A systematic review and meta‐analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue

Verheggen, R. J. H. M.; Maessen, M. F. H.; Green, D. J.; Hermus, A. R. M. M.; Hopman, M. T. E.; Thijssen, D. H. T.

doi:10.1111/obr.12406

Cited by 318Obesity, Physical Activity, DietPhysical Activity and HealthDiabetes, Cardiovascular Risks, and Lipoproteins

A systematic review and meta‐analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue

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Verheggen, R. J. H. M., Maessen, M. F. H., Green, D. J., Hermus, A. R. M. M., Hopman, M. T. E., Thijssen, D. H. T.·2016·Obesity Reviews

DOI 10.1111/obr.12406

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Abstract

Summary: Exercise training (‘exercise’) and hypocaloric diet (‘diet’) are frequently prescribed for weight loss in obesity. Whilst body weight changes are commonly used to evaluate lifestyle interventions, visceral adiposity (VAT) is a more relevant and stronger predictor for morbidity and mortality. A meta‐analysis was performed to assess the effects of exercise or diet on VAT (quantified by radiographic imaging). Relevant databases were searched through May 2014. One hundred seventeen studies (n = 4,815) were included. We found that both exercise and diet cause VAT loss (P < 0.0001). When comparing diet versus training, diet caused a larger weight loss (P = 0.04). In contrast, a trend was observed towards a larger VAT decrease in exercise (P = 0.08). Changes in weight and VAT showed a strong correlation after diet (R2 = 0.737, P < 0.001), and a modest correlation after exercise (R2 = 0.451, P < 0.001). In the absence of weight loss, exercise is related to 6.1% decrease in VAT, whilst diet showed virtually no change (1.1%). In conclusion, both exercise and diet reduce VAT. Despite a larger effect of diet on total body weight loss, exercise tends to have superior effects in reducing VAT. Finally, total body weight loss does not necessarily reflect changes in VAT and may represent a poor marker when evaluating benefits of lifestyle‐interventions.

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During moderate weight loss (5% of initial body weight), the associated loss in visceral adipose tissue is estimated at 21% in response to exercise and 13% in response to diet.
“During moderate weight loss, for example, 5% of initial body weight, the associated loss in visceral adipose tissue has been estimated at 21% in response to exercise and 13% in response to diet.”
From Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies (2021) · cites this paper as [36]

