Impact of exercise training duration on obesity and cardiometabolic biomarkers: a systematic review.

The primary aim for this review was to cook for the most ideal duration and specific exercise treatment that could help reduce the risk of cardiometabolic diseases and alongwith its complications for obese and deranged cardiometabolic risk markers. Of the 19 full text articles finalised to be included in the review, eight studies employed comparative high-intensity interval training (HIIT) to assess its effect on cardiometabolic biomarkers [ 5 , 8 , 12 – 14 , 20 , 22 , 23 ]. Seven studies took onto aerobic exercises to see their effect on various physiological markers [ 6 , 11 , 15 , 21 , 24 , 26 , 27 ]. Four studies utilized various programs to test their effect on cardiometabolic biomarkers [ 18 , 19 , 25 , 28 ]. The duration of exercise intervention ranged from 3 weeks to 1 year in the studies included as depicted in Tables  2 , 3 , 4 , 5 and 6 . Table 2 Data variables in the study having 3–6 weeks duration References Duration Observations (Experimental Group (EG) / Control Group (CG)) Ref No (Type Of Study) Unit VARIABLES MEASUREMENTS Smith-Ry an 2016 (Randomized control trial) Mean ± SD 3 weeks HDL (mg · dl − 1 ) EG: {SIT : Pre:59.36 ± 14.83 ;Post:58.55 ± 15.06} and {HIIT : Pre: 62.64 ± 9.41 ;Post: 63.50 ± 9.65}; CG: Pre: 48.50 ± 8.91 and Post: 51.00 ± 9.37 [ 7 ] LDL (mg · dl − 1 ) EG: {SIT : Pre:110.27 ± 30.67 ;Post:113.18 ± 27.49} and {HIIT : Pre: 96.73 ± 28.61 ;Post: 90.00 ± 33.49}; CG: Pre: 93.50 ± 24.65 and Post: 91.63 ± 24.39 Triglycerides (mg · dl − 1 ) EG: {SIT : Pre: 102.73 ± 48.18 ;Post:108.82 ± 50.06} and {HIIT : Pre:86.18 ± 36.98 ;Post: 97.70 ± 61.84}; CG: Pre:94.88 ± 49.11 and Post: 96.13 ± 51.82 VO2 peak (ml · kg − 1  min − 1 ) EG:{SIT : Pre: 23.18 ± 5.95 ;Post: 25.03 ± 6.05} and {HIIT : Pre: 25.01 ± 5.75; Post: 27.25 ± 6.02}; CG: Pre: 23.64 ± 9.27 and Post:24.64 ± 8.93 Insulin (IU · l − 1 ) EG: {SIT : Pre:16.34 ± 11.07 ;Post: 14.82 ± 9.71} and {HIIT : Pre: 13.43 ± 9.29 ;Post:12.41 ± 6.98}; CG: Pre: 9.73 ± 3.80 and Post:9.04 ± 2.73 Glucose (mmol · l − 1 ) EG: {SIT : Pre: 84.09 ± 8.78 ;Post: 84.82 ± 6.87} and {HIIT : Pre: 88.82 ± 9.61 ;Post: 88.60 ± 7.00}; CG: Pre: 89.00 ± 9.96 and Post: 89.50 ± 9.62 Cholesterol (mg · dl − 1 ) EG:{SIT : Pre: 190.18 ± 42.07 ;Post: 193.36 ± 38.58} and {HIIT : Pre:177.64 ± 30.31 ;Post:173.0 ± 40.00}; CG: Pre: 161.00 ± 24.05 and Post: 161.875 ± 26.40 Arefirad 2020 (Randomized controlle d trial) Mean ± SD 6 weeks HDL EG: Baseline: 35.81 ± 7.26; Second w : 40.32 ± 9.07; Last w : 42.11 ± 6.65; CG: Baseline: 38.09 ± 5.90 ; Second w :40.59 ± 12.25; Last w : 46.61 ± 21.98 [ 17 ] LDL EG: Baseline:102.6 ± 27.85 ; Second: 90.83 ± 24.76; Last:93.87 ± 36.05; CG: Baseline: 111.93 ± 30.36 ; Second:114.74 ± 33.51 ; Last: 112.75 ± 42.88 TC EG: Baseline: 184.8 ± 28.11; Second: 173.13 ± 20.53; Last b,w : 166.66 ± 24.16; CG: Baseline: 186.93 ± 40.84; Second: 185.33 ± 41.74; Last: 187.00 ± 42.40 DBP (mmHg) EG: Baseline:76.67 ± 4.88; Second: 76.33 ± 3.99; Last: 76 ± 5.07; CG: Baseline:76.67 ± 6.17; Second: 77 ± 4.93; Last: 77.33 ± 5.94 SBP (mmHg) EG: Baseline: 137.33 ± 15.34 ; Second: 135.96 ± 12.68; Last: 133.24 ± 15.60 ; CG: Baseline:131.67 ± 15.20; Second: 133.34 ± 11.86; Last: 133.06 ± 14.53 TG EG: Baseline: 170.47 ± 49.42; Second:164.86 ± 43.51; Last w :159.46 ± 44.66; CG: Baseline: 168.46 ± 32.95; Second: 169.00 ± 31.76; Last:169.06 ± 29.48 VO2 Max EG: Baseline:38.76 ± 6.85 ; Second:37.83 ± 4.13; Last: 35.66 ± 2.93; CG: Baseline: 35.81 ± 5.06; Second:36.74 ± 5.44; Last:36.43 ± 7.66 Insulin EG: Baseline: 7.44 ± 6.31; Second: 7.16 ± 5.88; Last: 6.08 ± 4.905; CG: Baseline: 7.88 ± 6.05; Second: 8.26 ± 5.14; Last:7.44 ± 5.94 HbA1c EG: Baseline: 6.67 ± 1.31 ; Second: 6.64 ± 1.24; Last b : 6.55 ± 1.18; CG: Baseline: 7.1 ± 1.85 ; Second:7.39 ± 1.95; Last:7.32 ± 2.13 Maximum Heart Rate EG: Baseline: 162.73 ± 26.06; Second:166.43 ± 17.6 ; Last: 180.78 ± 32.98; CG: Baseline: 169.87 ± 23.08; Second: 166.17 ± 23.49; Last:173.13 ± 28.06 HOMA-IR EG: Baseline:11.22 ± 9.18 ; Second:10.29 ± 8.43; Last: 9.91 ± 8.92; CG:Baseline: 14.65 ± 12.28; Second: 14.88 ± 11.24; Last:13.76 ± 12.65 Kong 2016 (Randomized Controlled trial) Mean ± SD 5 weeks BMI (kgm − 2 ) {HIIT (Pre: 25.8 ± 2.6 and Post: 26.0 ± 2.5)} and {MVCT (Pre:25.5 ± 2.1 and Post w :25.0 ± 2.0)} [ 12 ] HDL-C (mmolL − 1 ) {HIIT (Pre: 1.3 ± 0.2 and Post:1.4 ± 0.2)} and {MVCT (Pre:1.3 ± 0.2 and Post:1.3 ± 0.2)} LDL-C (mmolL − 1 ) {HIIT (Pre: 2.4 ± 0.8 and Post: 2.3 ± 0.4)} and {MVCT (Pre: 2.4 ± 0.5 and Post:2.4 ± 0.6)} TC (mmolL − 1 ) {HIIT (Pre: 4.3 ± 0.8 and Post: 4.3 ± 0.5)} and {MVCT (Pre:4.3 ± 0.5 and Post:4.3 ± 0.6)} TG (mmolL − 1 ) {HIIT (Pre: 1.0 ± 0.5 and Post:0.9 ± 0.5)} and {MVCT (Pre: 0.9 ± 0.3 and Post: 1.0 ± 0.4)} VO 2 peak(mlmin − 1  kg − 1 ) {HIIT (Pre: 32.0 ± 6.6 and Post w :34.3 ± 7.5)} and {MVCT (Pre:32.0 ± 5.0 and Post w :35.8 ± 6.9)} Fisher 2015 (Randomized Controlled Trial) Change in score Mean ± SD 6 weeks BMI (kg/m 2 ) HIIT(-0.26 (0.83)) and MIT (-0.35 (0.75)) [ 11 ] HDL-cholesterol(mg/dL) HIIT ( -1.4 (7.9)) and MIT (-2.0 (5.1)) LDL-cholesterol (mg/dL) HIIT (-4.78 (16.9)) and MIT(-7.8 (18.6)) Total cholesterol (mg/dL) HIIT w (-9.2 (17.6)) and MIT w (-12.9 (26.4)) SBP (mm Hg) HIIT( -0.3 (11.1)) and MIT(-4.6 (11.4)) DBP (mm Hg) HIIT( 1.6 (7.7)) and MIT (-4.6 (6.4)) VO2 peak (ml/kg/min) HIIT w ( 0.84 (3.50)) and MIT w,b (3.40 (3.36)) MIT > HIIT Triglycerides (mg/dL) HIIT w ( -15.3 (46.3)) and MIT w (-15.7 (47.4)) Insulin Sensitivity (SI) HIIT w (1.154 (1.826)) and MIT w (0.183 (0.799)) HOMA-IR HIIT w (0.16 (2.35)) and MIT w (-0.27 (0.40)) Data variables in the study having 3–6 weeks duration Smith-Ry an 2016 (Randomized control trial) Mean ± SD 3 weeks EG: {SIT : Pre:59.36 ± 14.83 ;Post:58.55 ± 15.06} and {HIIT : Pre: 62.64 ± 9.41 ;Post: 63.50 ± 9.65}; CG: Pre: 48.50 ± 8.91 and Post: 51.00 ± 9.37 EG: {SIT : Pre:110.27 ± 30.67 ;Post:113.18 ± 27.49} and {HIIT : Pre: 96.73 ± 28.61 ;Post: 90.00 ± 33.49}; CG: Pre: 93.50 ± 24.65 and Post: 91.63 ± 24.39 EG: {SIT : Pre: 102.73 ± 48.18 ;Post:108.82 ± 50.06} and {HIIT : Pre:86.18 ± 36.98 ;Post: 97.70 ± 61.84}; CG: Pre:94.88 ± 49.11 and Post: 96.13 ± 51.82 VO2 peak (ml · kg − 1  min − 1 ) EG:{SIT : Pre: 23.18 ± 5.95 ;Post: 25.03 ± 6.05} and {HIIT : Pre: 25.01 ± 5.75; Post: 27.25 ± 6.02}; CG: Pre: 23.64 ± 9.27 and Post:24.64 ± 8.93 EG: {SIT : Pre:16.34 ± 11.07 ;Post: 14.82 ± 9.71} and {HIIT : Pre: 13.43 ± 9.29 ;Post:12.41 ± 6.98}; CG: Pre: 9.73 ± 3.80 and Post:9.04 ± 2.73 EG: {SIT : Pre: 84.09 ± 8.78 ;Post: 84.82 ± 6.87} and {HIIT : Pre: 88.82 ± 9.61 ;Post: 88.60 ± 7.00}; CG: Pre: 89.00 ± 9.96 and Post: 89.50 ± 9.62 EG:{SIT : Pre: 190.18 ± 42.07 ;Post: 193.36 ± 38.58} and {HIIT : Pre:177.64 ± 30.31 ;Post:173.0 ± 40.00}; CG: Pre: 161.00 ± 24.05 and Post: 161.875 ± 26.40 Arefirad 2020 (Randomized controlle d trial) Mean ± SD EG: Baseline: 35.81 ± 7.26; Second w : 40.32 ± 9.07; Last w : 42.11 ± 6.65; CG: Baseline: 38.09 ± 5.90 ; Second w :40.59 ± 12.25; Last w : 46.61 ± 21.98 EG: Baseline:102.6 ± 27.85 ; Second: 90.83 ± 24.76; Last:93.87 ± 36.05; CG: Baseline: 111.93 ± 30.36 ; Second:114.74 ± 33.51 ; Last: 112.75 ± 42.88 EG: Baseline: 184.8 ± 28.11; Second: 173.13 ± 20.53; Last b,w : 166.66 ± 24.16; CG: Baseline: 186.93 ± 40.84; Second: 185.33 ± 41.74; Last: 187.00 ± 42.40 EG: Baseline:11.22 ± 9.18 ; Second:10.29 ± 8.43; Last: 9.91 ± 8.92; CG:Baseline: 14.65 ± 12.28; Second: 14.88 ± 11.24; Last:13.76 ± 12.65 Kong 2016 (Randomized Controlled trial) Mean ± SD 5 weeks Fisher 2015 (Randomized Controlled Trial) Change in score Mean ± SD 6 weeks Table 3 Data variables in the study having 10–12 weeks duration (earlier studies) Mathunjwa 2013 (Prospective experimental) Mean ± SD 95% CI 10 weeks BMI, kg/m 2 (Pre: 32.26 ± 5.65(30.8–33.72)); (Mid w : 31.22 ± 5.55(29.78–32.65) ); (Post w : 30.11 ± 5.46(28.70–31.52)) [ 25 ] WC, cm (Pre: 87.59 ± 9.95(85.02–90.16) ); (Mid w : 83.63 ± 9.71(81.13–86.14 )); (Post w : 81.82 ± 10.02(79.23–84.40)) HC, cm (Pre: 118.60 ± 10.86(115.8–121.40)); (Mid b :116.20 ± 10.66(113.40–119.00) ); (Post b : 116.20 ± 10.66(113.40–119.00)) HDL, mmol/L (Pre: 1.35 ± 0.75(2.52–2.91) ); (Mid w : 1.53 ± 0.49 (2.73–2.99)); (Post w : 1.61 ± 0.46 (2.69–2.93)) LDL, mmol/L (Pre: 2.12 ± 0.82(1.89–2.32 )); (Mid w : 1.92 ± 0.79 (1.71–2.12)); (Post w : 1.68 ± 0.65 (1.51–1.85)) TC, mmol/L (Pre: 3.76 ± 1.02(3.49–4.02) ); (Mid w :3.5 ± 0.82 (3.31–3.73) ); (Post w :3.36 ± 0.85 (3.14–3.58 )) SBP, mm Hg (Pre:106.30 ± 8.48(104.10–108.50) ); (Mid w : 104.20 ± 11.02 (101.40–107.00)); (Post w : 100.60 ± 8.05 (98.55–102.70)) DBP, mm Hg (Pre: 66.73 ± 6.96(64.93–68.53)); (Mid w : 63.45 ± 9.38(61.03–65.87) ); (Post w :62.45 ± 7.36(60.55–64.35)) TG, mmol/L (Pre: 1.74 ± 0.92(1.14–1.76)); (Mid w : 1.46 ± 1.15 (1.16–1.76)); (Post w :1.45 ± 1.23 (1.51–1.97)) Glucose, mmol/L (Pre: 3.99 ± 0.59(3.84–4.15) ); (Mid w : 3.83 ± 0.74 (3.64–4.02)); (Post w :3.61 ± 0.46 (3.49–3.73)) Ha & So 2012 (Experimental Study) Mean ± SD 12 Weeks BMI, kg/m 2 EG: Pre Exercise (24.97 ± 2.73) Post Exercise (24.76 ± 3.01); CG: PreActivity (24.18 ± 1.63) Post Activity (24.38 ± 1.66 ) [ 21 ] WC, cm EG: Pre Exercise (81.29 ± 6.02 ) Post Exercise (75.00 ± 7.39); CG: PreActivity (76.61 ± 4.78 ) Post Activity (75.22 ± 5.22) HDL EG: Pre Exercise (48.71 ± 9.29 ) Post Exercise (45.00 ± 4.51); CG: PreActivity (53.89 ± 7.66) Post Activity (50.89 ± 7.17) LDL mg/dL EG: PreExercise (112.14 ± 26.25) PostExercise (103.57 ± 24.31); CG:PreActivity (99.56 ± 30.61) Post Activity (104.56 ± 34.86) TC EG:PreExercise (180.29 ± 28.93) PostExercise (161.00 ± 20.58); CG:PreActivity (183.00 ± 26.125) PostActivity (178.89 ± 30.38) SBP, mmHg EG b :PreExercise (113.71 ± 11.22 ) PostExercise (107.00 ± 9.40); CG b : PreActivity (114.33 ± 11.18) PostActivity (116.56 ± 8.82) DBP, mmHg EG: Pre Exercise (76.86 ± 6.09) Post Exercise (69.71 ± 5.94 ); CG: Pre Activity (69.11 ± 5.40 ) Post Activity (69.56 ± 3.97) TG mg/dL EG: Pre Exercise (97.14 ± 32.49 ) Post Exercise (50.43 ± 9.93 ); CG: PreActivity (105.22 ± 34.45) Post Activity (93.22 ± 33.47) Glucose mg/dL EG: Pre Exercise (85.86 ± 6.91) Post Exercise (86.57 ± 7.00); CG: Pre Activity (86.33 ± 3.08) Post Activity (89.44 ± 5.50 ) Ho 2012 (Randomized parallel design) Mean ± SEM 12 Weeks A = Aerobic R = Resistance C = Combination B = b/w gr vs. aerobic BMI kg/m 2 EG: Baseline: (A: 32.7 ± 1.3;R:33.0 ± 1.3 ;C:33.3 ± 1.2), Week 8 (A: 32.5 ± 1.3; R: 33.1 ± 1.3;C W : 33.0 ± 1.1) and Week 12 (A:32.4 ± 1.2 ; R:33.0 ± 1.3 ;C W : 32.8 ± 1.1); CG: Baseline:(32.4 ± 1.4);Week 8 ( 32.5 ± 1.5) and Week 12 ( 32.4 ± 1.5) [ 5 ] Waist (cm) EG:Baseline: (A:103.7 ± 2.6 ;R:104.0 ± 3.2 ;C:102.2 ± 3.2),Week 8(A:102.5 ± 2.6 ; R:102.4 ± 3.2 ;C:100.5 ± 2.8) Week 12(A W : 101.6 ± 2.9; R W : 101.4 ± 3.3 ;C W :99.6 ± 3.0); CG:Baseline:(100.3 ± 3.6 );Week 8  W ( 98.3 ± 3.7) and Week 12 (99.1 ± 3.6) HDL (mmol/L) EG: Baseline: (A:1.38 ± 0.09 ;R:1.34 ± 0.08 ;C:1.43 ± 0.11), Week 8 (A w : 1.31 ± 0.08; R w : 1.44 ± 0.08;C: 1.44 ± 0.10) Week 12 (A W,b :1.28 ± 0.07; R W,b : 1.44 ± 0.08;C W,b :1.41 ± 0.11); CG: Baseline: (1.42 ± 0.11);Week 8 ( 1.45 ± 0.11) Week 12 (1.35 ± 0.10) LDL (mmol/L) EG:Baseline: (A:3.89 ± 0.30 ;R:3.56 ± 0.33 ;C:3.78 ± 0.27), Week 8 (A: 3.82 ± 0.27 ; R: 3.76 ± 0.31;C: 3.80 ± 0.22) Week 12(A:3.64 ± 0.33; R W : 4.08 ± 0.36;C W : 3.71 ± 0.22); CG: Baseline:(3.51 ± 0.26); Week 8 (3.79 ± 0.31) Week 12 (3.47 ± 0.25) TC(mmol/L) EG:Baseline: (A:5.83 ± 0.32 ;R:5.49 ± 0.38 ;C:5.71 ± 0.31), Week 8 (A: 5.72 ± 0.29; R: 5.76 ± 0.36;C: 5.74 ± 0.27) Week 12 (A:5.56 ± 0.37; R W : 6.15 ± 0.44 ;C W : 5.75 ± 0.26); CG: Baseline:5.51 ± 0.29; Week 8 ( 5.88 ± 0.32) Week 12 (5.49 ± 0.28 ) TG (mmol/L) EG:Baseline: (A:1.36 ± 0.19 ;R:1.27 ± 0.12 ;C:1.10 ± 0.10), Week 8 (A:1.29 ± 0.11 ; R: 1.21 ± 0.16 ;C:1.08 ± 0.10) and Week 12 (A:1.40 ± 0.16; R:1.38 ± 0.18 ;C W :1.36 ± 0.17); CG: Baseline: 1.25 ± 0.17; Week 8 ( 1.37 ± 0.19) and Week 12 (1.48 ± 0.23) VO2 max (mL/kg/min) EG:Baseline: (A:24.8 ± 1.1 ;R:24.8 ± 1.8 ;C:26.5 ± 1.3), Week 12 (A: 26.2 ± 0.9 ; R: 26.8 ± 0.8 ;C W :28.2 ± 0.8); CG:Baseline:27.2 ± 1.4; Week 12 ( 24.9 ± 0.8) Glucose (mmol/L) EG:Baseline: (A:5.68 ± 0.17 ;R:5.81 ± 0.46 ;C:5.38 ± 0.13), Week 8 (A: 5.78 ± 0.18; R: 5.81 ± 0.17 ;C: 5.31 ± 0.10) and Week 12 (A:5.73 ± 0.10; R: 5.77 ± 0.16;C:5.55 ± 0.13); CG: Baseline:5.35 ± 0.13 ;Week 8 ( 5.46 ± 0.10) and Week 12 ( 5.26 ± 0.18) Insulin (µUI/mL) EG: Baseline: (A:13.05 ± 1.01 ;R:13.98 ± 1.40 ;C:14.24 ± 1.03),Week 8 (A W :16.67 ± 1.48 ; R W : 16.82 ± 1.33;C W : 17.07 ± 1.33) Week 12(A:15.87 ± 1.86 ; R: 13.48 ± 1.24;C: 14.25 ± 1.25); CG: Baseline:14.89 ± 2.29 ;Week 8 ( 14.82 ± 1.66) Week 12 ( 14.76 ± 1.69) Stensvold 2010 (Randomized control trial) Mean ± SD 12 Weeks b = vs. control Body mass index, kg/m 2 EG: {AIT, Pre:31.3 ± 4.3 and Post: 30.9 ± 4.6}{ST, Pre: 32.2 ± 4.2 and Post:32.2 ± 4.4}; COM, Pre: 30.3 ± 3.5 and Post:30.4 ± 3.6} CG: Pre :31.9 ± 4.1 and Post: 32.0 ± 4.2 [ 26 ] WC, cm EG: {AIT, Pre: 109.6 ± 10.0 and Post w,b : 108.3 ± 10.7}{ST, Pre:111.5 ± 10.8 and Post w,b :110.1 ± 11.0} {COM, Pre:106.2 ± 8.6 and Post w :105.5 ± 8.2} CG: Pre : 108.7 ± 9.3 and Post w :110.4 ± 9.0 HDL, mmol/l EG: {AIT, Pre: 1.17 ± 0.35 and Post: 1.23 ± 0.40}{ST, Pre: 1.15 ± 0.18 and Post: 1.23 ± 0.21}; { COM, Pre: 1.38 ± 0.38 and Post: 1.49 ± 0.64}; CG: Pre : 1.29 ± 0.35 and Post:1.27 ± 0.63 Cholesterol, mmol/l EG: {AIT, Pre: 6.1 ± 0.96 and Post: 5.64 ± 0.63}{ST, Pre:5.49 ± 1.21 and Post: 5.77 ± 1.02}; {COM, Pre: 6.30 ± 0.88 and Post: 5.91 ± 0.67} CG: Pre : 5.72 ± 1.27 and Post: 5.59 ± 0.95 SBP, mmHg EG: {AIT, Pre: 140.0 ± 14.6 and Post: 134.2 ± 12}{ST, Pre:142.7 ± 14.2 and Post: 139.9 ± 16.9}; { COM, Pre:148.6 ± 14 and Post: 145.1 ± 15.2}; CG: Pre :141.5 ± 12.3 and Post: 142.1 ± 24.1 DBP, mmHg EG: {AIT, Pre: 89.0 ± 8.1 and Post: 85.0 ± 5.5}{ST, Pre: 90.7 ± 10.9 and Post: 88.9 ± 11.2}; {COM, Pre: 89.0 ± 7.1 and Post: 89.8 ± 6.4}; CG: Pre : 90.1 ± 7.1 and Post: 89.5 ± 13.6 Triglycerides, mmol/l EG: {AIT, Pre:2.3 ± 1.0 and Post: 1.8 ± 0.8}{ST, Pre:1.8 ± 0.9 and Post: 1.9 ± 1.2}; {COM, Pre:2.6 ± 1.4 and Post: 2.3 ± 1.1}; CG: Pre : 1.7 ± 0.8 and Post: 1.7 ± 1.0 Peak O2 uptake, ml·kg1 ·min − 1 EG: {AIT, Pre:34.2 ± 9.8 and Post:38.6 ± 11.3 } ST, Pre:31.9 ± 4.6 and Post:33.1 ± 4.3 }; {COM, Pre:28.4 ± 6.3 and Post:31.5 ± 10.2 }; CG: Pre:34.2 ± 10.2 and Post: 33.1 ± 9.9 Glucose, mmol/l EG: {AIT, Pre:6.0 ± 1.1 and Post: 5.9 ± 0.8}{ST, Pre: 6.6 ± 2.0 and Post: 6.6 ± 1.5}; {COM, Pre: 6.0 ± 2.4 and Post: 5.6 ± 1.8}; CG: Pre :6.2 ± 2.1 and Post: 6.1 ± 2.3 HbA1c, % EG: {AIT, Pre: 6.19 ± 0.80 and Post: 5.95 ± 0.66}{ST, Pre: 6.44 ± 0.95 and Post:6.47 ± 1.04}; {COM, Pre: 6.28 ± 0.78 and Post:6.30 ± 0.76}; CG: Pre :6.12 ± 1.62 and Post: 6.24 ± 1.40 Insulin sensitivity (HOMA), % EG: {AIT, Pre: 40.4 ± 8.3 and Post: 48.4 ± 17.1}{ST, Pre:38.1 ± 17.4 and Post:46.5 ± 24.4}; {COM, Pre:42.7 ± 24.8 and Post:44.9 ± 17.6}; CG: Pre : 41.0 ± 12.8 and Post:44.3 ± 20.4 Data variables in the study having 10–12 weeks duration (earlier studies) Mathunjwa 2013 (Prospective experimental) Mean ± SD 95% CI 10 weeks Ha & So 2012 (Experimental Study) Mean ± SD 12 Weeks Ho 2012 (Randomized parallel design) Mean ± SEM 12 Weeks A = Aerobic R = Resistance C = Combination B = b/w gr vs. aerobic VO2 max (mL/kg/min) Stensvold 2010 (Randomized control trial) Mean ± SD 12 Weeks b = vs. control EG: {AIT, Pre: 109.6 ± 10.0 and Post w,b : 108.3 ± 10.7}{ST, Pre:111.5 ± 10.8 and Post w,b :110.1 ± 11.0} {COM, Pre:106.2 ± 8.6 and Post w :105.5 ± 8.2} CG: Pre : 108.7 ± 9.3 and Post w :110.4 ± 9.0 EG: {AIT, Pre: 1.17 ± 0.35 and Post: 1.23 ± 0.40}{ST, Pre: 1.15 ± 0.18 and Post: 1.23 ± 0.21}; { COM, Pre: 1.38 ± 0.38 and Post: 1.49 ± 0.64}; CG: Pre : 1.29 ± 0.35 and Post:1.27 ± 0.63 EG: {AIT, Pre: 6.1 ± 0.96 and Post: 5.64 ± 0.63}{ST, Pre:5.49 ± 1.21 and Post: 5.77 ± 1.02}; {COM, Pre: 6.30 ± 0.88 and Post: 5.91 ± 0.67} CG: Pre : 5.72 ± 1.27 and Post: 5.59 ± 0.95 EG: {AIT, Pre: 140.0 ± 14.6 and Post: 134.2 ± 12}{ST, Pre:142.7 ± 14.2 and Post: 139.9 ± 16.9}; { COM, Pre:148.6 ± 14 and Post: 145.1 ± 15.2}; CG: Pre :141.5 ± 12.3 and Post: 142.1 ± 24.1 EG: {AIT, Pre: 89.0 ± 8.1 and Post: 85.0 ± 5.5}{ST, Pre: 90.7 ± 10.9 and Post: 88.9 ± 11.2}; {COM, Pre: 89.0 ± 7.1 and Post: 89.8 ± 6.4}; CG: Pre : 90.1 ± 7.1 and Post: 89.5 ± 13.6 EG: {AIT, Pre:2.3 ± 1.0 and Post: 1.8 ± 0.8}{ST, Pre:1.8 ± 0.9 and Post: 1.9 ± 1.2}; {COM, Pre:2.6 ± 1.4 and Post: 2.3 ± 1.1}; CG: Pre : 1.7 ± 0.8 and Post: 1.7 ± 1.0 EG: {AIT, Pre:34.2 ± 9.8 and Post:38.6 ± 11.3 } ST, Pre:31.9 ± 4.6 and Post:33.1 ± 4.3 }; {COM, Pre:28.4 ± 6.3 and Post:31.5 ± 10.2 }; CG: Pre:34.2 ± 10.2 and Post: 33.1 ± 9.9 EG: {AIT, Pre:6.0 ± 1.1 and Post: 5.9 ± 0.8}{ST, Pre: 6.6 ± 2.0 and Post: 6.6 ± 1.5}; {COM, Pre: 6.0 ± 2.4 and Post: 5.6 ± 1.8}; CG: Pre :6.2 ± 2.1 and Post: 6.1 ± 2.3 EG: {AIT, Pre: 6.19 ± 0.80 and Post: 5.95 ± 0.66}{ST, Pre: 6.44 ± 0.95 and Post:6.47 ± 1.04}; {COM, Pre: 6.28 ± 0.78 and Post:6.30 ± 0.76}; CG: Pre :6.12 ± 1.62 and Post: 6.24 ± 1.40 EG: {AIT, Pre: 40.4 ± 8.3 and Post: 48.4 ± 17.1}{ST, Pre:38.1 ± 17.4 and Post:46.5 ± 24.4}; {COM, Pre:42.7 ± 24.8 and Post:44.9 ± 17.6}; CG: Pre : 41.0 ± 12.8 and Post:44.3 ± 20.4 Table 4 Data variables in the study having 10–12 weeks duration (recent studies reviewed) Plavsic 2020 (Random ized control trial) Mean ± SD EG: Diet + HIIT CG: Diet 12 weeks BMI (kg/m 2 ) EG: Pre (32.6 ± 2.7) and Post w (30.9 ± 3.3) CG: Pre (33.2 ± 3.5) and Post w (32.2 ± 4.0) [ 13 ] WC (cm) EG:Pre (94.9 ± 6.2) and Post w (91.5 ± 7.8) CG:Pre (98.5 ± 11.2) and Post (96.9 ± 11.4) WtHR EG:Pre (0.57 ± 0.03) and Post w (0.55 ± 0.05) CG:Pre (0.60 ± 0.06) and Post(0.59 ± 0.06 ) HDL-C (mmol/L) EG:Pre (1.29 ± 0.30) and Post (1.33 ± 0.27) CG:Pre (1.31 ± 0.28) and Post (1.30 ± 0.26) LDL-C (mmol/L) EG:Pre (2.37 ± 0.57) and Post (2.28 ± 0.69) CG:Pre (2.13 ± 0.68) and Post (2.18 ± 0.55) TC (mmol/L) EG:Pre (4.06 ± 0.73) and Post (4.02 ± 0.74) CG:Pre (3.85 ± 0.68) and Post (3.93 ± 0.60) SBP (mmHg) EG:Pre (121.4 ± 5.6) and Post w (110.3 ± 8.5) CG:Pre (120.0 ± 8.8) and Post w (114.4 ± 6.8) DBP (mmHg) EG:Pre (77.2 ± 6.0) and Post w (69.2 ± 6.2) CG:Pre (75.6 ± 7.7) and Post (72.4 ± 6.6) TG (mmol/L) EG:Pre (0.89 ± 0.27) and Post (0.90 ± 0.32) CG: Pre (0.90 ± 0.35) and Post (1.00 ± 0.43) VO2peak(mL/min/kg) EG: Pre (22.7 ± 5.2) and Post (23.9 ± 3.7) CG: Pre (24.7 ± 5.1) and Post (23.3 ± 4.8) Insulin AUC EG: Pre (294 ± 193) and Post W (196 ± 85) CG: Pre (339 ± 212) and Post (329 ± 160) Glucose AUC EG: Pre (24.6 ± 3.6) and Post (23.6 ± 2.9) CG: Pre (26.3 ± 3.3) and Post (26.0 ± 3.1) HbA1c (%) EG: Pre (4.99 ± 0.23) and Post (5.03 ± 0.24) CG: Pre (4.98 ± 0.24) and Post (5.06 ± 0.22) HOMA-IR EG: Pre (3.35 ± 2.49) and Post (2.51 ± 0.96) CG: Pre (2.94 ± 1.31) and Post (2.93 ± 1.33) Álvarez 2019 (Experimental Study) Mean (95% CI) 12 weeks BMI (kg/m 2 ) EG: Map -CT : 31.9 (28.2, 35.5); Eur-CT: 30.3 (28.1, 32.5); CG: Map-CG :34.6 (30.3, 38.8); Eur-CG :28.3 (25.0, 31.6) [ 4 ] WC (cm) EG: Map-CT: 104.3 (97.1, 111.5); Eur-CT: 104.4 (96.8, 112.1); CG: Map-CG:114.4 (102.3, 126.4); Eur-CG :101.8 (89.5,114.2) TC (mg/dL) EG: Map-CT w : 170.3 (154.5, 186.1); Eur-CT w : 169.9 (160.2, 179.5); CG: Map-CG:173.3 (158.0, 188.5); Eur-CG :161.0 (149.5, 172.5) SBP (mmHg) EG: Map-CT b : 128 (113, 146); Eur-CT: 133 (126, 140); CG: Map-CG :141 (124, 157); Eur-CG :125 (116, 135) DBP (mmHg) EG: Map-CT w : 75 (70, 85); Eur-CT w : 78 (74, 82); CG: Map-CG :82 (73, 92); Eur-CG :76 (71, 80) Fasting glucose (mg/dL) EG: Map-CT w :101.6 (92.1, 11.1); Eur-CT w :102.8 (98.2, 107.4); CG: Map-CG:105.5 (97.5, 113.4); Eur-CG :99.6 (92.6, 106.6) Zhou 2018 (Pilot Intervention Study) Mean ± SD 12 weeks BMI (kg/m2) Baseline: 37.4 ± 6.7; Post 12 weeks : 37 ± 6.9 [ 27 ] HDL-c (mg/dL) Baseline:52.7 ± 11.6 ;Post 12 weeks * :43.2 ± 14 LDL-c (mg/dL) Baseline:116.3 ± 42.4 ;Post 12 weeks:118.5 ± 46 TC (mg/dL) Baseline:175.7 ± 35.8 ;Post 12 weeks:166.8 ± 46.8 Blood HbA1C (%) Baseline:6.8 ± 1.1 ;Post 12 weeks*:6.1 ± 1.1 Data variables in the study having 10–12 weeks duration (recent studies reviewed) Plavsic 2020 (Random ized control trial) Mean ± SD EG: Diet + HIIT CG: Diet 12 weeks Álvarez 2019 (Experimental Study) Mean (95% CI) 12 weeks EG: Map-CT w : 170.3 (154.5, 186.1); Eur-CT w : 169.9 (160.2, 179.5); CG: Map-CG:173.3 (158.0, 188.5); Eur-CG :161.0 (149.5, 172.5) Fasting glucose (mg/dL) EG: Map-CT w :101.6 (92.1, 11.1); Eur-CT w :102.8 (98.2, 107.4); CG: Map-CG:105.5 (97.5, 113.4); Eur-CG :99.6 (92.6, 106.6) Zhou 2018 (Pilot Intervention Study) Mean ± SD 12 weeks Table 5 Data variables in the study having 16 weeks duration Carr 2008 (Randomized controlled trial) Mean ± SEM 16 Weeks Only ALED-I vs. CG BMI (kg/m 2 ) EG: Baseline: 32.3 ± 1.3 ;Post intervention:31.9 ± 1.2; CG:Baseline: 30.6 ± 0.8;Post intervention: 30.6 ± 0.8 [ 19 ] WC (cm) EG: Baseline b :100.6 ± 2.4; Post intervention w 96.6 ± 2.7; CG:Baseline 99.2 ± 2.2; Post intervention 99.8 ± 2.1 HDL (mg/dL) EG:Baseline:45 ± 2 ;Post intervention: 45 ± 3; CG: Baseline:53 ± 1 ;Post intervention:52 ± 1 LDL (mg/dL) EG: Baseline:125 ± 13 ;Post intervention:120 ± 12; CG: Baseline:114 ± 5 ;Post intervention:109 ± 5 TC (mg/dL) EG: Baseline:212 ± 14 ;Post intervention:197 ± 15; CG:Baseline:191 ± 6 ;Post intervention: 184 ± 6 SBP (mmHg) EG: Baseline:122 ± 2 ;Post intervention:124 ± 3; CG:Baseline:124 ± 2 ;Post intervention: 121 ± 2 DBP (mmHg) EG:Baseline:79 ± 3 ;Post intervention: 80 ± 3; CG:Baseline:77 ± 2 ;Post intervention: 79 ± 2 TG (mg/dL) EG:Baseline:161 ± 16 b ;Post intervention: 108 ± 14 w,b ; CG:Baseline:103 ± 12 ;Post intervention: 89 ± 13 Pred VO2 peak (ml/kg/min) EG: Baseline:27.6 ± 2.4 ;Post intervention:30.9 ± 2.3 w ; CG:Baseline:24.2 ± 1.5 ;Post intervention: 29.3 ± 1.9 w Fasting glucose (mg/dL) EG: Baseline:95 ± 2 ;Post intervention:94 ± 3; CG: Baseline: 93 ± 2;Post intervention:94 ± 2 Fasting insulin (µIU/mL) EG:Baseline:10.5 ± 1.4 ;Post intervention: 9.3 ± 1.2; CG:Baseline:6.9 ± 1.1 ; Post intervention: 9.4 ± 1.1 IR & Sensitivity: EG:Baseline:17.5 ± 2.5 ;Post intervention: 13.9 ± 2.7; CG:Baseline:11.1 ± 2.4 ;Post intervention: 13.7 ± 2.4 Irving 2009 (Random ized trial) Mean ± SD 16 Weeks b*= vs. control group BMI kg/m 2 EG: LIECT {Pre Training (34.7 ± 7.5) and post Training(33.9 ± 6.5)}; HIET {Pre Training(34.7 ± 6.8) and post Training w (33.4 ± 5.6)}; CG: Pre Training (32.7 ± 3.8) and Post Training (32.4 ± 3.8) [ 23 ] WC, cm EG: LIECT {Pre Training (103.8 ± 10.6) and post Training (102.6 ± 10.4)}; HIET {Pre Training (103.7 ± 16.8) and post Training w,b (98.1 ± 13.3)}; CG: Pre Training (98.2 ± 10.0) and Post Training (97.5 ± 8.0) HDL-C, mg/dL EG: LIECT {Pre Training (44.6 ± 6.6) and post Training (49.0 ± 10.4)} and