PURPOSE: Obesity is associated with the development of insulin resistance (IR) and type 2 diabetes for which exercise training (Ex) and dietary interventions (DI) are effective interventions that can improve IR. We therefore performed a systematic meta-analysis to compare the effect of Ex plus DI compared with DI on IR and glucose homeostasis. METHODS: PubMed and Cochrane Library were conducted up to May 2021. Meta-analyses were conducted to compare the effect of Ex plus DI compared with DI on fasting glucose and insulin, IR and body weight. Standardized mean differences (SMDs), weighted mean differences (WMD) and 95% confidence intervals (95% CIs) were computed using random or fixed effect models. RESULTS: Fifty studies involving 2,864 participants with overweight or obesity were included in the meta-analysis. Ex plus DI caused a larger decrease in fasting glucose (p = 0.001, 62 trials) and IR (p = 0.01, 29 trials) when compared with DI alone. There was no significant evidence, however, for a greater effect of Ex plus DI on fasting insulin (p = 0.07, 48 trials) and body weight (p = 0.12, 58 trials), compared with DI alone. CONCLUSION: Our results suggest that a combination of Ex and DI may be more effective than DI alone at improving IR and fasting glucose in individuals with overweight and obesity.

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