Irka Dwi Fatmawati, Rahayu Sutrisno, Fajar Ari Nugroho, Mahenderan Appukutty, Yit Siew Chin, Nia Novita Wirawan
Introduction: Obesity and poor body composition are major contributors to chronic disease risk in adults. This review aimed to compare the effectiveness of exercise-only, diet-only, and combined interventions in improving body composition outcomes. Methods: A systematic review and meta-analysis were conducted based on studies published between 2016 and 2024 from Scopus, Web of Science, and ScienceDirect. Forty-six studies involving 3,429 adults across five continents met inclusion criteria. Quality appraisal followed PRISMA and MMAT guidelines. A meta-analysis using RevMan 5.4 included six eligible studies. Results: Combined interventions resulted in the most consistent improvements in body mass index (BMI) (SMD, −1.74; 95 % CI: −3.07 to-0.40; P =.01), body fat percentage (%BF) (SMD, −2.40; 95 % CI: −2.91 to −1.88; P <.00001), and total body water (TBW) (SMD, 1.54; 95 % CI: 1.04 to 2.04; P <.00001). Exercise-only and diet-only approaches also improved BMI and fat mass but had limited effects on muscle mass and TBW. Conclusions: Integrated interventions combining physical activity and dietary changes are more effective than single-modality strategies. Programs of at least 12 weeks with supervision and cultural adaptation are recommended for optimal improvements in adult body composition. Systematic Review Registration: This Systematic review is registered at PROSPERO (Reference number: CRD420251020596). © The Author(s) 2025:.
Master of Nutrition Science Study Program, Faculty of Health Science, Universitas Brawijaya, East Java, Malang, Indonesia; Department of Nutrition, Faculty of Health Science, Universitas Brawijaya, East Java, Malang, Indonesia; Sports Science Programme Faculty of Sports Science & Recreation, Universiti Teknologi MARA, Selangor, Shah Alam, Malaysia; Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Serdang, Malaysia; Research Centre of Excellence on Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Serdang, 43400, Malaysia; PUTRA-Strategic Health & Advanced Prevention for Excess Weight & Obesity (PUTRA-SHAPE), Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Serdang, 43400, Malaysia
