BACKGROUND: Numerous studies have shown that exercise and dietary interventions positively impact CVD outcomes; however, there is substantial variability in the efficacy of different interventions. The absence of direct comparisons between multiple interventions complicates the determination of their relative effects. This study aims to synthesize the literature on the impacts of exercise, dietary, and combined interventions on cardiovascular health indicators, and to perform a network meta-analysis to rank the efficacy of these approaches, providing a theoretical foundation for selecting optimal intervention strategies. METHODS: We systematically reviewed the literature from database inception through September 2024, searching PubMed, Web of Science, Embase, and the Cochrane Library. Data were aggregated and analyzed using network meta-analysis, with intervention efficacy ranked according to Surface Under the Cumulative Ranking (SUCRA) curves. RESULTS: The efficacy of these interventions was ranked as follows: (1). Triglycerides (TG) Reduction: CR plus EX > CR > 5/2F plus EX > TRF plus EX > KD > 5/2F > KD plus EX > EX > CON > TRF. (2). Total Cholesterol (TC) Reduction: CR plus EX > CR > 5/2F plus EX > 5/2F > TRF plus EX > EX > CON > KD > TRF > KD plus EX. (3). High-Density Lipoprotein (HDL) Increase: 5/2F > KD > KD plus EX > TRF plus EX > CON > EX > TRF > 5/2F plus EX > CR plus EX > CR. (4). Low-Density Lipoprotein (LDL) Reduction: CR plus EX > CR > TRF plus EX > KD plus EX > EX > KD > 5/2F > CON > 5/2F plus EX > TRF. (5). Systolic Blood Pressure (SBP) Reduction: 5/2F > CR plus EX > CR > EX > TRF > TRF plus EX > CON > 5/2F plus EX. (6). Diastolic Blood Pressure (DBP) Reduction: CR > CR plus EX > TRF > 5/2F > TRF plus EX > EX > CON > 5/2F plus EX. CONCLUSION: CR and CR plus EX demonstrated the most positive effects on cardiovascular health indicators. In contrast, 5/2F plus EX ranked relatively low in effectiveness, with its impact on several indicators being even lower than that of CON.

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