HIET {Pre Training (50.9 ± 10.7) and post Training (52.1 ± 9.1)}; CG: Pre Training (42.7 ± 6.7) and Post Training (45.7 ± 9.1) SBP mmHg EG: LIECT {Pre Training (135 ± 17) and post Training w,b* (124 ± 10)};HIET {Pre Training (124 ± 16) and post Training (123 ± 15)}; CG: Pre Training (129 ± 12) and Post Training (130 ± 11) DBP mmHg EG: LIECT {Pre Training(82 ± 12) and post Training(78 ± 10)};HIET {Pre Training(76 ± 8) and post Training(74 ± 8)}; CG: Pre Training (75 ± 7) and Post Training (76 ± 7) TG, mg/dL EG: LIECT {Pre Training (241.9 ± 202.4) and post Training(213.8 ± 135.8)} and HIET {Pre Training (152.1 ± 43.9) and post Training (126.7 ± 40.0)}; CG: Pre Training (187.3 ± 77.0) and Post Training (191.5 ± 97.3) VO 2 Peak, ml/kg/min EG: LIECT {Pre Training(21.0 ± 3.5) and post Training w (22.8 ± 2.6)} and HIET {Pre Training(21.7 ± 4.1) and post Training w,b* (24.7 ± 4.6)}; CG: Pre Training (21.6 ± 4.1) and Post Training (20.9 ± 2.8) FBG mg/dL EG: LIECT {Pre Training (106.7 + 13.5) and post Training (104.0 + 10.8)} and HIET {Pre Training (110.2 + 20.6) and post training (113.8 + 26.0)}; CG: Pre Training (107.7 + 14.6) and Post Training (110.4 + 16.6) Data variables in the study having 16 weeks duration Carr 2008 (Randomized controlled trial) Mean ± SEM 16 Weeks Only ALED-I vs. CG Pred VO2 peak (ml/kg/min) Fasting glucose (mg/dL) Fasting insulin (µIU/mL) Irving 2009 (Random ized trial) Mean ± SD 16 Weeks b*= vs. control group EG: LIECT {Pre Training(82 ± 12) and post Training(78 ± 10)};HIET {Pre Training(76 ± 8) and post Training(74 ± 8)}; CG: Pre Training (75 ± 7) and Post Training (76 ± 7) Table 6 Data variables in the study having 6 months duration Arsenault 2009 (Random ized controlle d trial) Mean ± SD 6 months BMI (kg/m2) EG: Before:32.0 ± 5.7 ; After: 31.1 ± 3.8; CG: Before: 31.9 ± 3.8; After W : 31.5 ± 4.0 [ 10 ] WC (cm) EG: Before: 100.1 ± 11.3; After; 97.7 ± 10.8 w ; CG: Before: 101.7 ± 12.0; After; 101.7 ± 12.1 HDL-C (mmol/L) EG: Before: 1.50 ± 0.37 ; After: 1.48 ± 0.34; CG: Before: 1.51 ± 0.36; After: 1.49 ± 0.31 LDL-C (mmol/L) EG: Before: 3.03 ± 0.70 ; After: 3.07 ± 0.72; CG: Before: 3.11 ± 0.68 ; After: 3.23 ± 0.87 VLDL-C (mmol/L) EG: Before: 0.65 ± 0.30; After: 0.63 ± 0.30; CG: Before:0.67 ± 0.33 ; After: 0.65 ± 0.26 TC (mmol/L) EG: Before:5.18 ± 6.63 ; After: 5.18 ± 0.79; CG: Before: 5.28 ± 0.81 ; After: 5.37 ± 0.96 SBP (mmHg) EG: Before:138.6 ± 13.0 ; After: 137.4 ± 14.0; CG: Before:142.4 ± 12.4 ; After w : 139.4 ± 11.9 DBP (mmHg) EG: Before: 80.7 ± 8.4; After: 81.0 ± 8.6; CG: Before: 81.1 ± 8.0; After: 80.5 ± 7.6 TG (mmol/L) EG: Before: 1.43 ± 0.66; After: 1.37 ± 0.67; CG: Before:1.46 ± 0.72 ; After: 1.41 ± 0.57 Peak relative VO2 (mL/kg) EG: Before: 15.4 ± 3.1; After: 16.6 ± 2.9 w ; CG: Before: 15.5 ± 2.9 ; After: 15.4 ± 3.1 Insulin (pmol/L) EG: Before: 72.9 ± 39.4 ; After w : 69.7 ± 43.4; CG: Before: 73.6 ± 50.4; After: 75.8 ± 54.1 Glucose (mmol/L) EG: Before: 5.25 ± 0.49 ; After w : 5.17 ± 0.48; CG: Before: 5.27 ± 0.75; After: 5.35 ± 0.53 Azar 2016 (Random ized Controlle d Trial) Mean (SD) Δ Mean (95% CI) 6 months BMI, kg/m 2 6 mon: Baseline: 37.1(5.4) Δ from baseline: -1.0 (1.5 to -0.5) w ; 3 mon: EG Δ CG : -0.7 (-1.3 to 0.2) b [ 18 ] WC cm 6 mon: Baseline: 119.6 (13.9) Δ from Baseline − 4.1(-6.5 to -1.7) w ; 3 mon: EG Δ CG : -0.6 (-3.8 to 2.6) HDL-C 6 mon: Baseline: 49.7 (16.3) Δ from Baseline 7.2(4.3–10.1) w ; 3 mon: EG Δ CG : 2.5 (-1.5 to 6.5) LDL-C 6 mon: Baseline: 98.5 (36) Δ from Baseline 5.3 (-6.1 to 16.7); 3 mon: EG Δ CG : -11.3 (-26.9 to 4.3) TC 6 mon: Baseline: 175.1 (40.6) Δ from Baseline 11.1 (-2.2 to 24.3); 3 mon: EG Δ CG : -10.5 (-28.7 to 7.7) SBP (mmHg) 6 mon: Baseline: 124.0 (10.1) Δ from Baseline 0.3 (-2.7 to 3.4); 3 mon: EG Δ CG : -0.4 (-4.4 to 3.6) DBP (mmHg) 6 mon: Baseline: 72.6 (10.7) Δ from Baseline 5.0(2.5 to 7.4) w ; 3 mon: EG Δ CG : 0.3 (-2.9 to 3.6) Tri- glyceride 6 mon: Baseline:134.5 (61.5) Δ from Baseline − 7.1 (-28.9 to 14.6); 3 mon: EG Δ CG : -12.6 (-42.5 to 17.3) Huffman 2014 (Random ized control trial) Mean ± SD 6 months TG (mmol/l) EG: High/Vigorous: Pre ( 1.57(0.61)) and Post (1.36(0.51) w ); CG: Inactive Pre (1.85(0.84)) and Post (1.73(0.94)) [ 22 ] VO2peak EG: Low/Moderate Pre (27.8(5.7))-Post (29.5(7.3) w ); Low/Vigorous Pre (27.9(6.8))-Post (30.2(6.9) w ); High/ Vigorous Pre (29.1(5.3))-Post (33.8(7.2) w ); Low/Vigorous + Resistance Training Pre (27.9(6.3))-Post (32.4(8.1) w ); CG: Inactive Pre (27.7(6.4)) and Post (27.5(6.6)) SI (mU / [l×min]) EG: Low/Moderate Pre (3.2 (2.7)) and Post (4.1(2.9) w ); Low/Vigorous + Resistance Training Pre (4.2 (2.8)) and Post (9.9(7.2) w ); CG: Inactive Pre (3.7(2.7)) and Post (3.4(1.8)) Dammen 2018 (Random ized control trial) Mean ± SE 6 months BMI (kg/m 2 ) EG: Baseline:(36.1 (0.2)) and 6 months b (34.3 (0.1)); CG: Baseline: (36.0 (0.2)) and 6 months (35.6 (0.1)) [ 14 ] WC (cm) EG: Baseline:(108.2 (0.6)) and 6 months b (102.9 (0.5)); CG: Baseline:(107.9 (0.6)) and 6 months w (106.3 (0.6)) HC (cm) EG: Baseline:(125.0 (0.5)) and 6 months b (120.4 (0.5)); CG: Baseline:(125.2 (0.5)) and 6 months (124.6 (0.5)) WHR EG: Baseline:(0.87 (0.004)) and 6 months(0.86 (0.01)); CG: Baseline:(0.86 (0.004)) and 6 months (0.86 (0.01)) HDL-C (mmol/l) EG: Baseline:(1.2 (0.02)) and 6 months (1.19 (0.02)); CG: Baseline:(1.2 (0.02)) and 6 months (1.21 (0.02)) LDL-C (mmol/l) EG: Baseline:(3.1 (0.05)) and 6 months (3.08 (0.04)); CG: Baseline:(3.1 (0.05)) and 6 months (3.14 (0.05) ) TC (mmol/l) EG: Baseline:(4.8 (0.06)) and 6 months b (4.75 (0.05)); CG: Baseline:(4.8 (0.06)) and 6 months (4.90 (0.05)) SBP (mmHg) EG: Baseline:(126.1 (0.9)) and 6 months b (121.3 (1.0)); CG: Baseline:(127.0 (0.8)) and 6 months (125.4 (1.0)) DBP (mmHg) EG: Baseline:(79.7 (0.6)) and 6 months b (78.4 (0.7)); CG: Baseline:(80.1 (0.5)) and 6 months (81.2 (0.7)) TG (mmol/l) EG: Baseline:(1.2 (0.05)) and 6 months b (1.25 (0.06)); CG: Baseline:(1.4 (0.1)) and 6 months (1.45 (0.06)) Insulin (pmol/L) EG: Baseline:(96.5 (3.3)) and 6 months (89.4 (3.9)); CG: Baseline:(103.5 (4.1)) and 6 months (95.4 (4.1) ) Glucose (mmol/l) EG: Baseline:(5.3 (0.04)) and 6 months b (5.24 (0.05)); CG: Baseline:(5.4 (0.05)) and 6 months (5.40 (0.06)) HOMA-IR EG: Baseline:(3.3 (0.1)) and 6 months(3.05 (0.15)); CG: Baseline:(3.6 (0.2)) and 6 months (3.27 (0.16)) Madjd 2016 (Random ized controlle d trial) Mean ± SD 24 weeks BMI, kg/m 2 Baseline:(LF:32.09 ± 2.57) and (HF:31.90 ± 2.61) ; Week 24 : (LF: 28.94 ± 2.47) w,b and (HF: 28.47 ± 2.18) w,b [ 24 ] WC, cm Baseline:(LF:98.32 ± 8.85) and (HF:98.24 ± 8.99) ; Week 24 : (LF: 88.96 ± 7.58) w,b and (HF: 90.38 ± 8.37) w,b HDL-C mmol/L Baseline:(LF:1.16 ± 0.20) and (HF:1.18 ± 0.14) ; Week 24 : (LF: 1.30 ± 0.21) w and (HF: 1.32 ± 0.14) w LDL-C mmol/L Baseline:(LF:2.57 ± 0.49) and (HF:2.59 ± 0.51) ; Week 24 : (LF: 2.12 ± 0.48) w and (HF: 2.12 ± 0.48) w TC, mmol/L Baseline:(LF:4.42 ± 0.51) and (HF:4.48 ± 0.51) ; Week 24 : (LF:3.97 ± 0.49) w and (HF: 4.05 ± 0.49) w TGs,mmol/L Baseline:(LF:1.52 ± 0.33) and (HF:1.54 ± 0.22) ; Week 24 : (LF: 1.30 ± 0.18) w and (HF: 1.33 ± 0.23) w Insulin, mU/L Baseline:(LF:13.36 ± 3.05) and (HF:13.22 ± 2.61) ; Week 24 : (LF:11.46 ± 2.91) w and (HF:11.50 ± 2.70) w HbA1c, % Baseline:(LF:5.29 ± 0.40) and (HF:5.06 ± 0.53) ; Week 24 : (LF:4.86 ± 0.43) w and (HF:4.68 ± 0.52) w HOMA Baseline:(LF:3.11 ± 0.88) and (HF:3.04 ± 0.73) ; Week 24 : (LF: 2.42 ± 0.77) w and (HF: 2.41 ± 0.66) w Goodpaster 2010 (Single-blind Randomi zed trial) Mean ± 95% CI 6 months BMI Baseline: Initial Activity (43.51 (42.21–44.81)); Delayed