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Obesity and cardiovascular disease: a scientific statement from the American Heart Association
Powell-Wiley, T. M., Poirier, P., Burke, L. E., Després, J.-P., Gordon-Larsen, P., Lavie, C. J., Lear, S. A., Ndumele, C. E., Neeland, I. J., Sanders, P., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000973 · Cited by 3,691 · see citing works
Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity
Ross, R., Neeland, I. J., Yamashita, S., Shai, I., Seidell, J., Magni, P., Santos, R. D., Arsenault, B., Cuevas, A., Hu, F. B., et al. (2020) · Nature Reviews Endocrinology · doi:10.1038/s41574-019-0310-7 · Cited by 1,966 · see citing works
Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement
Neeland, I. J., Ross, R., Després, J.-P., Matsuzawa, Y., Yamashita, S., Shai, I., Seidell, J., Magni, P., Santos, R. D., Arsenault, B., et al. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30084-1 · Cited by 1,603 · see citing works
Cardiovascular and Metabolic Heterogeneity of Obesity: Clinical Challenges and Implications for Management
Neeland, I. J., Poirier, P., & Després, J.-P. (2018) · Circulation · doi:10.1161/circulationaha.117.029617 · Cited by 881 · see citing works
The effects of high‐intensity interval training vs. moderate‐intensity continuous training on body composition in overweight and obese adults: a systematic review and meta‐analysis
Wewege, M., van den Berg, R., Ward, R. E., & Keech, A. (2017) · Obesity Reviews · doi:10.1111/obr.12532 · Cited by 661 · see citing works
Obesity and the risk of cardiometabolic diseases
Valenzuela, P. L., Carrera-Bastos, P., Castillo-García, A., Lieberman, D. E., Santos-Lozano, A., & Lucia, A. (2023) · Nature Reviews Cardiology · doi:10.1038/s41569-023-00847-5 · Cited by 452 · see citing works
Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies
Bellicha, A., van Baak, M. A., Battista, F., Beaulieu, K., Blundell, J. E., Busetto, L., Carraça, E. V., Dicker, D., Encantado, J., Ermolao, A., et al. (2021) · Obesity Reviews · doi:10.1111/obr.13256 · Cited by 375 · see citing works
Lifestyle interventions for the prevention and treatment of hypertension
Valenzuela, P. L., Carrera‐Bastos, P., Gálvez, B. G., Ruiz‐Hurtado, G., Ordovás, J. M., Ruilope, L. M., & Lucía, A. (2020) · Nature Reviews Cardiology · doi:10.1038/s41569-020-00437-9 · Cited by 379 · see citing works
Effect of High-Intensity Interval Training on Total, Abdominal and Visceral Fat Mass: A Meta-Analysis
Maillard, F., Pereira, B., & Boisseau, N. (2017) · Sports Medicine · doi:10.1007/s40279-017-0807-y · Cited by 349 · see citing works
Exercise in the management of obesity
Petridou, A., Siopi, A., & Mougios, V. (2019) · Metabolism · doi:10.1016/j.metabol.2018.10.009 · Cited by 317 · see citing works
The Role of Exercise in the Interplay between Myokines, Hepatokines, Osteokines, Adipokines, and Modulation of Inflammation for Energy Substrate Redistribution and Fat Mass Loss: A Review
Gonzalez-Gil, A. M., & Elizondo-Montemayor, L. (2020) · Nutrients · doi:10.3390/nu12061899 · Cited by 278 · see citing works
Exercise and inflammation
Metsios, G. S., Moe, R. H., & Kitas, G. D. (2020) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2020.101504 · Cited by 227 · see citing works
Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation
Metsios, G. S., & Kitas, G. D. (2018) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2019.03.013 · Cited by 198 · see citing works
Concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity: a systematic review and meta-analysis
García‐Hermoso, A., Ramírez‐Vélez, R., Ramírez‐Campillo, R., Peterson, M. D., & Martínez‐Vizcaíno, V. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096605 · Cited by 199 · see citing works
Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes
Belvederi Murri, M., Ekkekakis, P., Magagnoli, M., Zampogna, D., Cattedra, S., Capobianco, L., Serafini, G., Calcagno, P., Zanetidou, S., & Amore, M. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00762 · Cited by 163 · see citing works
Effect of High-Intensity Interval Training on Fitness, Fat Mass and Cardiometabolic Biomarkers in Children with Obesity: A Randomised Controlled Trial
Dias, K. A., Ingul, C. B., Tjønna, A. E., Keating, S. E., Gomersall, S. R., Follestad, T., Hosseini, M. S., Hollekim-Strand, S. M., Rø, T. B., Haram, M., et al. (2017) · Sports Medicine · doi:10.1007/s40279-017-0777-0 · Cited by 155 · see citing works
Impacts of exercise interventions on different diseases and organ functions in mice
Guo, S., Huang, Y., Yan, Z., Huang, H., Hong, S., & Liu, T. (2019) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2019.07.004 · Cited by 150 · see citing works
Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks
Gaesser, G. A., & Angadi, S. S. (2021) · iScience · doi:10.1016/j.isci.2021.102995 · Cited by 153 · see citing works
