{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:07:08Z","timestamp":1789459628650,"version":"build-2803163510"},"reference-count":63,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002630","name":"Ewha Womans University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002630","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Curr Cardiol Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose of Review<\/jats:title>\n                    <jats:p>While studies have established the independent benefits of diet and exercise, comparatively few have assessed these modalities side by side, evaluating diet-only, exercise-only, and combined interventions under comparable conditions. This review focuses on randomized trials and meta-analyses that provide such direct comparisons, emphasizing outcome-specific differences and the circumstances in which combining both modalities yields added benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent Findings<\/jats:title>\n                    <jats:p>Evidence indicates that the superiority of combined diet and exercise interventions is outcome-dependent rather than universal. Dietary interventions generally produce improvements in body weight, cholesterol, and fasting glucose, whereas exercise uniquely enhances cardiorespiratory fitness, muscular strength, endothelial function, and physical function. For cardiometabolic outcomes including insulin sensitivity and visceral adiposity, combined interventions frequently provide additive or synergistic benefits. However, for functional outcomes such as VO\u2082peak and muscular performance, exercise remains the primary determinant, and adding dietary modification confers limited additional benefit. Similarly, blood pressure responses to combined interventions vary widely and do not consistently exceed those produced by nutrient-focused dietary patterns alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Diet and exercise exert complementary but nonredundant effects across cardiometabolic pathways, and their combined advantages depend on the specific clinical outcome targeted. While integrated lifestyle interventions offer the broadest overall benefit, implementing both simultaneously is often constrained by practical and behavioral barriers. A patient-centered, outcome-specific strategy prioritizing diet or exercise based on the individual\u2019s metabolic profile, functional status, and readiness may support adherence and provide a scalable path toward multimodal intervention. Such tailored sequencing has the potential to optimize cardiometabolic health and extend healthspan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11886-026-02419-8","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:29:24Z","timestamp":1789457364000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diet Versus Exercise in Cardiometabolic Disease: Are Two Always Better Than One?"],"prefix":"10.1007","volume":"28","author":[{"given":"Jingyeong","family":"Jo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2015-4109","authenticated-orcid":false,"given":"Kyuwan","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"issue":"4","key":"2419_CR1","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.amepre.2018.04.046","volume":"55","author":"J Barbaresko","year":"2018","unstructured":"Barbaresko J, Rienks J, N\u00f6thlings U. Lifestyle indices and cardiovascular disease risk: a meta-analysis. Am J Prev Med. 2018;55(4):555\u201364.","journal-title":"Am J Prev Med"},{"issue":"14","key":"2419_CR2","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1056\/NEJMoa2206916","volume":"389","author":"GCR Consortium","year":"2023","unstructured":"Consortium GCR. Global effect of modifiable risk factors on cardiovascular disease and mortality. N Engl J Med. 2023;389(14):1273\u201385.","journal-title":"N Engl J Med"},{"issue":"1","key":"2419_CR3","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-022-01153-1","volume":"7","author":"H Chen","year":"2022","unstructured":"Chen H, et al. Exercise training maintains cardiovascular health: signaling pathways involved and potential therapeutics. Signal Transduct Target Ther. 2022;7(1):306.","journal-title":"Signal Transduct Target Ther"},{"key":"2419_CR4","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2018.00135","volume":"5","author":"MA Nystoriak","year":"2018","unstructured":"Nystoriak MA, Bhatnagar A. Cardiovascular effects and benefits of exercise. Frontiers in cardiovascular medicine. 