Activity (43.67 (42.33–45.02)); 6 Months: Initial Activity w ( 39.62(38.37–40.87)); Delayed Activity w ( 40.59(39.32–41.87)) [ 20 ] WC, cm Baseline: Initial Activity (124.35 (121.42-127.28)); Delayed Activity (121.70 (118.68-124.72)); 6 Months: Initial Activity w,b (115.75 (112.76-118.75)); Delayed Activity w (116.53(113.52-119.54)) HDL-C, mg/dL Baseline: Initial Activity (47.27 (44.63–49.90)); Delayed Activity (48.71 (46.00-51.43)); 6 Months: Initial Activity w (44.89 (42.20-47.59)); Delayed Activity w (45.10(42.24–47.96)) TC, mg/dL Baseline:Initial Activity (185.75 (178.05-193.44)); Delayed Activity (192.94 (185.00-200.87))}; 6 Months: Initial Activity (181.64 (173.88–189.40)); Delayed Activity (191.92(183.90-199.95)) Systolic BP, mm Hg Baseline: Initial Activity (135.43 (132.08-138.78)); Delayed Activity (134.43 (130.97-137.88)); 6 Months: Initial Activity (132.04 (128.14-135.94)); Delayed Activity (132.57(128.59-136.54))} Diastolic BP, mm Hg Baseline: Initial Activity (78.01 (75.97–80.05)); Delayed Activity (77.00 (74.89–79.10)); 6 Months: Initial Activity (75.68 (73.29–78.08)); Delayed Activity (75.46(73.03–77.89)) Triglycerides, mg/dL Baseline: Initial Activity (127.51 (112.23-142.79)); Delayed Activity (124.29 (108.53-140.04)); 6 Months: Initial Activity (123.23 (109.35-137.11)); Delayed Activity (131.90(116.71-147.08)) Glucose, mg/dL Baseline: Initial Activity (93.69 (90.94–96.43)); Delayed Activity (93.17 (90.35-96.00)); 6 Months: Initial Activity (90.11 (87.49–92.73)); Delayed Activity (90.66(87.85–93.47)) HOMA-IR Baseline:Initial Activity (4.03 (3.47–4.60)); Delayed Activity (3.68 (3.07–4.28)); 6 Months: Initial Activity w ( 2.70 (2.30–3.11)); Delayed Activity w ( 2.65 (2.23–3.07)) Data variables in the study having 6 months duration Arsenault 2009 (Random ized controlle d trial) Mean ± SD 6 months Azar 2016 (Random ized Controlle d Trial) Mean (SD) Δ Mean (95% CI) 6 months Huffman 2014 (Random ized control trial) Mean ± SD 6 months EG: Low/Moderate Pre (27.8(5.7))-Post (29.5(7.3) w ); Low/Vigorous Pre (27.9(6.8))-Post (30.2(6.9) w ); High/ Vigorous Pre (29.1(5.3))-Post (33.8(7.2) w ); Low/Vigorous + Resistance Training Pre (27.9(6.3))-Post (32.4(8.1) w ); CG: Inactive Pre (27.7(6.4)) and Post (27.5(6.6)) Dammen 2018 (Random ized control trial) Mean ± SE 6 months Madjd 2016 (Random ized controlle d trial) Mean ± SD 24 weeks Goodpaster 2010 (Single-blind Randomi zed trial) Mean ± 95% CI Baseline: Initial Activity (43.51 (42.21–44.81)); Delayed Activity (43.67 (42.33–45.02)); 6 Months: Initial Activity w ( 39.62(38.37–40.87)); Delayed Activity w ( 40.59(39.32–41.87)) Baseline: Initial Activity (124.35 (121.42-127.28)); Delayed Activity (121.70 (118.68-124.72)); 6 Months: Initial Activity w,b (115.75 (112.76-118.75)); Delayed Activity w (116.53(113.52-119.54)) Baseline: Initial Activity (47.27 (44.63–49.90)); Delayed Activity (48.71 (46.00-51.43)); 6 Months: Initial Activity w (44.89 (42.20-47.59)); Delayed Activity w (45.10(42.24–47.96)) TC, mg/dL Baseline:Initial Activity (185.75 (178.05-193.44)); Delayed Activity (192.94 (185.00-200.87))}; 6 Months: Initial Activity (181.64 (173.88–189.40)); Delayed Activity (191.92(183.90-199.95)) Baseline: Initial Activity (135.43 (132.08-138.78)); Delayed Activity (134.43 (130.97-137.88)); 6 Months: Initial Activity (132.04 (128.14-135.94)); Delayed Activity (132.57(128.59-136.54))} Baseline: Initial Activity (78.01 (75.97–80.05)); Delayed Activity (77.00 (74.89–79.10)); 6 Months: Initial Activity (75.68 (73.29–78.08)); Delayed Activity (75.46(73.03–77.89)) Baseline: Initial Activity (127.51 (112.23-142.79)); Delayed Activity (124.29 (108.53-140.04)); 6 Months: Initial Activity (123.23 (109.35-137.11)); Delayed Activity (131.90(116.71-147.08)) Baseline: Initial Activity (93.69 (90.94–96.43)); Delayed Activity (93.17 (90.35-96.00)); 6 Months: Initial Activity (90.11 (87.49–92.73)); Delayed Activity (90.66(87.85–93.47)) Baseline:Initial Activity (4.03 (3.47–4.60)); Delayed Activity (3.68 (3.07–4.28)); 6 Months: Initial Activity w ( 2.70 (2.30–3.11)); Delayed Activity w ( 2.65 (2.23–3.07)) Following limited database search, authors ended up with a pervasive population that has helped us in the unification of colossal presentations. The studies included in common sedentary obese/overweight individuals described with varied terminologies in the different articles on the basis of gender, lifestyle, health status, etc. [ 5 , 8 , 13 , 22 ]Subjects were physically overweight/obese: college students [ 27 , 28 ], and adolescent girls [ 14 ], Diabetic type 2 women [ 22 ], infertile women [ 15 ], post-menopausal women on HRT[ 11 ], only women [ 5 , 8 , 11 , 13 – 15 , 22 , 26 – 28 ] only males [ 12 ]. The inclusion and exclusion criteria and the outcome measures as depicted in all the studies under consideration are represented in Table  1 . Goodpaster et al. 2010 [ 24 ] administered moderate intensity physical activity in severely obese African American and White women subject along with dietary intervention for 1 year and found a statistically significant reduction in body fat and WC, both in 6 months and later even at 12 months, found no significant effect on the Lipid profile but showed significant reduction in hepatic steatosis which has a strong association with insulin resistance. However, time of sample collection post last bout of exercise was not specified. There was an auxiliary impressive finding of the study as they concluded that regardless of when PA was initiated in the control group, it helped by producing greater weight loss suggesting lifestyle intervention is a good alternative to surgical interventions. Madjd et al. 2016 [ 26 ] initiated a 24-week study with the idea of judging specific frequency of exercise per week to achieve goal of 300 min/week for weight reduction in overweight and obese women who otherwise had a sedentary lifestyle along with a controlled dietary intervention. Protocol for both the High Frequency (HF) exercise per week group and Low Frequency (LF) group was simple brisk walking. All the anthropometric measures showed similar significant improvement in both the groups. Weight and WC showed greater reduction in LF group than HF and BMI improved better in HF. They demonstrated statistically significant results for reductions in Total Cholesterol (TC), LDL Cholesterol and TGs and increase in HDL Cholesterol in both the groups. A salient observation was that LF group individuals got into a habit of healthy lifestyle on non-prescribed days unintentionally which helped them to lose more weight. Glucose metabolism measurements 10–12 h fasting and post prandial demonstrated statistically significant improvement over the period of observation, however there was no significant difference between the groups as seen in Table  5 . Thus, authors recommended that LF of exercise per week accumulating to have compliance and help induce behavioural adaptations to a healthier lifestyle by investing less time. Dammen et al. [ 15 ] conducted a study on caucasian women, as a part of or precursor to primary infertility treatment: a multicentre RCT where the strata were formed based on trial centre and ovulatory status. Calorie restriction of 1200 kcal/day along with 10,000 steps per day for 2 to 3 times a week (moderate intensity) was ensured using a pedometer for a period of 6 months. Structured counselling sessions were also provided by trained personnel. The control group was put on treatment according to the Dutch infertility guidelines for both