Diabetes, metabolic syndrome and obesity : targets and therapy · 2026
Effect of FATmax-Intensity Exercise on Body Composition and Cardiovascular Health in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis.
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Zhao Ge, Khong Teng Keen, Yan Yanqing, Yusof Ashril
Аннотация
PURPOSE: To determine the effects of exercising at maximal fat oxidation (FATmax) intensity on body composition, cardiorespiratory fitness, and metabolism outcomes in overweight and obese individuals through a systematic review and meta-analysis.
METHODS: Randomized controlled trials (RCTs) were retrieved from PubMed, Web of Science, CNKI, and the Cochrane Library. Search terms included FATmax or maximal fat oxidation, obesity or overweight, BMI, [Formula: see text], diastolic blood pressure (DBP), systolic blood pressure (SBP), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and homeostasis model assessment of insulin resistance (HOMA-IR). Risk of bias was assessed using Cochrane guidelines and the quality of evidence using GRADE. A random-effects model (Stata 16.0) calculated pooled mean differences for outcomes.
RESULTS: 18 RCTs were finally analysed. Compared to non-exercising controls, FATmax-intensity exercise improved (i) body composition, including reduced body weight (WMD = -4.43 kg, 95% CI: -5.11, -3.75), fat mass (WMD = -3.68 kg, 95% CI: -4.31, -3.06), waist circumference (WMD = -4.36 cm, 95% CI: -6.73, -1.99), and waist-to-hip ratio (WMD=-0.04, 95% CI: -0.05, -0.03); (ii) cardiorespiratory fitness, evidenced by increased [Formula: see text] (WMD = 3.89 mL/(kg·min), 95% CI: 3.04, 4.74), reduced SBP (WMD = -1.73 mmHg, 95% CI: -6.60, 3.15) and DBP (WMD = -2.10 mmHg, 95% CI: -3.70, -0.49); (iii) metabolism outcomes, such as reduced TG (SMD = -0.80, 95% CI: -1.24, -0.36), TC (SMD = -0.37, 95% CI: -0.72, -0.02), LDL-C (SMD = -0.44, 95% CI:-0.78, -0.10), increased (HDL-C) (SMD = 0.97, 95% CI: 0.64, 1.30) and improved HOMA-IR (SMD = -0.81, 95% CI: -1.44, -0.18). Subgroup analyses suggested that age, sex, and intervention characteristics (eg, duration and frequency) moderated these outcomes to varying degrees.
CONCLUSIONS: FATmax-intensity exercise confers beneficial effects on body composition, glucose and lipid metabolism, and cardiorespiratory fitness in populations with overweight and obesity. Despite outcome-specific variations and methodological heterogeneity warranting cautious interpretation, FATmax training represents a promising, individualized strategy for cardiometabolic health management.
METHODS: Randomized controlled trials (RCTs) were retrieved from PubMed, Web of Science, CNKI, and the Cochrane Library. Search terms included FATmax or maximal fat oxidation, obesity or overweight, BMI, [Formula: see text], diastolic blood pressure (DBP), systolic blood pressure (SBP), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and homeostasis model assessment of insulin resistance (HOMA-IR). Risk of bias was assessed using Cochrane guidelines and the quality of evidence using GRADE. A random-effects model (Stata 16.0) calculated pooled mean differences for outcomes.
RESULTS: 18 RCTs were finally analysed. Compared to non-exercising controls, FATmax-intensity exercise improved (i) body composition, including reduced body weight (WMD = -4.43 kg, 95% CI: -5.11, -3.75), fat mass (WMD = -3.68 kg, 95% CI: -4.31, -3.06), waist circumference (WMD = -4.36 cm, 95% CI: -6.73, -1.99), and waist-to-hip ratio (WMD=-0.04, 95% CI: -0.05, -0.03); (ii) cardiorespiratory fitness, evidenced by increased [Formula: see text] (WMD = 3.89 mL/(kg·min), 95% CI: 3.04, 4.74), reduced SBP (WMD = -1.73 mmHg, 95% CI: -6.60, 3.15) and DBP (WMD = -2.10 mmHg, 95% CI: -3.70, -0.49); (iii) metabolism outcomes, such as reduced TG (SMD = -0.80, 95% CI: -1.24, -0.36), TC (SMD = -0.37, 95% CI: -0.72, -0.02), LDL-C (SMD = -0.44, 95% CI:-0.78, -0.10), increased (HDL-C) (SMD = 0.97, 95% CI: 0.64, 1.30) and improved HOMA-IR (SMD = -0.81, 95% CI: -1.44, -0.18). Subgroup analyses suggested that age, sex, and intervention characteristics (eg, duration and frequency) moderated these outcomes to varying degrees.
CONCLUSIONS: FATmax-intensity exercise confers beneficial effects on body composition, glucose and lipid metabolism, and cardiorespiratory fitness in populations with overweight and obesity. Despite outcome-specific variations and methodological heterogeneity warranting cautious interpretation, FATmax training represents a promising, individualized strategy for cardiometabolic health management.