2018;5:408204.","journal-title":"Frontiers in cardiovascular medicine"},{"key":"2419_CR5","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2021.111561","volume":"155","author":"G Colleluori","year":"2021","unstructured":"Colleluori G, Villareal DT. Aging, obesity, sarcopenia and the effect of diet and exercise intervention. Exp Gerontol. 2021;155:111561.","journal-title":"Exp Gerontol"},{"issue":"1","key":"2419_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-024-01657-9","volume":"21","author":"J Huang","year":"2024","unstructured":"Huang J, et al. Comparing caloric restriction regimens for effective weight management in adults: a systematic review and network meta-analysis. Int J Behav Nutr Phys Act. 2024;21(1):108.","journal-title":"Int J Behav Nutr Phys Act"},{"key":"2419_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102519","author":"M-L Sun","year":"2024","unstructured":"Sun ML, et al. Intermittent fasting and health outcomes: an umbrella review of systematic reviews and meta-analyses of randomised controlled trials. EClinicalMedicine. 2024. https:\/\/doi.org\/10.1016\/j.eclinm.2024.102519.","journal-title":"EClinicalMedicine"},{"issue":"8","key":"2419_CR8","doi-asserted-by":"publisher","DOI":"10.3390\/nu12082290","volume":"12","author":"S Caristia","year":"2020","unstructured":"Caristia S, et al. Is caloric restriction associated with better healthy aging outcomes? A systematic review and meta-analysis of randomized controlled trials. Nutrients. 2020;12(8):2290.","journal-title":"Nutrients"},{"issue":"5","key":"2419_CR9","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.3945\/ajcn.2009.28380","volume":"90","author":"KA Varady","year":"2009","unstructured":"Varady KA, et al. Short-term modified alternate-day fasting: a novel dietary strategy for weight loss and cardioprotection in obese adults. Am J Clin Nutr. 2009;90(5):1138\u201343.","journal-title":"Am J Clin Nutr"},{"issue":"7","key":"2419_CR10","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1001\/jamainternmed.2017.0936","volume":"177","author":"JF Trepanowski","year":"2017","unstructured":"Trepanowski JF, et al. Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults: a randomized clinical trial. JAMA Intern Med. 2017;177(7):930\u20138.","journal-title":"JAMA Intern Med"},{"issue":"6","key":"2419_CR11","doi-asserted-by":"publisher","first-page":"1871","DOI":"10.1016\/j.clnu.2017.11.018","volume":"37","author":"JF Trepanowski","year":"2018","unstructured":"Trepanowski JF, et al. Effects of alternate-day fasting or daily calorie restriction on body composition, fat distribution, and circulating adipokines: secondary analysis of a randomized controlled trial. Clin Nutr. 2018;37(6):1871\u20138.","journal-title":"Clin Nutr"},{"issue":"1","key":"2419_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/s12986-022-00711-2","volume":"19","author":"W Wang","year":"2022","unstructured":"Wang W, et al. Beneficial effect of time-restricted eating on blood pressure: a systematic meta-analysis and meta-regression analysis. Nutr Metab (Lond). 2022;19(1):77.","journal-title":"Nutr Metab (Lond)"},{"issue":"9","key":"2419_CR13","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.1002\/oby.21581","volume":"24","author":"VA Catenacci","year":"2016","unstructured":"Catenacci VA, et al. A randomized pilot study comparing zero-calorie alternate\u2010day fasting to daily caloric restriction in adults with obesity. Obesity (Silver Spring). 2016;24(9):1874\u201383.","journal-title":"Obesity (Silver Spring)"},{"issue":"16","key":"2419_CR14","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1056\/NEJM199704173361601","volume":"336","author":"LJ Appel","year":"1997","unstructured":"Appel LJ, et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med. 1997;336(16):1117\u201324.","journal-title":"N Engl J Med"},{"issue":"1","key":"2419_CR15","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1097\/HJH.0000000000002604","volume":"39","author":"J Gibbs","year":"2021","unstructured":"Gibbs J, et al. The effect of plant-based dietary patterns on blood pressure: a systematic review and meta-analysis of controlled intervention trials. J Hypertens. 2021;39(1):23\u201337.","journal-title":"J Hypertens"},{"issue":"1","key":"2419_CR16","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/ejcn.2017.58","volume":"72","author":"M Dinu","year":"2018","unstructured":"Dinu M, et al. