Key result
Combined diet and exercise reduces body weight by ~2.9 kg vs exercise alone.
Why the study?
It remains unclear whether diet alone, exercise alone, or their combination is most effective in reducing specific ectopic fat depots to help prevent insulin resistance in individuals with overweight or obesity.
Does diet alone or combined diet and exercise reduce body weight and ectopic fat compared to exercise alone in adults with overweight or obesity?
Meta-Analysis (n=732)
Does diet alone or combined diet and exercise reduce body weight and ectopic fat compared to exercise alone in adults with overweight or obesity?
Combined exercise and dietary interventions are more effective than exercise alone in reducing body weight, but do not provide additional benefits for reducing ectopic fat depots like liver fat or intramuscular triglycerides.
Supports adding diet to exercise for greater weight loss; confirms additive benefit of combined interventions over exercise alone.
AIM: While it is well established that reducing ectopic fat can help prevent insulin resistance in individuals with overweight or obesity, it remains unclear whether diet alone, exercise alone, or their combination is most effective in reducing specific ectopic fat depots. Therefore, the objective of this study was to investigate the effects of diet-only, and combined diet-plus-exercise interventions versus exercise only on ectopic fat reduction, and weight loss in adults with overweight or obesity. METHODS: Web of Science, PubMed, and Scopus were searched for original articles, published until 1 March 2024 (no limitation on publication dates) that included diet only/or exercise and diet versus exercise alone on body weight, and ectopic fat in adults with overweight or obesity. Weighted mean differences (WMD) for body weight, liver fat, standardized mean differences (SMD) for visceral fat area (VFA), and intramuscular triglyceride (IMTG), and 95% confidence intervals (95% CI) were determined using random-effects models. Studies using noninvasive imaging techniques such as Computerized Tomography (CT), Magnetic Resonance Imaging (MRI), and hydrogen-based Magnetic Resonance Spectroscopy (H-MRs) for ectopic fat were included in this meta-analysis. Also, based on subgroup analysis by intervention duration, both exercise and calorie restriction interventions in long-term (more than 12 weeks) have been successful in decreasing VFA in adults with overweight/or obesity. CONCLUSION: Combined exercise and dietary interventions are more effective than exercise alone in reducing body weight. While VFA was reduced following long-term interventions of exercise in combination with caloric restriction, our analyses showed no change in liver fat, or IMTG. Additional investigation is required to delve into the processes behind these findings and to pinpoint treatments that efficiently focus on reducing ectopic fat.
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Kazeminasab et al. (2025) conducted a meta-analysis in Overweight and obesity (n=732). Combined exercise and dietary interventions vs. Exercise alone was evaluated on Body weight (WMD -2.85 kg, 95% CI -4.28 to -1.41, p=0.001). Combined exercise and dietary interventions significantly reduced body weight by a weighted mean difference of 2.85 kg compared to exercise alone in adults with overweight or obesity.
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