Metabolically healthy obesity: what–s in a name?
Magkos, F. (2019) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqz133 · Cited by 144 · see citing works
Effect of aerobic exercise on waist circumference in adults with overweight or obesity: A systematic review and meta‐analysis
Armstrong, A., Jungbluth Rodriguez, K., Sabag, A., Mavros, Y., Parker, H. M., Keating, S. E., & Johnson, N. A. (2022) · Obesity Reviews · doi:10.1111/obr.13446 · Cited by 142 · see citing works
Structured exercise alters the gut microbiota in humans with overweight and obesity—A randomized controlled trial
Kern, T., Blond, M. B., Hansen, T. H., Rosenkilde, M., Quist, J. S., Gram, A. S., Ekstrøm, C. T., Hansen, T., & Stallknecht, B. (2020) · International Journal of Obesity · doi:10.1038/s41366-019-0440-y · Cited by 130 · see citing works
The influence of high‐intensity interval training on anthropometric variables of adults with overweight or obesity: a systematic review and network meta‐analysis
Andreato, L. V., Esteves, J. V., Coimbra, D. R., Moraes, A. J. P., & de Carvalho, T. (2019) · Obesity Reviews · doi:10.1111/obr.12766 · Cited by 131 · see citing works
Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat—A systematic review and meta‐analysis
Battista, F., Ermolao, A., van Baak, M. A., Beaulieu, K., Blundell, J. E., Busetto, L., Carraça, E. V., Encantado, J., Dicker, D., Farpour‐Lambert, N. J., et al. (2021) · Obesity Reviews · doi:10.1111/obr.13269 · Cited by 131 · see citing works
Exercise Increases Adiponectin and Reduces Leptin Levels in Prediabetic and Diabetic Individuals: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Becic, T., Studenik, C., & Hoffmann, G. (2018) · Medical Sciences · doi:10.3390/medsci6040097 · Cited by 127 · see citing works
The pathophysiology of visceral adipose tissues in cardiometabolic diseases
Lee, M., & Kim, J. (2024) · Biochemical Pharmacology · doi:10.1016/j.bcp.2024.116116 · Cited by 137 · see citing works
Association Between Neighborhood Walkability and Predicted 10‐Year Cardiovascular Disease Risk: The CANHEART (Cardiovascular Health in Ambulatory Care Research Team) Cohort
Howell, N. A., Tu, J. V., Moineddin, R., Chu, A., & Booth, G. L. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.013146 · Cited by 113 · see citing works
Physical Activity Habits, Limitations, and Predictors in People with Inflammatory Bowel Disease
Tew, G. A., Jones, K., & Mikocka‐Walus, A. A. (2016) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000962 · Cited by 105 · see citing works
Active Commuting and Physical Fitness: A Systematic Review
Henriques‐Neto, D., Peralta, M., Garradas, S. S. M., Pelegrini, A., Pinto, A. D. A., Miguel, P. A. S., & Marques, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17082721 · Cited by 104 · see citing works
Effects of various exercise types on visceral adipose tissue in individuals with overweight and obesity: A systematic review and network meta‐analysis of 84 randomized controlled trials
Chen, X., He, H., Xie, K., Zhang, L., & Cao, C. (2023) · Obesity Reviews · doi:10.1111/obr.13666 · Cited by 102 · see citing works
The Role of Exercise, Diet, and Cytokines in Preventing Obesity and Improving Adipose Tissue
ATAKAN, M. M., Koşar, Ş. N., Güzel, Y., Tin, H. T., & Yan, X. (2021) · Nutrients · doi:10.3390/nu13051459 · Cited by 94 · see citing works
Position paper of the European Society of Cardiology–working group of coronary pathophysiology and microcirculation: obesity and heart disease
Badimón, L., Bugiardini, R., Cenko, E., Cubedo, J., Dorobanţu, M., Duncker, D. J., Estruch, R., Miličić, D., Tousoulis, D., Vasiljević, Z., et al. (2017) · European Heart Journal · doi:10.1093/eurheartj/ehx181 · Cited by 88 · see citing works
Environmental risk factors and nonpharmacological and nonsurgical interventions for obesity: An umbrella review of meta‐analyses of cohort studies and randomized controlled trials
Solmi, M., Köhler, C. A., Stubbs, B., Koyanagi, A., Bortolato, B., Monaco, F., Vancampfort, D., Machado, M. O., Maes, M. H. J., Tzoulaki, I., et al. (2018) · European Journal of Clinical Investigation · doi:10.1111/eci.12982 · Cited by 87 · see citing works
Overweight, Obesity, and CVD Risk: a Focus on Visceral/Ectopic Fat
Chartrand, D. J., Murphy-Després, A., Alméras, N., Lemieux, I., Larose, É., & Després, J. (2022) · Current Atherosclerosis Reports · doi:10.1007/s11883-022-00996-x · Cited by 84 · see citing works
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
Recchia, F., Leung, C. K., Yu, A. P., Leung, W., Yu, D. J., Fong, D., Montero, D., Lee, C., Wong, S. H., & Siu, P. M. (2023) · British Journal of Sports Medicine · doi:10.1136/bjsports-2022-106304 · Cited by 80 · see citing works
From movement to motivation: a proposed framework to understand the antidepressant effect of exercise
