Impact of exercise training after bariatric surgery on cardiometabolic risk factors: a systematic review and meta-analysis of controlled trials

The purpose of this systematic review was to provide updated evidence synthesis of the effectiveness of exercise training in patients with obesity undergoing bariatric surgery to improve cardio-metabolic risk. We systematically searched the MEDLINE, EMBASE, Scopus, Cochrane, and Web of Science datab...

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Bibliographic Details
Published in:Reviews in endocrine & metabolic disorders 2021-12, Vol.22 (4), p.891-912
Main Authors: Carretero-Ruiz, Alejandro, Martínez-Rosales, Elena, Cavero-Redondo, Iván, Álvarez-Bueno, Celia, Martínez-Vizcaíno, Vicente, Gómez Navarro, Carlos, Reyes Parrilla, Raúl, Ferrer-Márquez, Manuel, Soriano-Maldonado, Alberto, Artero, Enrique G.
Format: Article
Language:English
Subjects:
Bariatric Surgery
Blood Pressure
Body weight
Cardiovascular Diseases - prevention & control
Cholesterol
Clinical trials
Diabetes
Endocrinology
Exercise
Fitness training programs
Gastrointestinal surgery
Heart rate
High density lipoprotein
Humans
Insulin
Internal Medicine
Intervention
Medicine
Medicine & Public Health
Meta-analysis
Obesity - surgery
Patients
Physical training
Randomized Controlled Trials as Topic
Risk factors
Surgery
Systematic review
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Summary:The purpose of this systematic review was to provide updated evidence synthesis of the effectiveness of exercise training in patients with obesity undergoing bariatric surgery to improve cardio-metabolic risk. We systematically searched the MEDLINE, EMBASE, Scopus, Cochrane, and Web of Science databases. The studies selected were those in which an exercise-based intervention was performed after bariatric surgery, a control group was present, and at least one of the following outcomes was investigated: VO 2max or VO 2peak , resting heart rate (RHR), blood pressure, lipid profile, glucose, and insulin. The study quality was assessed using the PEDro scale and the data were meta-analyzed with a random effects model, comparing control groups to intervention groups using standardized measurements. Twenty articles were included in the systematic review and fourteen (70%) in the meta-analysis. Significant differences were observed between the control and intervention groups (always in favor of exercise) for absolute VO 2max / VO 2peak (ES = 0.317; 95% CI = 0.065, 0.569; p = 0.014), VO 2max / peak relative to body weight (ES = 0.673; 95% CI = 0.287, 1.060; p = 0.001), HDL cholesterol (ES = 0.22; 95% CI = 0.009, 0.430; p = 0.041) and RHR (ES = -0.438; 95% CI = -0.753, -0.022; p = 0.007). No effects were observed for either systolic or diastolic blood pressure. Exercise training for patients undergoing bariatric surgery appears to be effective in improving absolute and relative VO 2max / VO 2peak , HDL cholesterol and reducing the RHR. More intervention studies using (better) exercise interventions are needed before discarding their effects on other cardiometabolic risk factors. This systematic review and meta-analysis has been registered in Prospero (CRD42020153398).
ISSN:1389-9155
1573-2606
DOI:10.1007/s11154-021-09651-3