{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:10:10Z","timestamp":1793211010901,"version":"4.5.0"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Federal Ministry of Education and Research"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This overview synthesized evidence from systematic reviews (SRs) of combined physical activity (PA) and diet interventions versus diet-only or PA-only approaches on obesity-related anthropometric, cardiometabolic, and physical fitness outcomes, and identified program features linked to better effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an Overview of SRs following Cochrane guidance and PRIOR standards. Five databases were searched until June 13, 2024, and Google Scholar was updated on January 25, 2025. Eligible SRs synthesized randomized controlled trials of combined PA and diet interventions in people with overweight or obesity. We extracted key intervention characteristics, outcomes, and meta-analytic estimates where available. Methodological quality was assessed with AMSTAR 2, and overlap was quantified using the corrected covered area (CCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-two SRs (19 meta-analyses) met inclusion criteria. In adults, combined PA and diet interventions generally outperformed single-component comparators for reducing weight, BMI, waist circumference, and fat mass, and improving cardiorespiratory fitness. More favorable and sustained effects were most often reported in programs lasting \u22656\u201312 months with frequent, structured contact and supervised, resistance-inclusive exercise. In children and adolescents, face-to-face and family-engaged programs produced the most consistent improvements in BMI\/BMI-z, but effects often attenuated 6\u201312 months after program end without maintenance. In older adults, combined programs reduce fat mass while preserving lean mass, strength, and function. Across diverse settings (including type 2 diabetes, workplaces, and digital delivery), combined interventions improved glucose control, insulin resistance, lipids, and inflammation, and some benefits occurred even without additional weight loss. Long-term lifestyle programs reduced incident type 2 diabetes by about half. Review quality varied (31% high; 69% low\/critically low) and overlap between SRs was minimal (CCA 0.0\u20130.6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined PA and diet interventions tended to outperform diet-only and PA-only approaches. The most consistent and durable benefits were linked to longer duration, higher contact, supervision, resistance training, and family engagement in youth, underscoring maintenance planning. These findings support prioritizing structured lifestyle programs, including scalable hybrid\/digital delivery models, while interpreting effects cautiously given the predominance of low-quality SRs. Future research should improve rigor, standardize outcomes, report intervention dose and behavior-change methods, include longer follow-up, and improve representation of underserved groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1821389","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:47:05Z","timestamp":1778647625000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Combined diet and physical activity effects on health-related outcomes in people with overweight or obesity: an overview of systematic reviews"],"prefix":"10.3389","volume":"13","author":[{"given":"Atef","family":"Salem","sequence":"first","affiliation":[{"name":"Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz","place":["Mainz, Germany"]},{"name":"High Institute of Sport and Physical Education of Sfax, University of Sfax","place":["Sfax, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achraf","family":"Ammar","sequence":"additional","affiliation":[{"name":"Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz","place":["Mainz, Germany"]},{"name":"High Institute of Sport and Physical Education of Sfax, University of Sfax","place":["Sfax, Tunisia"]},{"name":"Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax","place":["Sfax, Tunisia"]},{"name":"Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Trabelsi","sequence":"additional","affiliation":[{"name":"Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax","place":["Sfax, Tunisia"]},{"name":"Department of Movement Sciences and Sports Training, School of Sports Science, The University of Jordan","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Boukhris","sequence":"additional","affiliation":[{"name":"SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University","place":["Melbourne, VIC, Australia"]},{"name":"Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University","place":["Melbourne, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Heydenreich","sequence":"additional","affiliation":[{"name":"Department of Experimental Sports Nutrition, Faculty of Sports Sciences, Leipzig University","place":["Leipzig, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadeel Ali","family":"Ghazzawi","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam Tawfiq","family":"Amawi","sequence":"additional","affiliation":[{"name":"Department of Movement Sciences and Sports Training, School of Sports Science, The University of Jordan","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Grosso","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Zmijewski","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Gdansk University of Physical Education and Sport","place":["Gda\u0144sk, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitham","family":"Jahrami","sequence":"additional","affiliation":[{"name":"Government Hospitals","place":["Manama, Bahrain"]},{"name":"Department of Psychiatry, College of Medicine and Health Sciences, Arabian Gulf University","place":["Manama, Bahrain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waqar","family":"Husain","sequence":"additional","affiliation":[{"name":"Department of Humanities, COMSATS University Islamabad","place":["Islamabad, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdi","family":"Chtourou","sequence":"additional","affiliation":[{"name":"High Institute of Sport and Physical Education of Sfax, University of Sfax","place":["Sfax, Tunisia"]},{"name":"Research Unit, Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang I.","family":"Sch\u00f6llhorn","sequence":"additional","affiliation":[{"name":"Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz","place":["Mainz, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","article-title":"Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults","volume":"403","author":"Phelps","year":"2024","journal-title":"Lancet"},{"key":"ref2","first-page":"1","volume-title":"Prevalence of Overweight, Obesity, and Severe Obesity among Adults Age 20 and Older: United States, 1960\u20131962 through August 2021\u2013August 2023. 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