Hird, E. J., Slanina-Davies, A., Lewis, G., Hamer, M., & Roiser, J. P. (2024) · Translational Psychiatry · doi:10.1038/s41398-024-02922-y · Cited by 79 · see citing works
Effects of Tai Chi or Conventional Exercise on Central Obesity in Middle-Aged and Older Adults
Siu, P. M., Yu, A. P., Chin, E. C., Yu, D. S. F., Hui, S. S., Woo, J., Fong, D., Wei, G., & Irwin, M. R. (2021) · Annals of Internal Medicine · doi:10.7326/m20-7014 · Cited by 79 · see citing works
Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis
Al-Mhanna, S. B., Rocha‐Rodrigues, S., Mohamed, M., Batrakoulis, A., Aldhahi, M. I., Afolabi, H. A., Yağın, F. H., Alhussain, M. H., Gülü, M., Abubakar, B. D., et al. (2023) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-023-00766-5 · Cited by 79 · see citing works
Targeting epicardial adipose tissue with exercise, diet, bariatric surgery or pharmaceutical interventions: A systematic review and meta-analysis
Launbo, N., Zobel, E. H., von Scholten, B. J., Færch, K., Jørgensen, P. G., & Christensen, R. H. (2021) · Obesity Reviews · doi:10.1111/obr.13136 · Cited by 76 · see citing works
Effect of Exercise and Pharmacological Interventions on Visceral Adiposity: A Systematic Review and Meta-analysis of Long-term Randomized Controlled Trials
Rao, S. G., Pandey, A., Garg, S. K., Park, B., Mayo, H., Després, J., Kumbhani, D. J., de Lemos, J. A., & Neeland, I. J. (2019) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2018.09.019 · Cited by 75 · see citing works
Moderate-Intensity Continuous Training or High-Intensity Interval Training with or without Resistance Training for Altering Body Composition in Postmenopausal Women
DUPUIT, M., RANCE, M., MOREL, C., BOUILLON, P., PEREIRA, B., BONNET, A., MAILLARD, F., DUCLOS, M., & BOISSEAU, N. (2020) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002162 · Cited by 74 · see citing works
The Effects of Intensive Weight Reduction on Body Composition and Serum Hormones in Female Fitness Competitors
Hulmi, J. J., Isola, V., Suonpää, M., Järvinen, N. J., Kokkonen, M., Wennerström, A., Nyman, K., Perola, M., Ahtiainen, J. P., & Häkkinen, K. (2017) · Frontiers in Physiology · doi:10.3389/fphys.2016.00689 · Cited by 74 · see citing works
Normal-weight central obesity: Unique hazard of the toxic waist.
Bosomworth, N. J. (2019) · PubMed Central · Cited by 72 · see citing works
Physical Exercise, a Potential Non-Pharmacological Intervention for Attenuating Neuroinflammation and Cognitive Decline in Alzheimer’s Disease Patients
Ribarič, S. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23063245 · Cited by 72 · see citing works
Orange juice allied to a reduced-calorie diet results in weight loss and ameliorates obesity-related biomarkers: A randomized controlled trial
Ribeiro, C., Dourado, G. K. Z. S., & Cesar, T. B. (2017) · Nutrition · doi:10.1016/j.nut.2016.12.020 · Cited by 69 · see citing works
Effect of exercise intervention dosage on reducing visceral adipose tissue: a systematic review and network meta-analysis of randomized controlled trials
Chang, Y., Yang, H.-Y., & Shun, S. (2021) · International Journal of Obesity · doi:10.1038/s41366-021-00767-9 · Cited by 69 · see citing works
Abdominal visceral adipose tissue over the menopause transition and carotid atherosclerosis: the SWAN heart study
Samargandy, S. J., Matthews, K. A., Brooks, M. M., Barinas‐Mitchell, E., Magnani, J. W., Janssen, İ., Kazlauskaite, R., & Khoudary, S. R. E. (2021) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000001755 · Cited by 69 · see citing works
The Effects of Exercise on Abdominal Fat and Liver Enzymes in Pediatric Obesity: A Systematic Review and Meta-Analysis
González‐Ruíz, K., Ramírez‐Vélez, R., Correa‐Bautista, J. E., Peterson, M. D., & García‐Hermoso, A. (2017) · Childhood Obesity · doi:10.1089/chi.2017.0027 · Cited by 68 · see citing works
Hypothalamic mTORC2 is essential for metabolic health and longevity
Chellappa, K., Brinkman, J. A., Mukherjee, S., Morrison, M., Alotaibi, M., Carbajal, K. A., Alhadeff, A. L., Perron, I. J., Yao, R., Purdy, C. S., et al. (2019) · Aging Cell · doi:10.1111/acel.13014 · Cited by 65 · see citing works
Change in Visceral Fat and Total Body Fat and the Effect on Cardiometabolic Risk Factors During Transgender Hormone Therapy
Klaver, M., van Velzen, D. M., de Blok, C. J. M., Nota, N. M., Wiepjes, C. M., Defreyne, J., Schreiner, T., Fisher, A. D., Twisk, J. W. R., Seidell, J. C., et al. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab616 · Cited by 64 · see citing works
The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis
Metsios, G. S., Moe, R. H., van der Esch, M., Zanten, J. V., Fenton, S. A. M., Koutedakis, Y., Vitalis, P., Kennedy, N., Brodin, N., Boström, C., et al. (2019) · Rheumatology International · doi:10.1007/s00296-019-04483-6 · Cited by 62 · see citing works
