Table 4 Summary of findings for primary outcomes: exercise versus control

Outcomes

Relative effect(95% CI)

№ of participants (studies)

Certainty of the evidence(GRADE)

Comments

Risk with usual care

Risk with exercise

Systolic blood pressure (change from baseline) follow-up: range 8 weeks to 16 weeks

The mean systolic blood pressure (change from baseline) ranged from − 2.5 to 1.1 mmHg

The mean systolic blood pressure (change from baseline) in the intervention group was 2.93 mmHg lower (7.06 lower to 1.2 higher)

–

158 (4 RCTs)

⨁⨁◯◯ LOW ^a,b

Exercise may result in little to no difference in systolic blood pressure (change from baseline).

Diastolic blood pressure (change from baseline)follow-up: range 8 weeks to 16 weeks

The mean diastolic blood pressure (change from baseline) ranged from −3.1 to 2.9 mmHg

The mean diastolic blood pressure (change from baseline) in the intervention group was 2.19 mmHg lower (5.23 lower to 0.85 higher)

–

158 (4 RCTs)

⨁⨁◯◯ LOW ^a,b

Exercise may result in little to no difference in diastolic blood pressure (change from baseline).

Fasting blood glucose (change from baseline)follow-up: range 8 weeks to 16 weeks

The mean fasting blood glucose (change from baseline) ranged from − 1.3 to 2.6 mg/dL

The mean fasting blood glucose (change from baseline) in the intervention group was 1.08 mg/dL lower (2.47 lower to 0.3 higher)

–

263 (9 RCTs)

⨁⨁◯◯ LOW ^c,d

Exercise may result in little to no difference in fasting blood glucose (change from baseline).

Fasting insulin (change from baseline) follow-up: range 8 weeks to 16 weeks

The mean fasting insulin (change from baseline) ranged from −4.1 to 2.5 μU/ml

The mean fasting insulin (change from baseline) in the intervention group was 2.44 μU/ml lower (4.42 lower to 0.64 lower)

–

263 (9 RCTs)

⨁◯◯◯ VERY LOW ^e,f,g

Exercise may reduce fasting insulin (change from baseline) but we are very uncertain.

HOMA-IR (change from baseline)follow-up: range 8 weeks to 16 weeks

The mean HOMA-IR (change from baseline) ranged from − 0.4 to 0.7

The mean HOMA-IR (change from baseline) in the intervention group was 0.57 lower (0.99 lower to 0.14 lower)

–

173 (8 RCTs)

⨁◯◯◯ VERY LOW ^d,e,h

Exercise may reduce HOMA-IR (change from baseline) but we are very uncertain.

Total cholesterol (change from baseline) follow-up: range 8 weeks to 16 weeks

The mean total cholesterol (change from baseline) ranged from −8.85 to 6.85 mg/dL

The mean total cholesterol (change from baseline) in the intervention group was 6.48 mg/dL lower (10.5 lower to 2.45 lower)

–

225 (7 RCTs)

⨁⨁◯◯ LOW ^g,i

Exercise may reduce total cholesterol (change from baseline) slightly.

LDL-C (change from baseline) follow-up: range 8 weeks to 16 weeks

The mean LDL-C (change from baseline) ranged from − 17.7 to 7.03 mg/dL

The mean LDL-C (change from baseline) in the intervention group was 7.51 mg/dL lower (10.01 lower to 5.02 lower)

–

225 (7 RCTs)

⨁⨁◯◯ LOW ^g,i

Exercise may reduce LDL-C (change from baseline) slightly.

HDL-C (change from baseline) follow-up: range 8 weeks to 16 weeks

The mean HDL-C (change from baseline) ranged from − 17.7 to 3.5 mg/dL

The mean HDL-C (change from baseline) in the intervention group was 0.01 mg/dL lower (1.91 lower to 1.89 higher)

–

225 (7 RCTs)

⨁⨁◯◯ LOW ^d,i

Exercise may result in little to no difference in HDL-C (change from baseline).

Triglycerides (change from baseline) follow-up: range 8 weeks to 16 weeks

The mean triglycerides (change from baseline) ranged from − 1.0 to 8.9 mg/dL

The mean triglycerides (change from baseline) in the intervention group was 4.78 mg/dL lower (7.52 lower to 2.05 lower)

–

225 (7 RCTs)

⨁⨁◯◯ LOW ^g,i

Exercise likely results in a small effect that may not be an important (or unimportant) reduction in triglycerides (change from baseline).