The effects of Mediterranean diet with and without exercise on body composition in adults with chronic disease: A systematic review and meta-analysis of clinical trials
Abstract
BACKGROUND & AIMS
The Mediterranean diet (MedDiet), with and without energy restriction, has been associated with reduced risk of numerous chronic diseases, including type 2 diabetes and cardiovascular disease. Exercise is well known to improve various health outcomes in individuals with chronic diseases and emerging evidence indicates that combining diet and exercise may be superior to individual interventions. The primary aim of this systematic review and meta-analysis was to assess the effects of all MedDiet interventions (regardless of exercise or energy restriction), as well as MedDiet alone (and in hypocaloric and isocaloric subgroups) on body composition outcomes [weight, waist circumference (WC), body mass index (BMI), body fat (BF), lean mass (LM) and visceral adipose tissue (VAT)] in adults with chronic disease. Secondary aims were to assess the effects of MedDiet plus exercise, including in hypocaloric and isocaloric subgroups, on body composition outcomes.
METHODS
Four electronic databases (ProQuest, Medline, Embase and CINAHL) were searched from inception to January 2025. Randomised controlled trials including MedDiet interventions in adults with chronic diseases that assessed body composition as outcomes were included. Outcomes were pooled using random-effect meta-analysis for MedDiet interventions compared with controls to determine the standardised mean difference.
RESULTS
Twenty papers were included in the systematic review and meta-analysis, reporting data…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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