Implications of a New Obesity Definition Among the All of Us Cohort
Fourman, L. T., Awwad, A., Gutiérrez‐Sacristán, A., Dash, C. A., Johnson, J. E., Thistle, A. K., Chahal, N., Stockman, S. L., Toribio, M. P., Anekwe, C. V., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.37619 · Cited by 64 · see citing works
Muscles and the Media: A Natural Experiment Across Cultures in Men’s Body Image
Thornborrow, T., Onwuegbusi, T., Mohamed, S., Boothroyd, L. G., & Tovée, M. J. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00495 · Cited by 59 · see citing works
Effects of high-intensity interval training and nutrition advice on cardiometabolic markers and aerobic fitness in adolescent girls with obesity
Plavšić, L., Knežević, O. M., Sovtić, A., Minic, P. B., Vuković, R., Mažibrada, I., Stanojlović, O. P., Hrnčić, D., Rašić-Marković, A., & Μacut, D. (2019) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2019-0137 · Cited by 59 · see citing works
Effects of early, late and self-selected time-restricted eating on visceral adipose tissue and cardiometabolic health in participants with overweight or obesity: a randomized controlled trial
Dote‐Montero, M., Clavero‐Jimeno, A., Merchán-Ramírez, E., Osés, M., Echarte, J., Camacho-Cardeñosa, A., Alavarez, M. C., Amaro‐Gahete, F. J., Alcántara, J. M. A., López-Vázquez, A., et al. (2025) · Nature Medicine · doi:10.1038/s41591-024-03375-y · Cited by 58 · see citing works
The effects of prehabilitation on body composition in patients undergoing multimodal therapy for esophageal cancer
Halliday, L. J., Boshier, P. R., Doganay, E., Wynter-Blyth, V., Buckley, J., & Moorthy, K. (2022) · Diseases of the Esophagus · doi:10.1093/dote/doac046 · Cited by 57 · see citing works
Mechanisms of body fat distribution and gluteal-femoral fat protection against metabolic disorders
Alser, M., Naja, K., & Elrayess, M. A. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1368966 · Cited by 55 · see citing works
A systematic review and meta-analysis of the effects of supervised exercise therapy on modifiable cardiovascular risk factors in intermittent claudication
Jansen, S. C. P., Hoorweg, B., Hoeks, S. E., van den Houten, M. M. L., Scheltinga, M. R., Teijink, J. A. W., & Rouwet, E. V. (2019) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2018.10.069 · Cited by 55 · see citing works
Effects of Exercise in Addition to a Family-Based Lifestyle Intervention Program on Hepatic Fat in Children With Overweight
Labayen, I., Medrano, M., Arenaza, L., Maíz, E., Osés, M., Martínez‐Vizcaíno, V., Ruiz, J. R., & Ortega, F. B. (2019) · Diabetes Care · doi:10.2337/dc19-0351 · Cited by 53 · see citing works
Associations of Visceral Adipose Tissue, Circulating Protein Biomarkers, and Risk of Cardiovascular Diseases: A Mendelian Randomization Analysis
Huang, Y., Liu, Y., Ma, Y., Tu, T., Liu, N., Bai, F., Xiao, Y., Liu, C., Hu, Z., Lin, Q., et al. (2022) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2022.840866 · Cited by 54 · see citing works
Effect of high intensity interval training on body composition in women before and after menopause: a meta‐analysis
Dupuit, M., Maillard, F., Pereira, B., Marquezi, M. L., Lancha, A. H., & Boisseau, N. (2020) · Experimental Physiology · doi:10.1113/ep088654 · Cited by 54 · see citing works
Physical Activity Promotes Health and Reduces Cardiovascular Mortality in Depressed Populations: A Literature Overview
Murri, M. B., Folesani, F., Zerbinati, L., Nanni, M. G., Ounalli, H., Caruso, R., & Grassi, L. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17155545 · Cited by 47 · see citing works
Effect of resistance training with and without caloric restriction on visceral fat: A systemic review and meta‐analysis
Khalafi, M., Malandish, A., Rosenkranz, S. K., & Ravasi, A. A. (2021) · Obesity Reviews · doi:10.1111/obr.13275 · Cited by 57 · see citing works
Epigenetic Regulation of Metabolism and Inflammation by Calorie Restriction
Hernández‐Saavedra, D., Moody, L., Xu, G. B., Chen, H., & Pan, Y. (2018) · Advances in Nutrition · doi:10.1093/advances/nmy129 · Cited by 51 · see citing works
Associations of Visceral Adipose Tissue and Skeletal Muscle Density With Incident Stroke, Myocardial Infarction, and All‐Cause Mortality in Community‐Dwelling 70‐Year‐Old Individuals: A Prospective Cohort Study
Ballin, M., Nordström, P., Niklasson, J., & Nordström, A. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.120.020065 · Cited by 52 · see citing works
Effectiveness of high-intensity interval training for weight loss in adults with obesity: a randomised controlled non-inferiority trial
D’Amuri, A., Sanz, J. M., Capatti, E., Vece, F. D., Vaccari, F., Lazzer, S., Zuliani, G., Nora, E. D., & Passaro, A. (2021) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2020-001021 · Cited by 50 · see citing works