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. Eur J Clin Nutr. 2018;72(1):30\u201343.","journal-title":"Eur J Clin Nutr"},{"issue":"2","key":"2419_CR17","doi-asserted-by":"publisher","first-page":"125","DOI":"10.2337\/ds19-0073","volume":"33","author":"G Benson","year":"2020","unstructured":"Benson G, Hayes J. An update on the Mediterranean, vegetarian, and DASH eating patterns in people with type 2 diabetes. Diabetes Spectr. 2020;33(2):125\u201332.","journal-title":"Diabetes Spectr"},{"issue":"9","key":"2419_CR18","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1016\/j.amjmed.2011.04.024","volume":"124","author":"AJ Nordmann","year":"2011","unstructured":"Nordmann AJ, et al. Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. Am J Med. 2011;124(9):841-851. e2.","journal-title":"Am J Med"},{"key":"2419_CR19","doi-asserted-by":"crossref","unstructured":"Kastorini CM, et al. The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. Journal of the American college of cardiology, 2011:57(11): 1299\u20131313.","DOI":"10.1016\/j.jacc.2010.09.073"},{"issue":"11","key":"2419_CR20","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1038\/ejcn.2014.243","volume":"69","author":"R Huo","year":"2015","unstructured":"Huo R, et al. Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: a meta-analysis. Eur J Clin Nutr. 2015;69(11):1200\u20138.","journal-title":"Eur J Clin Nutr"},{"key":"2419_CR21","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009825.pub3","author":"K Rees","year":"2019","unstructured":"Rees K, et al. Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2019. https:\/\/doi.org\/10.1002\/14651858.CD009825.pub3.","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"2419_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/met.2010.0031","volume":"9","author":"K Esposito","year":"2011","unstructured":"Esposito K, et al. Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metab Syndr Relat Disord. 2011;9(1):1\u201312.","journal-title":"Metab Syndr Relat Disord"},{"issue":"11","key":"2419_CR23","doi-asserted-by":"publisher","DOI":"10.3390\/nu10111577","volume":"10","author":"E Malakou","year":"2018","unstructured":"Malakou E, et al. The combined effect of promoting the Mediterranean diet and physical activity on metabolic risk factors in adults: a systematic review and meta-analysis of randomised controlled trials. Nutrients. 2018;10(11):1577.","journal-title":"Nutrients"},{"issue":"3","key":"2419_CR24","doi-asserted-by":"publisher","DOI":"10.3390\/nu8030168","volume":"8","author":"M Garcia","year":"2016","unstructured":"Garcia M, et al. The effect of the traditional Mediterranean-style diet on metabolic risk factors: a meta-analysis. Nutrients. 2016;8(3):168.","journal-title":"Nutrients"},{"issue":"1","key":"2419_CR25","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-025-00645-9","volume":"14","author":"Z-h Dai","year":"2025","unstructured":"Dai ZH, et al. Additional effect of exercise to intermittent fasting on body composition and cardiometabolic health in adults with overweight\/obesity: a systematic review and meta-analysis. Curr Obes Rep. 2025;14(1):54.","journal-title":"Curr Obes Rep"},{"issue":"2","key":"2419_CR26","doi-asserted-by":"publisher","DOI":"10.3390\/nu17020218","volume":"17","author":"KL Haganes","year":"2025","unstructured":"Haganes KL, et al. Impact of time-restricted eating and high-intensity exercise on nutrient intake in women with overweight\/obesity: secondary analysis of a randomized controlled trial. Nutrients. 2025;17(2):218.","journal-title":"Nutrients"},{"issue":"8","key":"2419_CR27","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1038\/oby.2011.76","volume":"20","author":"KE Foster-Schubert","year":"2012","unstructured":"Foster-Schubert KE, et al. Effect of diet and exercise, alone or combined, on weight and body composition in overweight\u2010to\u2010obese postmenopausal women. Obesity. 2012;20(8):1628\u201338.","journal-title":"Obesity"},{"issue":"2","key":"2419_CR28","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1177\/0017896911398235","volume":"71","author":"TA Apekey","year":"2012","unstructured":"Apekey TA, et al. Benefits of moderate-intensity exercise during a calorie-restricted low-fat diet. Health Educ J. 2012;71(2):154\u201364.","journal-title":"Health Educ J"},{"issue":"3","key":"2419_CR29","doi-asserted-by":"publisher","first-page":"576","DOI":"10.3945\/ajcn.116.131391","volume":"104","author":"EP Weiss","year":"2016","unstructured":"Weiss EP, et al. Effects of matched weight loss from calorie restriction, exercise, or both on cardiovascular disease risk factors: a randomized intervention trial. Am J Clin Nutr. 2016;104(3):576\u201386.","journal-title":"Am J Clin Nutr"},{"issue":"10","key":"2419_CR30","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1016\/j.cmet.2022.09.003","volume":"34","author":"KL Haganes","year":"2022","unstructured":"Haganes KL, et al. Time-restricted eating and exercise training improve HbA1c and body composition in women with overweight\/obesity: a randomized controlled trial. Cell Metab. 