Jun, 2023 | 15:14h | UTC
Position Statement | Mononucleosis and athletic participation
2 Jun, 2023 | 12:25h | UTC
Position Statement | Athletes with attention-deficit/hyperactivity disorder
2 Jun, 2023 | 12:24h | UTC
Systematic review | Analgesic use in sports
2 Jun, 2023 | 12:17h | UTC
FDA warns of use of selective androgen receptor modulators (SARMs) among teens, young adults
10 May, 2023 | 16:00h | UTCCommentaries:
FDA issues warning for bodybuilding products marketed to teens, young adults – AAP News
Young Men Are Using Banned ‘SARM’ Supplements to Bulk Up, With Harmful Results – HealthDay
Guidelines | Prevention and treatment of nonfreezing cold injuries and warm water immersion tissue injuries
5 May, 2023 | 15:21h | UTCRelated:
Wilderness Medical Society Clinical Practice Guidelines for Spinal Cord Protection
Wilderness Medical Society Clinical Practice Guidelines for Diabetes Management
ACSM expert consensus statement on exertional heat illness: recognition, management, and return to activity
19 Apr, 2023 | 13:27h | UTCRelated:
Exertional heat stroke: pathophysiology and risk factors – BMJ Medicine
Classic and exertional heatstroke – Nature Reviews Disease Primers
Treatment and Prevention of Heat-Related Illness – New England Journal of Medicine
RCT | Exercise and protein intervention may improve resilience and reduce frailty in seniors
17 Apr, 2023 | 13:04h | UTC
Adolescent sudden cardiac death: the role of underlying conditions and physical activity
5 Apr, 2023 | 13:26h | UTCSudden Cardiac Death Among Adolescents in the United Kingdom – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentary on Twitter
Among the causes of SCD in adolescents, arrhythmogenic #cardiomyopathy, coronary artery anomalies & commotio cordis are more common in young athletes who die suddenly than in similarly aged sedentary individuals.
Read more on this https://t.co/VHRIiNz1hE… pic.twitter.com/N3bev3Nv8i
— JACC Journals (@JACCJournals) March 14, 2023
Review | Exercise in octogenarians: how much is too little?
31 Mar, 2023 | 13:34h | UTCExercise in Octogenarians: How Much Is Too Little? – Annual Reviews of Medicine
An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension
23 Mar, 2023 | 12:42h | UTC