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Meta-Analysis
. 2013;8(2):e56415.
doi: 10.1371/journal.pone.0056415. Epub 2013 Feb 8.

The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis

Dirk Vissers  1 , Wendy Hens, Jan Taeymans, Jean-Pierre Baeyens, Jacques Poortmans, Luc Van Gaal
Affiliations
Meta-Analysis

The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis

Dirk Vissers et al. PLoS One. 2013.

Abstract

Excessive visceral adipose tissue appears to trigger a cascade of metabolic disturbances that seem to coexist with ectopic fat storage in muscle, liver, heart and the ß-cell. Therefore, the reduction of visceral adipose tissue potentially plays a pivotal role in the treatment of the metabolic syndrome. The purpose of this systematic review and meta-analysis is to describe the overall effect of exercise on visceral adipose tissue and to provide an overview of the effect of different exercise regimes, without caloric restriction, on visceral adipose tissue in obese persons. A systematic literature search was performed according to the PRISMA statement for reporting systematic reviews and meta-analyses. The initial search resulted in 87 articles after removing duplicates. After screening on title, abstract and full-text 15 articles (totalling 852 subjects) fulfilled the a priori inclusion criteria. The quality of each eligible study was assessed in duplicate with "The Critical Review Form for Quantitative Studies". Using random-effects weights, the standardized mean difference (Hedge's g) of the change in visceral adipose tissue was -0.497 with a 95% confidence interval of -0.655 to -0.340. The Z-value was -6.183 and the p-value (two tailed) was <0.001. A subgroup analysis was performed based on gender, type of training and intensity. Aerobic training of moderate or high intensity has the highest potential to reduce visceral adipose tissue in overweight males and females. These results suggest that an aerobic exercise program, without hypocaloric diet, can show beneficial effects to reduce visceral adipose tissue with more than 30 cm(2) (on CT analysis) in women and more than 40 cm(2) in men, even after 12 weeks.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Four-phase flow diagram of the systematic reviewing process.
Figure 2
Figure 2. Forest plot of the effects found in the individual studies and the overall effect.
Figure 3
Figure 3. Funnel plot of the standard error by Hedge's g.
Figure 4
Figure 4. Forest plot of the subgroup analysis: controlled and uncontrolled studies.
Figure 5
Figure 5. Forest plot of the subgroup analysis: low intensity, moderate intensity and high intensity studies.
See this image and copyright information in PMC

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