Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Aug;57(16):1035-1041.
doi: 10.1136/bjsports-2022-106304. Epub 2023 Jan 20.

Dose-response effects of exercise and caloric restriction on visceral adiposity in overweight and obese adults: a systematic review and meta-analysis of randomised controlled trials

Francesco Recchia  1 , Chit K Leung  1 , Angus P Yu  1 , Welton Leung  1 , Danny J Yu  2 , Daniel Y Fong  3 , David Montero  1 , Chi-Ho Lee  4 , Stephen H S Wong  5 , Parco M Siu  6
Affiliations
Meta-Analysis

Dose-response effects of exercise and caloric restriction on visceral adiposity in overweight and obese adults: a systematic review and meta-analysis of randomised controlled trials

Francesco Recchia et al. Br J Sports Med. 2023 Aug.

Abstract

Objective: To determine and compare the dose-response effects of exercise and caloric restriction on visceral adipose tissue in overweight and obese adults, while controlling for the weekly energy deficit induced by the interventions.

Methods: PubMed, Embase, CINAHL and Web of Science were searched for randomised controlled trials comparing exercise or caloric restriction against eucaloric controls in overweight or obese adults. The primary outcome was the change in visceral fat measured by CT or MRI. Meta-analyses and meta-regressions were performed to determine the overall effect size (ES) and the dose-dependent relationship of exercise and caloric restriction on visceral fat. Heterogeneity, risk of bias and the certainty of evidence were also assessed.

Results: Forty randomised controlled trials involving 2190 participants were included. Overall, exercise (ES -0.28 (-0.37 to -0.19); p<0.001; I2=25%) and caloric restriction (ES -0.53 (-0.71 to -0.35); p<0.001; I2=33%) reduced visceral fat compared with the controls. Exercise demonstrated a dose-response effect of -0.15 ((-0.23 to -0.07); p<0.001) per 1000 calories deficit per week, whereas the effect of caloric restriction was not dose-dependent (ES 0.03 (-0.12 to 0.18); p=0.64). Most of the studies showed a moderate risk of bias.

Conclusions: These findings support the dose-dependent effects of exercise to reduce visceral fat in overweight and obese adults. Caloric restriction did not demonstrate a dose-response relationship, although this may be attributed to the smaller number of studies available for analysis, compared with exercise studies.

Prospero registration number: CRD42020210096.

Keywords: Exercise.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Forest plot of the effect of exercise on visceral fat.
Figure 2
Figure 2
Dose–response effect of exercise on visceral fat.
Figure 3
Figure 3
Forest plot of the effect of caloric restriction on visceral fat.
Figure 4
Figure 4
Dose–response effect of caloric restriction on visceral fat.
See this image and copyright information in PMC

References

    1. World Health Organization . Obesity and overweight [Fact sheet]; 2021.
    1. Lauby-Secretan B, Scoccianti C, Loomis D, et al. . Body fatness and Cancer-viewpoint of the IARC working group. N Engl J Med Overseas Ed 2016;375:794–8. 10.1056/NEJMsr1606602 - DOI - PMC - PubMed
    1. Singh GM, Danaei G, Farzadfar F, et al. . The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis. PLoS One 2013;8:e65174. 10.1371/journal.pone.0065174 - DOI - PMC - PubMed
    1. Tchernof A, Després J-P. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013;93:359–404. 10.1152/physrev.00033.2011 - DOI - PubMed
    1. Emerging Risk Factors Collaboration, Wormser D, Kaptoge S, et al. . Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet 2011;377:1085–95. 10.1016/S0140-6736(11)60105-0 - DOI - PMC - PubMed

LinkOut - more resources