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Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials

Abbigail Tan Orcid Logo, Becky Thomas, Matthew D. Campbell Orcid Logo, Sarah Prior Orcid Logo, Richard Bracken Orcid Logo, Rachel Churm Orcid Logo, Soon Tan

Clinical Nutrition, Volume: 42, Issue: 3, Pages: 337 - 351

Swansea University Authors: Becky Thomas, Sarah Prior Orcid Logo, Richard Bracken Orcid Logo, Rachel Churm Orcid Logo, Soon Tan

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DOI (Published version): 10.1016/j.clnu.2023.01.008

Abstract

Background & AimsAlterations in the hormonal profiles as women transition to the menopause predisposes individuals to the metabolic syndrome (MetS). In post-menopausal women, this can be exacerbated by sedentary behaviour and physical inactivity. Physical activity can convey many health benefits...

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Published in: Clinical Nutrition
ISSN: 0261-5614
Published: Elsevier BV 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa62276
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>62276</id><entry>2023-01-07</entry><title>Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials</title><swanseaauthors><author><sid>e83b45ec71428bd748ce201048f43d6a</sid><ORCID/><firstname>Becky</firstname><surname>Thomas</surname><name>Becky Thomas</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>cdda101035997acfaa6fdf17097f52b2</sid><ORCID>0000-0001-8703-8092</ORCID><firstname>Sarah</firstname><surname>Prior</surname><name>Sarah Prior</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f5da81cd18adfdedb2ccb845bddc12f7</sid><ORCID>0000-0002-6986-6449</ORCID><firstname>Richard</firstname><surname>Bracken</surname><name>Richard Bracken</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>c6cd8267ff0b13f2ea333bbfefdae144</sid><ORCID>0000-0001-9855-6282</ORCID><firstname>Rachel</firstname><surname>Churm</surname><name>Rachel Churm</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>c9aff2b363f84809330fb77bea6528d3</sid><firstname>Soon</firstname><surname>Tan</surname><name>Soon Tan</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-01-07</date><deptcode>HDAT</deptcode><abstract>Background &amp; AimsAlterations in the hormonal profiles as women transition to the menopause predisposes individuals to the metabolic syndrome (MetS). In post-menopausal women, this can be exacerbated by sedentary behaviour and physical inactivity. Physical activity can convey many health benefits including improvement in MetS risk factors. However, it remains to be elucidated how differing exercise intensities and its mode of delivery can ameliorate MetS risk factors and resultant progression amongst post-menopausal women. The purpose of this systematic review and meta-analysis was to investigate the effects and efficacy of exercise training on MetS risk factors in post-menopausal women.MethodsDatabase searches using PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials were conducted from inception to December 2021 for randomised controlled studies (RCTs) investigating exercise training (&gt;8 weeks) in at least one of the MetS risk factors in post-menopausal women. Utilising the random-effects model, appropriate standardised mean differences (SMD) or mean differences (MD) with 95% confidence interval (CI) for each MetS risk factor were used to calculate the overall effect size between the exercise and control groups. Sub-group analyses were performed for exercise intensity, modality, and duration for each risk factor. Meta-regression was performed for categorical (health status) and continuous (body mass index) covariates.Results39 RCTs (40 studies) involving 2,132 participants were identified as eligible. Overall, the meta-analysis shows that exercise training significantly improved all MetS risk factors: waist circumference (WC) [MD: -2.61 cm; 95% CI: -3.39 to -1.86 cm; p &lt; 0.001; 21 studies]; triglycerides (TG) [SMD: -0.40 mmol/L; 95% CI: -0.71 to -0.09 mmol/L; p = 0.01; 25 studies]; high-density lipoprotein (HDL) [SMD: 0.84 mmol/L; (95% CI: 0.41 to 1.27 mmol/L; p &lt; 0.001; 26 studies]; fasting glucose (BG) [SMD: -0.38 mmol/L (95% CI: -0.60 to -0.16 mmol/L; p &lt; 