Should we target increased physical activity or less sedentary behavior in the battle against cardiovascular disease risk development?
Katzmarzyk, P. T., Ross, R., Blair, S. N., & Després, J. (2020) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2020.07.010 · Cited by 53 · see citing works
Physical activity in the management of obesity in adults: A position statement from Exercise and Sport Science Australia
Johnson, N. A., Sultana, R. N., Brown, W. J., Bauman, A. E., & Gill, T. (2021) · Journal of Science and Medicine in Sport · doi:10.1016/j.jsams.2021.07.009 · Cited by 47 · see citing works
Physical exercise and epicardial adipose tissue: A systematic review and meta-analysis of randomized controlled trials
Saco‐Ledo, G., Valenzuela, P. L., Castillo‐García, A., Arenas, J., León‐Sanz, M., Ruilope, L. M., & Lucia, A. (2021) · Obesity Reviews · doi:10.1111/obr.13103 · Cited by 47 · see citing works
The Role of the Growth Hormone/Insulin-Like Growth Factor System in Visceral Adiposity
LEWITT, M. S. (2017) · Biochemistry Insights · doi:10.1177/1178626417703995 · Cited by 46 · see citing works
Negative Energy Balance Induced by Exercise or Diet: Effects on Visceral Adipose Tissue and Liver Fat
Ross, R., Soni, S., & Houle, S. (2020) · Nutrients · doi:10.3390/nu12040891 · Cited by 45 · see citing works
The role of exercise in obesity-related cancers: Current evidence and biological mechanisms
Larson, E. A., Dalamaga, Μ., & Magkos, F. (2023) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2023.02.008 · Cited by 43 · see citing works
Associations of apelin, leptin, irisin, ghrelin, insulin, glucose levels, and lipid parameters with physical activity during eight weeks of regular exercise training
Dündar, A., Kocahan, S., & Şahin, L. (2019) · Archives of Physiology and Biochemistry · doi:10.1080/13813455.2019.1635622 · Cited by 43 · see citing works
Age-Related Skeletal Muscle Dysfunction Is Aggravated by Obesity: An Investigation of Contractile Function, Implications and Treatment
Tallis, J. A., Shelley, S. P., Degens, H., & Hill, C. (2021) · Biomolecules · doi:10.3390/biom11030372 · Cited by 44 · see citing works
The Impact of the Rate of Weight Loss on Body Composition and Metabolism
Fogarasi, A., Gonzalez, K. D., Dalamaga, Μ., & Magkos, F. (2022) · Current Obesity Reports · doi:10.1007/s13679-022-00470-4 · Cited by 42 · see citing works
A Proposed Strategy against Obesity: How Government Policy Can Counter the Obesogenic Environment
Temple, N. J. (2023) · Nutrients · doi:10.3390/nu15132910 · Cited by 42 · see citing works
The impact of exercise training versus caloric restriction on inflammation markers: a systemic review and meta-analysis
Khalafi, M., Symonds, M. E., & Akbari, A. M. (2021) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2021.1873732 · Cited by 43 · see citing works
High-intensity interval training improves cardiovascular and physical health in patients with rheumatoid arthritis: a multicentre randomised controlled trial
Bilberg, A., Mannerkorpi, K., Börjesson, M., Svedlund, S., Sivertsson, J., Klingberg, E., & Bjersing, J. L. (2024) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-108369 · Cited by 41 · see citing works
Combined versus independent effects of exercise training and intermittent fasting on body composition and cardiometabolic health in adults: a systematic review and meta-analysis
Khalafi, M., Symonds, M. E., Maleki, A. H., Sakhaei, M. H., Ehsanifar, M., & Rosenkranz, S. K. (2024) · Nutrition Journal · doi:10.1186/s12937-023-00909-x · Cited by 40 · see citing works
How does 6 months of active bike commuting or leisure-time exercise affect insulin sensitivity, cardiorespiratory fitness and intra-abdominal fat? A randomised controlled trial in individuals with overweight and obesity
Blond, M. B., Rosenkilde, M., Gram, A. S., Tindborg, M., Christensen, A. N., Quist, J. S., & Stallknecht, B. M. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2018-100036 · Cited by 40 · see citing works
A Novel Personalized Systems Nutrition Program Improves Dietary Patterns, Lifestyle Behaviors and Health-Related Outcomes: Results from the Habit Study
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Meta-analysis Of The Effect Of Exercise Training Versus Diet On Visceral Adipose Tissue And Weight Loss
Thijssen, D. H. J., Verheggen, R. J. H. M., Maessen, M. F. H., GREEN, D. J., Hermus, A. R., & Hopman, M. T. E. (2015) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000477715.61925.4a
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Comparisons of calorie restriction and structured exercise on reductions in visceral and abdominal subcutaneous adipose tissue: a systematic review
Abe, T., Song, J. S., Bell, Z. W., Wong, V. H. Y., Spitz, R. W., Yamada, Y., & Loenneke, J. P. (2021) · European Journal of Clinical Nutrition · doi:10.1038/s41430-021-00942-1 · Cited by 36 · see citing works

