Effects of physical exercise on metabolic syndrome in psychotic disorders: A systematic review with meta-analysis of randomized controlled trials

Abstract Background Physical exercise improves mental and physical health of individuals with severe mental illness (SMI); however, its impact on metabolic syndrome remains unclear. Aims To evaluate the effects of exercise interventions on metabolic syndrome components in individuals with SMI and e...

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Main Authors: Arantxa Ancín-Osés, Mikel Izquierdo, Manuel J. Cuesta, Mikel L. Sáez de Asteasu
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933825100643/type/journal_article
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author Arantxa Ancín-Osés
Mikel Izquierdo
Manuel J. Cuesta
Mikel L. Sáez de Asteasu
author_facet Arantxa Ancín-Osés
Mikel Izquierdo
Manuel J. Cuesta
Mikel L. Sáez de Asteasu
author_sort Arantxa Ancín-Osés
collection DOAJ
description Abstract Background Physical exercise improves mental and physical health of individuals with severe mental illness (SMI); however, its impact on metabolic syndrome remains unclear. Aims To evaluate the effects of exercise interventions on metabolic syndrome components in individuals with SMI and explore interactions between exercise and antipsychotic medications on metabolic outcomes. Methods Following PRISMA guidelines, we systematically searched PubMed, CINAHL, Web of Science, and APA PsycINFO through October 10, 2023, for randomized controlled trials (RCTs) assessing the effects of exercise on waist circumference, blood pressure, glucose, triglycerides, and HDL cholesterol in SMI. Risk of bias was evaluated using the Cochrane RoB-2 tool. Data were pooled using random-effects models in Comprehensive Meta-Analysis and JASP. Results Ten RCTs (N = 773; mean age 39.9 ± 7.36 years; 38.7% female; 71.5% schizophrenia spectrum disorders) met inclusion criteria. Pooled analyses revealed no significant effects of exercise on waist circumference (SMD = 0.206, 95% CI [−0.118, 0.530], p = 0.171), systolic blood pressure (SMD = 0.194, 95% CI [−0.115, 0.504], p = 0.219), diastolic blood pressure (SMD = −0.21, 95% CI [−0.854, 0.434], p = 0.522), HDL (SMD = 0.157, 95% CI [−0.36, 0.674], p = 0.551), triglycerides (SMD = −0.041, 95% CI [−0.461, 0.38], p = 0.849), or glucose (SMD = −0.071, 95% CI [−0.213, 0.071], p = 0.326). Heterogeneity was moderate to high. Conclusions Exercise interventions did not significantly improve metabolic syndrome components in SMI. Future trials must prioritize tailored regimens, adjunctive therapies, and rigorous control of medication effects.
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spelling doaj-art-b8614090f29c4ec4b6c6cbe8f4f9c8d42025-08-20T03:23:07ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.10064Effects of physical exercise on metabolic syndrome in psychotic disorders: A systematic review with meta-analysis of randomized controlled trialsArantxa Ancín-Osés0https://orcid.org/0009-0003-2947-6301Mikel Izquierdo1https://orcid.org/0000-0002-1506-4272Manuel J. Cuesta2https://orcid.org/0000-0003-0250-5718Mikel L. Sáez de Asteasu3https://orcid.org/0000-0002-4111-5045Navarrabiomed, Hospital Universitario de Navarra (HUN), https://ror.org/02z0cah89 Universidad Pública de Navarra (UPNA) , IdiSNA, Pamplona, SpainNavarrabiomed, Hospital Universitario de Navarra (HUN), https://ror.org/02z0cah89 Universidad Pública de Navarra (UPNA) , IdiSNA, Pamplona, Spain CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, SpainDepartment of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, SpainNavarrabiomed, Hospital Universitario de Navarra (HUN), https://ror.org/02z0cah89 Universidad Pública de Navarra (UPNA) , IdiSNA, Pamplona, Spain CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, SpainAbstract Background Physical exercise improves mental and physical health of individuals with severe mental illness (SMI); however, its impact on metabolic syndrome remains unclear. Aims To evaluate the effects of exercise interventions on metabolic syndrome components in individuals with SMI and explore interactions between exercise and antipsychotic medications on metabolic outcomes. Methods Following PRISMA guidelines, we systematically searched PubMed, CINAHL, Web of Science, and APA PsycINFO through October 10, 2023, for randomized controlled trials (RCTs) assessing the effects of exercise on waist circumference, blood pressure, glucose, triglycerides, and HDL cholesterol in SMI. Risk of bias was evaluated using the Cochrane RoB-2 tool. Data were pooled using random-effects models in Comprehensive Meta-Analysis and JASP. Results Ten RCTs (N = 773; mean age 39.9 ± 7.36 years; 38.7% female; 71.5% schizophrenia spectrum disorders) met inclusion criteria. Pooled analyses revealed no significant effects of exercise on waist circumference (SMD = 0.206, 95% CI [−0.118, 0.530], p = 0.171), systolic blood pressure (SMD = 0.194, 95% CI [−0.115, 0.504], p = 0.219), diastolic blood pressure (SMD = −0.21, 95% CI [−0.854, 0.434], p = 0.522), HDL (SMD = 0.157, 95% CI [−0.36, 0.674], p = 0.551), triglycerides (SMD = −0.041, 95% CI [−0.461, 0.38], p = 0.849), or glucose (SMD = −0.071, 95% CI [−0.213, 0.071], p = 0.326). Heterogeneity was moderate to high. Conclusions Exercise interventions did not significantly improve metabolic syndrome components in SMI. Future trials must prioritize tailored regimens, adjunctive therapies, and rigorous control of medication effects. https://www.cambridge.org/core/product/identifier/S0924933825100643/type/journal_articlemetabolic syndromephysical exercisepsychotic disorderschizophreniasevere mental disorder
spellingShingle Arantxa Ancín-Osés
Mikel Izquierdo
Manuel J. Cuesta
Mikel L. Sáez de Asteasu
Effects of physical exercise on metabolic syndrome in psychotic disorders: A systematic review with meta-analysis of randomized controlled trials
European Psychiatry
metabolic syndrome
physical exercise
psychotic disorder
schizophrenia
severe mental disorder
title Effects of physical exercise on metabolic syndrome in psychotic disorders: A systematic review with meta-analysis of randomized controlled trials
title_full Effects of physical exercise on metabolic syndrome in psychotic disorders: A systematic review with meta-analysis of randomized controlled trials
title_fullStr Effects of physical exercise on metabolic syndrome in psychotic disorders: A systematic review with meta-analysis of randomized controlled trials
title_full_unstemmed Effects of physical exercise on metabolic syndrome in psychotic disorders: A systematic review with meta-analysis of randomized controlled trials
title_short Effects of physical exercise on metabolic syndrome in psychotic disorders: A systematic review with meta-analysis of randomized controlled trials
title_sort effects of physical exercise on metabolic syndrome in psychotic disorders a systematic review with meta analysis of randomized controlled trials
topic metabolic syndrome
physical exercise
psychotic disorder
schizophrenia
severe mental disorder
url https://www.cambridge.org/core/product/identifier/S0924933825100643/type/journal_article
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