0.001; 20 studies]; systolic blood pressure (SBP) [MD: -5.95 mmHg (95% CI: -7.98 to -3.92 mmHg; p &lt; 0.001; 23 studies]; and diastolic blood pressure (DBP) [MD: -4.14 mmHg (95% CI: -6.19 to -2.08 mmHg; p &lt; 0.001; 23 studies]. Furthermore, sub-group analyses identified that moderate intensity and combined exercise training significantly improved MetS risk factors (p &lt; 0.05) except for HDL, with combined exercise being the most effective. Long duration (≥12 weeks) training also significantly improved MetS risk factors except for TG. Meta-regression revealed no moderating effects on any MetS risk variables.ConclusionThis study reinforces the importance of regular physical activity as a non-pharmacological tool in the reduction of MetS risk in post-menopausal women, with significant metabolic improvements seen in interventions spanning 8 – 10 weeks. Moderate intensity and combined training significantly benefitted abdominal obesity, dyslipidaemia, dysglycaemia and hypertension in post-menopausal women. Improvements in at least one MetS risk were also seen with other exercise modalities and intensities.</abstract><type>Journal Article</type><journal>Clinical Nutrition</journal><volume>42</volume><journalNumber>3</journalNumber><paginationStart>337</paginationStart><paginationEnd>351</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0261-5614</issnPrint><issnElectronic/><keywords>Cardiometabolic health, Aging, Women’s health, Exercise Interventions</keywords><publishedDay>1</publishedDay><publishedMonth>3</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-03-01</publishedDate><doi>10.1016/j.clnu.2023.01.008</doi><url>http://dx.doi.org/10.1016/j.clnu.2023.01.008</url><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders>No funding was used to support this manuscript.</funders><projectreference/><lastEdited>2023-06-01T15:11:03.3193487</lastEdited><Created>2023-01-07T13:14:36.4637567</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Abbigail</firstname><surname>Tan</surname><orcid>0000-0001-7365-8338</orcid><order>1</order></author><author><firstname>Becky</firstname><surname>Thomas</surname><orcid/><order>2</order></author><author><firstname>Matthew D.</firstname><surname>Campbell</surname><orcid>0000-0001-5883-5041</orcid><order>3</order></author><author><firstname>Sarah</firstname><surname>Prior</surname><orcid>0000-0001-8703-8092</orcid><order>4</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>5</order></author><author><firstname>Rachel</firstname><surname>Churm</surname><orcid>0000-0001-9855-6282</orcid><order>6</order></author><author><firstname>Soon</firstname><surname>Tan</surname><order>7</order></author></authors><documents><document><filename>Under embargo</filename><originalFilename>Under embargo</originalFilename><uploaded>2023-01-07T13:19:05.4832824</uploaded><type>Output</type><contentLength>575078</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2024-01-07T00:00:00.0000000</embargoDate><copyrightCorrect>false</copyrightCorrect></document><document><filename>62276__26865__d4c6c07eed2648b6a6f0cee6c8da28d9.pdf</filename><originalFilename>62276.pdf</originalFilename><uploaded>2023-03-14T11:34:07.8757162</uploaded><type>Output</type><contentLength>3541271</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 62276 2023-01-07 Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials e83b45ec71428bd748ce201048f43d6a Becky Thomas Becky Thomas true false cdda101035997acfaa6fdf17097f52b2 0000-0001-8703-8092 Sarah Prior Sarah Prior true false f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false c6cd8267ff0b13f2ea333bbfefdae144 0000-0001-9855-6282 Rachel Churm Rachel Churm true false c9aff2b363f84809330fb77bea6528d3 Soon Tan Soon Tan true false 2023-01-07 HDAT Background & AimsAlterations in the hormonal profiles as women transition to the menopause predisposes individuals to the metabolic syndrome (MetS). In post-menopausal women, this can be exacerbated by sedentary behaviour and physical inactivity. Physical activity can convey many health benefits including improvement in MetS risk factors. However, it remains to be elucidated how differing exercise intensities and its mode of delivery can ameliorate MetS risk factors and resultant