2022;34(10):1457-1471. e4.","journal-title":"Cell Metab"},{"issue":"2","key":"2419_CR31","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1001\/archinternmed.2009.470","volume":"170","author":"JA Blumenthal","year":"2010","unstructured":"Blumenthal JA. Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Intern Med. 2010;170(2):126\u201335.","journal-title":"Arch Intern Med"},{"key":"2419_CR32","doi-asserted-by":"publisher","DOI":"10.1024\/0300-9831\/a000462","author":"E Pavi\u0107","year":"2019","unstructured":"Pavi\u0107 E, et al. Effect of the Mediterranean diet in combination with exercise on metabolic syndrome parameters: 1-year randomized controlled trial. Int J Vitam Nutr Res. 2019. https:\/\/doi.org\/10.1024\/0300-9831\/a000462.","journal-title":"Int J Vitam Nutr Res"},{"key":"2419_CR33","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.950900","volume":"9","author":"J Hernando-Redondo","year":"2022","unstructured":"Hernando-Redondo J, et al. Mid-and long-term changes in satiety-related hormones, lipid and glucose metabolism, and inflammation after a Mediterranean diet intervention with the goal of losing weight: a randomized, clinical trial. Front Nutr. 2022;9:950900.","journal-title":"Front Nutr"},{"issue":"7","key":"2419_CR34","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1038\/ejcn.2013.92","volume":"67","author":"S Mishra","year":"2013","unstructured":"Mishra S, et al. A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr. 2013;67(7):718\u201324.","journal-title":"Eur J Clin Nutr"},{"key":"2419_CR35","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2025.06.019","author":"S Sood","year":"2025","unstructured":"Sood S, et al. 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. Clin Nutr. 2025. https:\/\/doi.org\/10.1016\/j.clnu.2025.06.019.","journal-title":"Clin Nutr"},{"issue":"9","key":"2419_CR36","doi-asserted-by":"publisher","first-page":"2125","DOI":"10.1016\/j.clnu.2024.07.025","volume":"43","author":"J Sampaio","year":"2024","unstructured":"Sampaio J, et al. Combined mediterranean diet-based sustainable healthy diet and multicomponent training intervention impact on plasma biomarkers and metabolome in older adults. Clin Nutr. 2024;43(9):2125\u201335.","journal-title":"Clin Nutr"},{"issue":"11","key":"2419_CR37","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1016\/j.jand.2012.07.007","volume":"112","author":"DE Epstein","year":"2012","unstructured":"Epstein DE, et al. Determinants and consequences of adherence to the dietary approaches to stop hypertension diet in African-American and white adults with high blood pressure: results from the ENCORE trial. J Acad Nutr Diet. 2012;112(11):1763\u201373.","journal-title":"J Acad Nutr Diet"},{"issue":"7","key":"2419_CR38","doi-asserted-by":"publisher","first-page":"637","DOI":"10.4070\/kcj.2017.0349","volume":"48","author":"CJ Lee","year":"2018","unstructured":"Lee CJ, et al. The effects of diet alone or in combination with exercise in patients with prehypertension and hypertension: a randomized controlled trial. Korean Circ J. 2018;48(7):637.","journal-title":"Korean Circ J"},{"issue":"1","key":"2419_CR39","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-023-01424-2","volume":"20","author":"AL Deslippe","year":"2023","unstructured":"Deslippe AL, et al. Barriers and facilitators to diet, physical activity and lifestyle behavior intervention adherence: a qualitative systematic review of the literature. Int J Behav Nutr Phys Act. 2023;20(1):14.","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"1","key":"2419_CR40","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-016-0454-y","volume":"13","author":"S Schoeppe","year":"2016","unstructured":"Schoeppe S, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act. 2016;13(1):127.","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"4","key":"2419_CR41","doi-asserted-by":"publisher","DOI":"10.3390\/nu11040825","volume":"11","author":"LM Ashton","year":"2019","unstructured":"Ashton LM, et al. Effectiveness of interventions and behaviour change techniques for improving dietary intake in young adults: a systematic review and meta-analysis of RCTs. Nutrients. 