Effect of exercise as adjuvant to energy-restricted diets on quality of life and depression outcomes: a meta-analysis of randomized controlled trials

Seyede Hamide Rajaie, Sepideh Soltani, Zeinab Yazdanpanah, Tayebeh Zohrabi, Sara Beigrezaei, Sahar Mohseni-Takalloo, Mojtaba Kaviani, Scott C. Forbes, Julien S. Baker, Amin Salehi-Abargouei*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)


Background and aim: Obesity and related co-morbidities lead to a decrease in health-related quality of life (HRQOL) and mood. Lifestyle strategies may improve these outcomes. However, the efficacy of exercise in conjunction with a weight-loss diet on HRQOL and mood is unclear. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to examine whether the addition of exercise to energy-restricted dietary programs improves HRQOL and mood status when compared with energy-restricted diets alone in overweight and obese adults. 

Methods: Eligible RCTs were identified by searching PubMed/MEDLINE, EMBASE, ISI (Web of sciences), Scopus, and Google Scholar up to April 2021. Summary effects were derived using a random-effects model. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. 

Results: The meta-analysis revealed that an energy-restricted diet plus exercise compared with an energy-restricted diet alone had no significant effects on depression (n = 6, hedges’g = − 0.04, 95% CI: − 0.28,0.20), MOS 36-Item Short-Form Health Survey (SF-36)-physical component summary scores (n = 8, weighted mean difference (WMD) = 1.51, 95% CI: − 0.16, 3.18), SF36-mental component summary scores (n = 7, WMD = 0.64, 95% CI: − 1.00, 2.28), and HRQOL disease-specific questionnaire scores (n = 5, hedges’g = 0.16, 95% CI: − 0.09, 0.40). The GRADE revealed that the quality of evidence was low for disease-specific HRQOL scores, and depression status; and high for physical and mental health assessed by SF-36. 

Conclusion: In our sample of overweight and obese adults, no beneficial effect of adding exercise to an energy-restricted diet was found in terms of HRQOL and Depression.

Original languageEnglish
Pages (from-to)3123-3137
Number of pages15
JournalQuality of Life Research
Issue number11
Early online date6 May 2022
Publication statusPublished - Nov 2022

Scopus Subject Areas

  • Public Health, Environmental and Occupational Health

User-Defined Keywords

  • Adults
  • Aerobic
  • Depression,mood
  • Diet
  • Exercise
  • IVhet model
  • Meta-analysis
  • Obese
  • Overweight
  • Quality of life
  • Randomized controlled trial
  • Resistance
  • Systematic review
  • Weight loss


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