anovulatory and ovulatory women. Due to the kind of intervention, subjects could not be blinded to the study but outcome measures were assessed by trained nurses who were not involved in the program. Physical component score on the SF-36 was higher for the lifestyle intervention group than control group and so was the improvement in weight, BMI, WC as well as the HC at both 3 months and 6 months but had no statistically significant effect on Waist Hip Ratio, Triglycerides, TC, HDL-C, LDL-C post intervention. Improvement in fasting glucose and insulin resistance at 3 months, only fasting Glucose at 6 months and the odds for developing MetS reduced by half in the intervention group performing exercise. Spending 1200 kcal/week, several groups with varied intensity exercise vs. inactive control groups showed significant within group reduction in the biochemical testing after a 6 months period when overweight to obese participants were analysed for Serum Triglycerides in the study done by Huffman et al. [ 23 ]. They suggested skeletal muscle activity to be relatively high for a specific period post exercise and it was suggested to collect the sample for biochemical analysis at 16–24 h after the last bout of exercise. Only the two groups ‘low amount moderate intensity exercise group’ and ‘the resistance with the low/vigorous aerobic exercise group’ demonstrated within group improvement in Insulin sensitivity at 16–24 h after last bout of exercise in a period of 6 months, however they have related this to a distinct metabolic process and which they say is not similar to the one that leads to changes in VO2 peak and serum triglycerides. Subjecting the participants to 3 to 4 days of exercise per week at 50% of peak VO2 spending 4, 8 and 12 kcal/kg/week in a progressive fashion for 6 months, Arsenault et al. [ 11 ] found no change in different types of exercise groups and thus statistically compared them pooled together versus no exercise control group. They demonstrated statistically significant improvement in cardiorespiratory status and glucose data as observed in Table 5 . No significant change was observed in lipid profile nor inflammatory biomarkers as they preumed their subjects to be “metabolically healthy”. Azar et al. [ 25 ] conducted an Electronic Cardio Metabolic Program for 6 months. In the blinded outcome measurements, there was between group difference at 3 months in the BMI and weight of the individuals who were enrolled in intervention and waiting on the list. However, within the group difference was also found for both the groups for weight, BMI, WC and HDL-C at 6 months as seen in Table 5 . The virtual program led to more availability and less absentees thus, authors advocated virtual sessions as a good option to physical in-person. Whereas Irving et al. did not show effect any effect of Light versus High intensity exercise on the lipid profile in 16 weeks protocol, In contrast subjects in Carr et al. study shown improvement in triglycerides over a period of 16 weeks and in HDL-C with higher energy expenditure in 12 weeks than the other counterparts of the study [ 18 , 20 ]. Other observations also advocate Internet delivered lifestyle strategies to be challenging and have demonstrated considerable effects on the baselines activity level, WC and coronary risk ratio over a period of 16 weeks and some improvement seen at 6 months in HDL-C [ 18 , 25 ]. Where Alvarez et al. has shown no effect of HIIT 12-week protocol on physical assessment but demonstrated between group changes in TC regardless of the descendance of the population under study, Plavsic et al. in 2020 have shown within group improvement in BMI and WC but not on lipid profile with both ‘HIIT and diet control’ in their RCT from Serbia both reported change in blood glucose parameters at 12 weeks of HIIT [ 5 , 14 ]. Whereas both Ha & So et al. and Ho et al. in 2012 reported nil change in glucose and insulin, improvement in ‘percentage Body Fat, WC’ and ‘Body weight, Body Fat %, Abdominal Fat %’ respectively in their studies. Ha and So e t al found no change in lipid profile with combination of aerobic plus resistance exercise in 12 weeks and Ho et al. found early improvement in HDL-C and TC at 12 weeks but within group [ 6 , 27 ]. Stensvold et al. in 2010 having conducted RCT on Norwegian Population with Metabolic syndrome also reported improvement in WC in comparison to the Control group after 12-week Aerobic Interval Training and combination group, in comparison to Strength training alone but no change in any lipid or insulin biomarker [ 21 ]. Zhou et al. found no statistically significant change with increase in energy expenditure as they followed lifestyle intervention protocols over a period of 12 weeks, but significant decrease in HbA1c was observed [ 19 ]. Mathunjwa et al. reported changes following 10 weeks of aerobic exercise (TAE-BO) protocol to suggest improvement in BMI, WC, HC, Glucose level and lipid profile (triglycerides, TC, LDL-C, HDL-C) with the same [ 28 ]. Arefirad et al. 2020 conducted the RCT by subjecting the female type 2 diabetic subjects to High interval training versus Control Group however has not conducted analysis on the anthropometric measures but found between group difference in 6 weeks in TC, Triglycerides and HbA1c [ 22 ]. Fisher et al. 2015 [ 12 ] studied effect of six week of HIIT protocol for one hour activity per week and continuous moderate intensity training (MIT) protocol for five hours per week. Both exercise protocol showed improvement in % body fat but not in lipid profile. However, it is to be noted that the group participants showed significant difference in the baseline percent body fat (p = 0.0454) even though the participants were randomly allotted. They found an overall 17.6% increase in insulin sensitivity irrespective of the intensity. They advocated measuring the biomarker not earlier than 48 h of the last session, to evade the effect of glucose regulation followed by acute muscle contractions. Kong et al. having studied HIIT versus Moderate to Vigorous Continuous Training (MVCT) in a 5-week protocol study and concluded to suggest within group changes in the MVCT for the BMI whereas has reported no change in any other biomarker [ 13 ]. Smith Ryan et al. conducted a RCT dividing the participant into Sprint Interval Training, HIIT and Control Group for a 3 weeks protocol. As seen in the Table  2 there was no significant effect seen in any of the anthropometric measures or biomarkers [ 8 ]. Thus, we observe a consistency in improvement in anthropometric measures in different study populations across different parts of the globe at 10–12 weeks of aerobic as well as aerobic and resistance exercise combination training. A moderate intensity exercise for 5 days per week accumulating a minimum of 300 min/week or 10,000 steps per day for 2 to 3 times per week is equally effective as other protocol where one is subjected to LF higher duration exercise per week. Also, a Low intensity workout did not show significant results unless the workout is expended to an approximate of less than 1200 kcal per week. However, studies have advocated a ‘LF high intensity and more duration/day’ form of exercise, as the obese subject tends to get habitual to a healthy lifestyle for the rest of the days/week, have better compliance and keep more than active than otherwise and thus this pattern is found to be time efficient and more productive. Changes found and method of assessment for outcome measures was not consistent in all the studies and thus not commented on. Lipid profile measured post physical activity training has shown extreme variability among studies, with respect to duration of exercise which could be due to variation in the time of blood sample collection post intervention. Changes have been observed in HDL-C and TC in as early as 6 weeks post intervention with the increase in number of kilocalories burned over that period and is also independent of the intensity of exercise performed. Improvement in the fasting glucose and HbA1c with high intensity exercise and lifestyle interventions s reported in as early as 12 weeks and in all biomarkers related to glucose metabolism with moderate intensity exercise not before 6 months. Moreover, lifestyle interventions, dietary control and behavioural counselling along with stress management play a vital role in management of obesity and comorbidities. Only a handful of new studies have shown conclusive evidence for parameter such as Blood Pressure [ 11 , 15 , 24 ]. However, long-term studies which considered it as a part of the outcome measure, have not specified the time for the measurement post exercise considering the acute biochemical effects that persist for 24–48 h post exercise. Ignoring this aspect significant change in BP has been observed in most of the studies not before a minimum of 10–12 weeks of moderate exercise for 5 days and high intensity exercise for at least 3 days/week accumulating a minimum of 300 min /week or at greater than Lactate Threshold irrespective of the frequency per week [ 5 , 14 , 27 , 28 ]. VO2 peak is a marker of fitness and that can affect all- cause mortality has a dose-response relationship and changes are observed in this outcome measure in as early as 5–6 weeks [ 6 , 8 , 11 – 13 , 22 , 23 ].

Early work in the field generally did not control for confounding variables (such as age, diet, sex hormones, stress factors, lifestyle, initial physical activity status, method and time of measuring the biomarkers post intervention etc.). In comparison, current literature often controls for a myriad of potential confounding variables. One of the likely confounding factors which is unexplored is also circadian rhythm due to chronobiological adaptations [ 29 , 30 ]. It is also suggestive that studies may also include other cost effective adipokines and cytokines in the evaluation to find if any of them are more sensitive to start gauging the changes earlier than 10–12 weeks of physical activity and training.

Objective assessment of the various outcome measures shows compelling evidence for benefits exerted on Cardiorespiratory fitness as early as 5–6 weeks and not before 10–12 weeks of exercise for anthropometric measures and 24 weeks for other biomarkers. None of the Cardiometabolic outcome measures on examining the literature emerged to be more sensitive to HIIT or LITT.

This review was is registered in PROSPERO ( CRD42023397930) and was performed according to the PRISMA guidelines [ 16 ], includes Experimental studies/Randomised Controlled Trials (RCT’s) on obese individuals. Studies having an Intervention program of duration ≥ 3 weeks with the inclusion of aerobic/anaerobic/resistance/strength training /any other exercise plan that leads to moderate to vigorous amount of Physical activity as per American College of Sports Medicine (ACSM) guidelines [ 17 ]. The studies were done on an Age Group of 23-57-year-old men and women. Five investigators independently conducted a literature search using PubMed/MedLine, IEEE Xplorer for various studies including the keywords: “OBESITY”, “CARDIOMETABOLIC DISEASES” and “PHYSICAL ACTIVITY INTERVENTION”, “EFFECT OF PA on CMD”, “CMD and PA intervention”. These searches derived data of the period between 2004 and 2020. The strategy was then adapted for the other databases. At this stage, the search strategy organized the data based on: population (P), Obesity (O) intervention (I), control group (CG) and Cardiometabolic Disease (CMD), Physical Activity (PA) from the several articles collected from the aforementioned databases. After performing the initial literature searches, each study title and abstract was screened for eligibility by all the authors. Only articles in English and full text of all potentially relevant studies were subsequently retrieved and further examined. The PRISMA flow diagram also postulates information further inculcated in the selection process of studies (Fig. 1 ). Fig. 1 Flow diagram of article selection for review Flow diagram of article selection for review Independent investigators extracted key data from the included articles in a standardized template database and other reviewers as independent investigators validated the data extraction. Biasing was removed by reviewing with peers There was no blinding of authors and journals. All the authors were involved in scanning research papers and presenting the findings. Information from the included studies was then analyzed and recorded in an electronic spreadsheet designed by the authors as seen in Table  1 . Table 1 Participant/ Population characteristics of included studies Study (Type) Age (yr) and No. Of Participants /Region Inclusion Criteria Exclusion Criteria Ref Álvarez 2019 (Experimental Study) Map-CT: 45 (35–54) Eur-CT: 40 (33–47) & Map-CG: 57 (49–66) and Eur-CG: 40 (35–44); (Mean (95% CI) Map-CT: N = 15 Eur-CT: N = 14 & Map-CG: N = 44 and Eur-CG: N = 23; Chile Overweight/obese of age 18–70 years, BMI > 25 kg/m 2 , women, Physically inactive(, fasting glycaemia 100–126 mg/dL; and WC > 80 cm, South American individuals, SBP and DBP > 130 and 85 mm Hg, respectively, total cholesterol > 200 mg/dL, > 70% compliance. Cardiovascular contra-indications to exercise; history of stroke, asthma or chronic obstructive pulmonary disease; muscle–skeletal disorders; and smoking. [ 4 ] Arefirad 2020 (RCT) CG: 46.07 ± 4.77 and EG: 44.97 ± 5.89; N = 30 (15 in each group) ;Iran Females, Type 2 diabetes mellitus for atleast 3 months at onset aged 40–55 years, Not taking insulin for treatment; Baseline HbA1c 6–9% history of the last stage of liver and kidney disease, neuropathy, retinopathy, cardiovascular disease or blood pressure and involved in fun related unprofessional physical activity. [ 17 ] Arsenault 2009 (RCT) CG:57.2 ± 6.1; EG: 57.3 ± 6.6; CG: N = 82 and EG: N = 267. North and South Dallas, TX Sedentary Women, body mass index (BMI) of 25.0–43.0 kg/m2, SBP:120.0 to 159.9 mmHg, using Hormone Replacement therapy History of stroke, heart attack, or any serious medical condition [ 10 ] Azar 2016 (RCT) EG: 59.6 (11.9) and CG: 59.8 (10.5); N = 32 each group; Northern California. Adults, BMI ≥ 35 kg/m2 and with Pre-diabetes, previous gestational diabetes and/or metabolic syndrome, Proficient in written and spoken English Type 1 diabetes, pregnancy or active breastfeeding, taking treatment for a serious medical condition, mental health issues, or life expectancy less than 12 months. [ 18 ] Carr 2008 (RCT) CG:49.4 ± 1.7 and EG: 41.4 ± 3.7*; N = 18 CG and N = 14 EG; Southern Wyoming USA Age 21–65 years, BMI 18–40 kg/m2, sedentary, having internet access for at least one hour per week, were non-smokers Overt cardiovascular, metabolic, respiratory, or neurological diseases as assessed by medical history, and premenopausal females, exercise limitations [ 19 ] Dammen 2018 (RCT) IG: 29.7(4.5) & CG:29.8 (4.6); IG: N = 289 & CG: N = 285; Netherland Infertile women aged 18–39 years, BMI 29 kg/m2. Severe endometriosis, premature ovarian insufficiency, endocrinopathy, untreated pre-existing hypertension, or history of hypertension related pregnancy complications [ 14 ] Fisher 2015 (RCT) Both groups 20.0 (1.5); MIT N = 13,HIIT N = 15; Birmingham 17–22 years; BMI 25–35 kg/m 2 , sedentary men, normal glucose tolerance, no use of medications Asthmatics; On Medications; Weight change > 10% in 6 months; Out of age range; Smokers; Declined to participate. [ 11 ] Goodpaster 2010. (randomised trial) N = 46.1(6.5) and N = 47.5 (6.2); Initial activity N = 67; Delayed activity N = 63 ; Pittsburgh. 