2019;11(4):825.","journal-title":"Nutrients"},{"issue":"4","key":"2419_CR42","doi-asserted-by":"publisher","DOI":"10.1016\/j.advnut.2023.100156","volume":"15","author":"K Garrity","year":"2024","unstructured":"Garrity K, et al. Local food system approaches to address food and nutrition security among low-income populations: a systematic review. Adv Nutr. 2024;15(4):100156.","journal-title":"Adv Nutr"},{"issue":"8","key":"2419_CR43","doi-asserted-by":"publisher","first-page":"2580","DOI":"10.1016\/j.clnu.2019.11.025","volume":"39","author":"C de Mestral","year":"2020","unstructured":"de Mestral C, et al. Perceived barriers to healthy eating and adherence to dietary guidelines: nationwide study. Clin Nutr. 2020;39(8):2580\u20135.","journal-title":"Clin Nutr"},{"issue":"20","key":"2419_CR44","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17207479","volume":"17","author":"J-H Lim","year":"2020","unstructured":"Lim J-H, et al. Understanding how nutrition literacy links to dietary adherence in patients undergoing maintenance hemodialysis: a theoretical exploration using partial least squares structural equation modeling. Int J Environ Res Public Health. 2020;17(20):7479.","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"2419_CR45","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1093\/nutrit\/nuad072","volume":"82","author":"G Ares","year":"2024","unstructured":"Ares G, et al. Development of food literacy in children and adolescents: implications for the design of strategies to promote healthier and more sustainable diets. Nutr Rev. 2024;82(4):536\u201352.","journal-title":"Nutr Rev"},{"issue":"12","key":"2419_CR46","doi-asserted-by":"publisher","first-page":"2157","DOI":"10.1017\/S1368980019001289","volume":"22","author":"MK Taylor","year":"2019","unstructured":"Taylor MK, et al. Nutrition literacy predicts adherence to healthy\/unhealthy diet patterns in adults with a nutrition-related chronic condition. Public Health Nutr. 2019;22(12):2157\u201369.","journal-title":"Public Health Nutr"},{"key":"2419_CR47","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2023.107051","volume":"191","author":"K Hanna","year":"2023","unstructured":"Hanna K, et al. The association between loneliness or social isolation and food and eating behaviours: a scoping review. Appetite. 2023;191:107051.","journal-title":"Appetite"},{"issue":"2","key":"2419_CR48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0014669","volume":"6","author":"C Worringham","year":"2011","unstructured":"Worringham C, Rojek A, Stewart I. Development and feasibility of a smartphone, ECG and GPS based system for remotely monitoring exercise in cardiac rehabilitation. PLoS One. 2011;6(2):e14669.","journal-title":"PLoS One"},{"issue":"1","key":"2419_CR49","doi-asserted-by":"publisher","DOI":"10.1186\/s13102-024-00992-5","volume":"16","author":"A Mitropoulos","year":"2024","unstructured":"Mitropoulos A, et al. Exploring the feasibility, acceptability, and safety of a real-time cardiac telerehabilitation and tele coaching programme using wearable devices in people with a recent myocardial infarction. BMC Sports Sci Med Rehabil. 2024;16(1):207.","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"2419_CR50","doi-asserted-by":"crossref","unstructured":"Ahmed RE, et al. Empowering self-efficacy by using patient empowerment among chronic obstructive pulmonary disease: pre\u2013post-test study. in Healthcare. MDPI. 2023.","DOI":"10.3390\/healthcare11030430"},{"issue":"1","key":"2419_CR51","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-018-0749-y","volume":"19","author":"A K\u00e4rner K\u00f6hler","year":"2018","unstructured":"K\u00e4rner K\u00f6hler A, et al. Patient empowerment and general self-efficacy in patients with coronary heart disease: a cross-sectional study. BMC Fam Pract. 2018;19(1):76.","journal-title":"BMC Fam Pract"},{"key":"2419_CR52","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S425505","author":"F Sugiharto","year":"2023","unstructured":"Sugiharto F, et al. Barriers to participation in cardiac rehabilitation among patients with coronary heart disease after reperfusion therapy: a scoping review. Vasc Health Risk Manag. 2023. https:\/\/doi.org\/10.2147\/VHRM.S425505.","journal-title":"Vasc Health Risk Manag"},{"issue":"1","key":"2419_CR53","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-12-72","volume":"12","author":"S Shanmugasegaram","year":"2013","unstructured":"Shanmugasegaram S, et al. Cardiac rehabilitation barriers by rurality and socioeconomic status: a cross-sectional study. Int J Equity Health. 