Authors: Verheggen, R. J. H. M., Maessen, M. F. H., Green, D. J., Hermus, A. R. M. M., Hopman, M. T. E., & Thijssen, D. H. T.
Affiliations: Radboud University Nijmegen (NL)
The University of Western Australia (AU)
Department of Physiology Radboud University Medical Centre Nijmegen The Netherlands
Corresponding author: Verheggen, R. J. H. M.
ORCID: Verheggen, R. J. H. M.
Maessen, M. F. H.
Green, D. J.
Hermus, A. R. M. M.
Hopman, M. T. E.
Venue: Obesity Reviews
Publisher: Wiley
Published: 2016-05-23
Volume: 17
Issue: 8
Pages: 664-690
ISSN: 1467-7881 (ISSN-L)
1467-789X
DOI: 10.1111/obr.12406
OpenAlex: W2397931148
Semantic Scholar: 512581ef66a90e4e2c48fe3cbcf7ad8cf5add095
Cited by: 318
References: 145
Citations by year: 2026: 24 · 2025: 31 · 2024: 15 · 2023: 39 · 2022: 46 · 2021: 43 · 2020: 45 · 2019: 34 · 2018: 19 · 2017: 17 · 2016: 5
FWCI: 3.70
Type: journal article
Language: en
Open access: green
researchonline.ljmu.ac.uk
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Obesity Reviews (publishedVersion)
PubMed (publishedVersion)
Liverpool John Moores University (acceptedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion)
Radboud Repository (Radboud University) (submittedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: exercise training, hypocaloric diet, visceral adipose tissue, weight loss, obesity, weight loss interventions, lifestyle intervention, visceral fat
MeSH terms: Body Weight, Diet, Reducing, Humans, Obesity, Exercise, Randomized Controlled Trials as Topic, Caloric Restriction, Adiposity, Overweight

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A systematic review and meta‐analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue

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