Combined effects of exercise and diet interventions in patients with coronary artery disease: A systematic review and meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: The aim of the systematic review was to examine the combined effects of exercise and diet interventions on any risk factor of coronary artery disease (CAD) in patients with CAD. We conducted a systematic review and meta-analysis (PROSPERO registration: CRD42024605701). PubMed, Ovid and Sport Discus databases were searched up to October 2025. Eligibility criteria included adults >18 years old diagnosed with CAD, who undertook combined interventions of any type and intensity of physical activity/exercise and diet, to examine any risk factor of CAD. We assessed quality of the eligible studies through the Risk of Bias 2 Cochrane Library and RTI item bank tools, while we used random-effect model continuous meta-analyses to synthesize the data. We included 53 eligible studies. Our meta-analyses revealed that the intervention improved exercise capacity in watt [number of studies (n) = 8; mean difference (MD) = 33.04; confidence interval (CI) = 20.25, 45.83; I 2 = 37%; p < 0.01; high quality of evidence (QoE)], peak oxygen consumption (n = 5; MD = 5.75; CI = 2.14, 9.36; I 2 = 91%; p < 0.01; moderate QoE), body fat % (n = 13; MD = -2.15; CI = -2.83, -1.48; I 2 = 69%; p < 0.01; low QoE) and glycated haemoglobin (n = 3; MD = -0.70; CI = -0.87, -0.52; I 2 = 71%; p < 0.01; low QoE). Also, the intervention slightly reduced very low-density lipoprotein (n = 3; standardized mean difference (SMD) = -0.28; CI = -0.51, -0.05; I 2 = 0%; p = 0.02; low QoE) and low-density lipoprotein (LDL) to high-density lipoprotein (HDL) ratio (n = 5; MD = -0.26; CI = -0.35, -0.17; I 2 = 0%; p < 0.01; low QoE; p < 0.05). We found very uncertain evidence to support an effect of the intervention on body weight (kg), resting systolic blood pressure, resting diastolic blood pressure, LDL, total cholesterol (TC), resting heart rate and TC to HDL ratio. Finally, the narrative data synthesis showed improvement on diameter of stenosed coronary arteries. Future research should focus on interventions of either aerobic or resistance exercise types, in combination with either low-fat diet, calorie restriction or American Heart Association diet, while they should focus on examining the effects of combined exercise and diet interventions based on specific characteristics (e.g. intervention duration and intensity). We conclude that specific combinations of exercise and diet increase aerobic exercise capacity and improves glycaemic control, lipids profile as well as coronary artery plaque, in CAD patients.
Institution: University of Thessaly
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7134890258