2013;12(1):72.","journal-title":"Int J Equity Health"},{"issue":"3","key":"2419_CR54","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21030339","volume":"21","author":"P Iyngkaran","year":"2024","unstructured":"Iyngkaran P, et al. Barriers to cardiac rehabilitation among patients diagnosed with cardiovascular diseases\u2014a scoping review. Int J Environ Res Public Health. 2024;21(3):339.","journal-title":"Int J Environ Res Public Health"},{"key":"2419_CR55","doi-asserted-by":"crossref","unstructured":"Del Buono MG, et al. Exercise intolerance in patients with heart failure: JACC state-of-the-art review. Journal of the American College of Cardiology, 2019;73(17): 2209\u20132225.","DOI":"10.1016\/j.jacc.2019.01.072"},{"key":"2419_CR56","doi-asserted-by":"crossref","unstructured":"Bozkurt B, et al. Cardiac rehabilitation for patients with heart failure: JACC expert panel. Journal of the American College of Cardiology, 2021;77(11): 1454\u20131469.","DOI":"10.1016\/j.jacc.2021.01.030"},{"key":"2419_CR57","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.709898","volume":"8","author":"A Passantino","year":"2021","unstructured":"Passantino A, et al. The future of exercise-based cardiac rehabilitation for patients with heart failure. Front Cardiovasc Med. 2021;8:709898.","journal-title":"Front Cardiovasc Med"},{"issue":"1","key":"2419_CR58","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-69929-9","volume":"14","author":"L Liu","year":"2024","unstructured":"Liu L, et al. Prevalence and influencing factors of kinesiophobia in patients with heart disease: a meta-analysis and systematic review. Sci Rep. 2024;14(1):18956.","journal-title":"Sci Rep"},{"key":"2419_CR59","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S440984","author":"Z Yang","year":"2023","unstructured":"Yang Z, et al. \u201cChallenges to normalcy\u201d-perceived barriers to adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure. Patient Prefer Adherence. 2023. https:\/\/doi.org\/10.2147\/PPA.S440984.","journal-title":"Patient Prefer Adherence"},{"issue":"2","key":"2419_CR60","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1097\/HCR.0b013e3181be7e32","volume":"30","author":"B Eder","year":"2010","unstructured":"Eder B, et al. Early 4-week cardiac rehabilitation exercise training in elderly patients after heart surgery. J Cardiopulm Rehabil Prev. 2010;30(2):85\u201392.","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"3","key":"2419_CR61","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1016\/j.mayocp.2025.01.015","volume":"100","author":"CJ Lavie","year":"2025","unstructured":"Lavie CJ, Laukkanen JA, Nath KA. Cardiorespiratory fitness and Mayo Clinic proceedings. Mayo Clin Proc. 2025;100(3):402\u20134.","journal-title":"Mayo Clin Proc"},{"key":"2419_CR62","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2026.07.004","author":"F Sanchis-Gomar","year":"2026","unstructured":"Sanchis-Gomar F, et al. Physical activity, fitness, and longevity. Prog Cardiovasc Dis. 2026. https:\/\/doi.org\/10.1016\/j.pcad.2026.07.004.","journal-title":"Prog Cardiovasc Dis"},{"issue":"17","key":"2419_CR63","doi-asserted-by":"publisher","DOI":"10.3390\/nu16173007","volume":"16","author":"Y Xie","year":"2024","unstructured":"Xie Y, Gu Y, Li Z, He B, Zhang L. Effects of different exercises combined with different dietary interventions on body composition: a systematic review and network meta-analysis. Nutrients. 2024;16(17):3007.","journal-title":"Nutrients"}],"container-title":["Current Cardiology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11886-026-02419-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11886-026-02419-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11886-026-02419-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:29:28Z","timestamp":1789457368000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11886-026-02419-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":63,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2419"],"URL":"https:\/\/doi.org\/10.1007\/s11886-026-02419-8","relation":{},"ISSN":["1534-3170"],"issn-type":[{"value":"1534-3170","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"assertion":[{"value":"3 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable. This article is a review based on previously published studies.","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"95"}}