30–55 years, BMI 35–39.9 kg/m 2 and 40 or greater, self reported Race/ethnicity (African American vs. White), compliant and with medical clearance for intervention. Unable to walk without assistance, recent history of cancer, on treatment for coronary artery disease, in a formal weight loss program, > 5% loss of current body weight, bariatric surgery, or uncontrolled hypertension, diabetes, or pregnancy. [ 20 ] Ha & So 2012 (Experimental Study) EG: 21.14 ± 1.57 and CG: 20.78 ± 1.99; EG: N = 16 CG: N = 9; Korea Obese female college students aged 20–26 years, > 30% body fat, exercised at the Dongguk University fitness center, Korea. Previously diagnosed with abnormal glucose metabolism, or other health problems and subjects who exercise regularly [ 21 ] Ho 2012 (randomized parallel design) CG: 52 ± 1.8; A: 55 ± 1.2 ; R: 52 ± 1.1; C: 53 ± 1.3 CG:N = 16; A:N = 15;R:N = 16 and C:N + 17; Australia BMI > 25 kg/m2 or waist circumference > 80 cm for women and 90 cm for men, aged 40–66 years, sedentary or relatively inactive Diabetes mellitus, pre-existing heart conditions, lipid lowering medication, beta-blockers, pregnant or lactating women, smokers, gastrointestinal tract surgery, major illness, physical limitation. [ 5 ] Huffman 2014 (RCT) 18–70 years; CG:Inactive: N = 20; L/M: N = 15; L/V: N = 20; H/V: N = 17; AT/RT: N = 20 and RT:N = 20; USA Inactive Subjects, age 18–70 years, overweight to mildly obese (BMI 25–35 kg/m2) and dyslipidaemic Diabetes mellitus, hypertension, known cardiovascular disease, musculoskeletal conditions that prohibited exercise training, used tobacco or medications or specific dietary regimen. [ 22 ] Irving 2009 (randomized trial) 51 ± 9 years; CG:N = 7; LIET EG: N = 11 and HIET EG: N = 9 ; Virginia Middle age adults who Met IDF criteria i.e. elevated waist circumference with at least two of; elevated FBG/ low HDL-C/ hyper triglyceridemia, and/or elevated BP, isocaloric conditions) Participants who didn’t meet IDF criteria. [ 23 ] Kong 2016 (RCT) HIIT: 21.5 ± 4.0 and MVCT: 20.5 ± 1.9; HIIT:N = 13 and MVCT:N = 13; South Korea 18 to 35 years; sedentary, obese (body fat over 30%), and with a medical clearance for vigorous exercise. Unable to do strenuous physical exercise, smokers, alcoholics, and users of contraceptive pills or prescribed drugs [ 12 ] Madjd 2016 (RCT) LF: 29.4 ± 5.7 and HF: 29.7 ± 5.8; N = 75; LF = N = 38, HF = N = 37; Iran Women,18–40 y, BMI (kg/m2): 27–35, sedentary, willing to comply, non-smokers, no medical ailment Pregnancy or lactation; depression; weight loss > 10% of body weight; involved in exercise; taking medication; reported positive on the PAR-Q ; no medical clearance. [ 24 ] Mathunjwa 2013 (Prospective experimental) 25 ± 5 years; N = 67; South Africa Female College students, overweight and obese, sedentary since 6 months (adhering to normal dietary practices) No medical clearance and as per PAR-Q [ 25 ] Plavsic 2020 (RCT) CG: Diet Only:15.5 ± 1.5 years; EG: Diet + HIIT: 16.2 ± 1.3; CG: N = 20; EG: N = 19;Serbia,Belgrade 13–19 years; females; body mass index (BMI) = 33.0 ± 3.1 kg/m2, Exhibiting menarche > 2 yrs, regular menstrual periods during the study, non-smoker on hormonal treatment, enrolment in physical activity, Cushing’s syndrome, hyperprolactinemia, thyroid dysfunction and other endocrine disorders or ailment, alcohol users. [ 13 ] Smith-Ryan 2016 (RCT) SIT: 33.2 ± 12.8; HIIT: 33.6 ± 11.6; CG: 35.2 ± 11.4; SIT: N = 11, HIIT: N = 10 and Control N = 09; south-east USA Age 18–55 years, women, overweight (BMI > 25 kg · m2 ); <10 lb body weight change within the last 3 months; sedentary Cardiovascular, musculoskeletal, hypertension or metabolic renal, hepatic, autoimmune or neurological disease; participating exercise; no personal physician clearance or on any medication, physical limitation [ 7 ] Stensvold 2010 (RCT) CG:47.3 ± 10.2;AIT: 49.9 ± 10.1; COM: 52.9 ± 10.4; ST: 50.9 ± 7.6; CG: N = 11;AIT: N = 11; COM: N = 10; ST:N = 11; Norway Age: 50.2 ± 9.5 yrs with metabolic syndrome according to IDF Unstable angina pectoris, uncompensated heart failure, myocardial infarction during the past 4 wk, complex ventricular arrhythmias, and kidney failure. [ 26 ] Zhou 2018 (A Pilot Intervention) 56.7 ± 11.4 years old; N = 30; African American in South eastern US. Age > 21 years, African American, English speaking, BMI > 25 kg/m2, stable on medication for hypertension, high cholesterol, type 2 diabetes and having telephone access, willing to participate Malignant cancer, physical activity limitation, weight loss > 5 pounds, pregnancy or lactation, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and cancer, and any psychiatric illness on self-declaration, required medical clearance. [ 27 ] Participant/ Population characteristics of included studies Map-CT: 45 (35–54) Eur-CT: 40 (33–47) & Map-CG: 57 (49–66) and Eur-CG: 40 (35–44); (Mean (95% CI) Map-CT: N = 15 Eur-CT: N = 14 & Map-CG: N = 44 and Eur-CG: N = 23; Chile Arefirad 2020 (RCT) Azar 2016 (RCT) Carr 2008 (RCT) EG: 21.14 ± 1.57 and CG: 20.78 ± 1.99; EG: N = 16 CG: N = 9; Korea CG: 52 ± 1.8; A: 55 ± 1.2 ; R: 52 ± 1.1; C: 53 ± 1.3 CG:N = 16; A:N = 15;R:N = 16 and C:N + 17; Australia HIIT: 21.5 ± 4.0 and MVCT: 20.5 ± 1.9; HIIT:N = 13 and MVCT:N = 13; South Korea LF: 29.4 ± 5.7 and HF: 29.7 ± 5.8; N = 75; LF = N = 38, HF = N = 37; Iran SIT: 33.2 ± 12.8; HIIT: 33.6 ± 11.6; CG: 35.2 ± 11.4; SIT: N = 11, HIIT: N = 10 and Control N = 09; south-east USA CG:47.3 ± 10.2;AIT: 49.9 ± 10.1; COM: 52.9 ± 10.4; ST: 50.9 ± 7.6; CG: N = 11;AIT: N = 11; COM: N = 10; ST:N = 11; Norway The average score of all articles was fair on the (modified) Downs and Black checklist for quality of reporting, external validity, internal validity, and statistical power.

In the last 2 decades physical inactivity, change in lifestyle, increasing stress levels, unhealthy diet, insomnia followed by several health-related complications has lowered the quality of life. It not only affects the metabolism but also the chemical milieu of the body; making one susceptible to a dreaded Cardiometabolic combination of morbidities and cancers leading to premature mortality and also increasing the adjusted odds ratio for dreadful viruses like SARS-CoV-2 [ 1 – 3 ]. Despite of the literature and continuous reiteration from the different health agencies[ 4 ] the minimal recommendations on healthy lifestyle are not being met due to behavioural factors like lack of motivation, compliance and also busy schedule and thus lack of time [ 3 , 5 – 9 ]. Children are falling prey to obesity [ 10 ] inducing low cardiorespiratory fitness and other chronic inflammatory atherosclerosis and dyslipidaemia [ 2 , 11 – 15 ]. Thus, this review was taken up to study the effectiveness of exercise on obesity related anthropometric parameters, and key biomarkers like glycaemic control, lipid profile, blood pressure and cardiorespiratory status with an aim to find the most ideal duration and outstanding form of exercise treatment.