progression amongst post-menopausal women. The purpose of this systematic review and meta-analysis was to investigate the effects and efficacy of exercise training on MetS risk factors in post-menopausal women.MethodsDatabase searches using PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials were conducted from inception to December 2021 for randomised controlled studies (RCTs) investigating exercise training (>8 weeks) in at least one of the MetS risk factors in post-menopausal women. Utilising the random-effects model, appropriate standardised mean differences (SMD) or mean differences (MD) with 95% confidence interval (CI) for each MetS risk factor were used to calculate the overall effect size between the exercise and control groups. Sub-group analyses were performed for exercise intensity, modality, and duration for each risk factor. Meta-regression was performed for categorical (health status) and continuous (body mass index) covariates.Results39 RCTs (40 studies) involving 2,132 participants were identified as eligible. Overall, the meta-analysis shows that exercise training significantly improved all MetS risk factors: waist circumference (WC) [MD: -2.61 cm; 95% CI: -3.39 to -1.86 cm; p < 0.001; 21 studies]; triglycerides (TG) [SMD: -0.40 mmol/L; 95% CI: -0.71 to -0.09 mmol/L; p = 0.01; 25 studies]; high-density lipoprotein (HDL) [SMD: 0.84 mmol/L; (95% CI: 0.41 to 1.27 mmol/L; p < 0.001; 26 studies]; fasting glucose (BG) [SMD: -0.38 mmol/L (95% CI: -0.60 to -0.16 mmol/L; p < 0.001; 20 studies]; systolic blood pressure (SBP) [MD: -5.95 mmHg (95% CI: -7.98 to -3.92 mmHg; p < 0.001; 23 studies]; and diastolic blood pressure (DBP) [MD: -4.14 mmHg (95% CI: -6.19 to -2.08 mmHg; p < 0.001; 23 studies]. Furthermore, sub-group analyses identified that moderate intensity and combined exercise training significantly improved MetS risk factors (p < 0.05) except for HDL, with combined exercise being the most effective. Long duration (≥12 weeks) training also significantly improved MetS risk factors except for TG. Meta-regression revealed no moderating effects on any MetS risk variables.ConclusionThis study reinforces the importance of regular physical activity as a non-pharmacological tool in the reduction of MetS risk in post-menopausal women, with significant metabolic improvements seen in interventions spanning 8 – 10 weeks. Moderate intensity and combined training significantly benefitted abdominal obesity, dyslipidaemia, dysglycaemia and hypertension in post-menopausal women. Improvements in at least one MetS risk were also seen with other exercise modalities and intensities. Journal Article Clinical Nutrition 42 3 337 351 Elsevier BV 0261-5614 Cardiometabolic health, Aging, Women’s health, Exercise Interventions 1 3 2023 2023-03-01 10.1016/j.clnu.2023.01.008 http://dx.doi.org/10.1016/j.clnu.2023.01.008 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU Library paid the OA fee (TA Institutional Deal) No funding was used to support this manuscript. 2023-06-01T15:11:03.3193487 2023-01-07T13:14:36.4637567 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Abbigail Tan 0000-0001-7365-8338 1 Becky Thomas 2 Matthew D. Campbell 0000-0001-5883-5041 3 Sarah Prior 0000-0001-8703-8092 4 Richard Bracken 0000-0002-6986-6449 5 Rachel Churm 0000-0001-9855-6282 6 Soon Tan 7 Under embargo Under embargo 2023-01-07T13:19:05.4832824 Output 575078 application/pdf Accepted Manuscript true 2024-01-07T00:00:00.0000000 false 62276__26865__d4c6c07eed2648b6a6f0cee6c8da28d9.pdf 62276.pdf 2023-03-14T11:34:07.8757162 Output 3541271 application/pdf Version of Record true This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). true eng http://creativecommons.org/licenses/by/4.0/
title Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials
spellingShingle Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials
Becky Thomas
Sarah Prior
Richard Bracken
Rachel Churm
Soon Tan
title_short Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials
title_full Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials
title_fullStr Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials
title_full_unstemmed Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials
title_sort Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials
author_id_str_mv e83b45ec71428bd748ce201048f43d6a
cdda101035997acfaa6fdf17097f52b2
f5da81cd18adfdedb2ccb845bddc12f7
c6cd8267ff0b13f2ea333bbfefdae144
c9aff2b363f84809330fb77bea6528d3
author_id_fullname_str_mv e83b45ec71428bd748ce201048f43d6a_***_Becky Thomas
cdda101035997acfaa6fdf17097f52b2_***_Sarah Prior
f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
c6cd8267ff0b13f2ea333bbfefdae144_***_Rachel Churm
c9aff2b363f84809330fb77bea6528d3_***_Soon Tan
author Becky Thomas
Sarah Prior
Richard Bracken
Rachel Churm
Soon Tan
author2 Abbigail Tan
Becky Thomas
Matthew D. Campbell
Sarah Prior
Richard Bracken
Rachel Churm
Soon Tan
format Journal article
container_title Clinical Nutrition
container_volume 42
container_issue 3
container_start_page 337
publishDate 2023
institution Swansea University
issn 0261-5614
doi_str_mv 10.1016/j.clnu.2023.01.008
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
url http://dx.doi.org/10.1016/j.clnu.2023.01.008
document_store_str 1
active_str 0
description Background & AimsAlterations in the hormonal profiles as women transition to the menopause predisposes individuals to the metabolic syndrome (MetS). In post-menopausal women, this can be exacerbated by sedentary behaviour and physical inactivity. Physical activity can convey many health benefits including improvement in MetS risk factors. However, it remains to be elucidated how differing exercise intensities and its mode of delivery can ameliorate MetS risk factors and resultant progression amongst post-menopausal women. The purpose of this systematic review and meta-analysis was to investigate the effects and efficacy of exercise training on MetS risk factors in post-menopausal women.MethodsDatabase searches using PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials were conducted from inception to December 2021 for randomised controlled studies (RCTs) investigating exercise training (>8 weeks) in at least one of the MetS risk factors in post-menopausal women. Utilising the random-effects model, appropriate standardised mean differences (SMD) or mean differences (MD) with 95% confidence interval (CI) for each MetS risk factor were used to calculate the overall effect size between the exercise and control groups. Sub-group analyses were performed for exercise intensity, modality, and duration for each risk factor. Meta-regression was performed for categorical (health status) and continuous (body mass index) covariates.Results39 RCTs (40 studies) involving 2,132 participants were identified as eligible. Overall, the meta-analysis shows that exercise training significantly improved all MetS risk factors: waist circumference (WC) [MD: -2.61 cm; 95% CI: -3.39 to -1.86 cm; p < 0.001; 21 studies]; triglycerides (TG) [SMD: -0.40 mmol/L; 95% CI: -0.71 to -0.09 mmol/L; p = 0.01; 25 studies]; high-density lipoprotein (HDL) [SMD: 0.84 mmol/L; (95% CI: 0.41 to 1.27 mmol/L; p < 0.001; 26 studies]; fasting glucose (BG) [SMD: -0.38 mmol/L (95% CI: -0.60 to -0.16 mmol/L; p < 0.001; 20 studies]; systolic blood pressure (SBP) [MD: -5.95 mmHg (95% CI: -7.98 to -3.92 mmHg; p < 0.001; 23 studies]; and diastolic blood pressure (DBP) [MD: -4.14 mmHg (95% CI: -6.19 to -2.08 mmHg; p < 0.001; 23 studies]. Furthermore, sub-group analyses identified that moderate intensity and combined exercise training significantly improved MetS risk factors (p < 0.05) except for HDL, with combined exercise being the most effective. Long duration (≥12 weeks) training also significantly improved MetS risk factors except for TG. Meta-regression revealed no moderating effects on any MetS risk variables.ConclusionThis study reinforces the importance of regular physical activity as a non-pharmacological tool in the reduction of MetS risk in post-menopausal women, with significant metabolic improvements seen in interventions spanning 8 – 10 weeks. Moderate intensity and combined training significantly benefitted abdominal obesity, dyslipidaemia, dysglycaemia and hypertension in post-menopausal women. Improvements in at least one MetS risk were also seen with other exercise modalities and intensities.
published_date 2023-03-01T15:11:02Z
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