Comparison of aerobic exercise, diet or both on lipids and lipoproteins in adults: a meta-analysis of randomized controlled trials

Clin Nutr. 2012 Apr;31(2):156-67. doi: 10.1016/j.clnu.2011.11.011. Epub 2011 Dec 10.


Objective: Given that previous studies have reached conflicting conclusions regarding the effects of diet (D), aerobic exercise (E) or both (DE) on blood lipid and lipoprotein concentrations in adults, the meta-analytic approach was used to address this issue.

Data sources: Nine electronic databases, cross-referencing, and expert review.

Study selection: Randomized controlled trials ≥ 4 weeks that included a D, E, DE and control (C) group in adults ≥ 18 years of age and in which data for one or more of the following were available: total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG).

Data extraction: Dual data extraction by the first two authors.

Statistical analysis: Random-effects models as well as mixed-effects models for between-group differences.

Results: Seven-hundred and eighty-eight men and women from 6 studies were included. Non-overlapping 95% confidence intervals were observed for D and DE with respect to lowering TC, LDL-C and TG while reductions in E were limited to TG. No significant changes in HDL-C were observed. When compared to E, reductions in TC and LDL-C were greater for D and DE (p < 0.05 for all).

Conclusions: Diet, especially DE, are superior to E for improving selected lipids and lipoproteins in adults.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adult
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood*
  • Databases, Factual
  • Diet*
  • Exercise / physiology*
  • Female
  • Humans
  • Male
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Triglycerides / blood


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides