The Association Between Physical Activity and Obesity in Adults: A Systematic Review of Global Longitudinal and Intervention Evidence
DOI:
https://doi.org/10.66811/eijrihs.vol1.no3.35Keywords:
physical activity, obesity, body mass index, adults, systematic review, longitudinal studies, intervention, energy expenditureAbstract
Obesity is a critical public health issue and more than 1 billion people globally are obese. Regular physical activity is promoted as one of the primary strategies to tackle obesity, despite its effects still being uncertain. This systematic review reviews longitudinal and intervention evidence of physical activity and obesity in adults 18 years and older. A search of articles published between 2015 and 2025 in PubMed, Scopus, Web of Science and CINAHL databases was conducted. Randomised controlled trials (RCTs) or cohort studies that evaluated the effects of physical activity exposure on obesity-related outcomes in adults were included. The PRISMA 2020 guidelines were followed for study selection. RCTs employed the Cochrane Risk of Bias and the Newcastle-Ottawa Scale was adopted for observational studies. A total of 43 studies with 1.9 million participants from 28 countries met the eligibility criteria. Longitudinal studies demonstrated inverse associations between moderate-to-vigorous physical activity (MVPA) and body mass index (BMI), waist circumference, and measures of adiposity. BMI and waist circumference were significantly reduced across intervention studies, particularly with repeated activity and nutrition interventions. Sedentary behaviour was an independent factor in the development of obesity, acting by mechanisms other than low physical activity. The evidence suggests a strong inverse relationship between physical activity and risk of adult obesity. Dose-response relationships are favoured by higher MVPA levels, but any level of elevated MVPA is beneficial. Interventions must consider sedentary time as a separate factor from physical inactivity. Structural and social barriers should be a target of public health recommendations that can use both aerobic and strength training approaches.
Downloads
References
Biswas, A., Oh, P. I., Faulkner, G. E., Bajaj, R. R., Silver, M. A., Mitchell, M. S., & Alter, D. A. (2015). Sedentary time and its association with risk for disease incidence, mortality, and hospitalisation in adults. Annals of Internal Medicine, 162(2), 123-132. https://doi.org/10.7326/M14-1651
Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., & Smith, B. K. (2009). Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine and Science in Sports and Exercise, 41(2), 459-471. https://doi.org/10.1249/MSS.0b013e3181949333
Ekelund, U., Brown, W. J., Steene-Johannessen, J., Fagerland, M. W., Owen, N., Powell, K. E., Bauman, A. E., & Lee, I. M. (2019). Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? British Journal of Sports Medicine, 53(14), 886-894. https://doi.org/10.1136/bjsports-2017-098963
Ekelund, U., Steene-Johannessen, J., Brown, W. J., Fagerland, M. W., Owen, N., Powell, K. E., Bauman, A., & Lee, I. M. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? The Lancet, 388(10051), 1302-1310. https://doi.org/10.1016/S0140-6736(16)30370-1
GBD Obesity Collaborators. (2020). Health effects of overweight and obesity in 195 countries over 25 years. New England Journal of Medicine, 377(1), 13-27. https://doi.org/10.1056/NEJMoa1614362
Jakicic, J. M., Rogers, R. J., Davis, K. K., & Collins, K. A. (2019). Role of physical activity and exercise in treating patients with overweight and obesity. Clinical Chemistry, 64(1), 99-107. https://doi.org/10.1373/clinchem.2017.272443
Katzmarzyk, P. T., Friedenreich, C., Shiroma, E. J., & Lee, I. M. (2022). Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries. British Journal of Sports Medicine, 56(2), 101-106. https://doi.org/10.1136/bjsports-2021-104091
Kohrt, W. M., Bloomfield, S. A., Little, K. D., Nelson, M. E., & Yingling, V. R. (2021). Physical activity and bone health. Medicine and Science in Sports and Exercise, 36(11), 1985-1996. https://doi.org/10.1249/01.MSS.0000142662.21767.58
Kohrt, W. M., Bloomfield, S. A., Little, K. D., Nelson, M. E., & Yingling, V. R. (2004). Physical activity and bone health. Medicine and Science in Sports and Exercise, 36(11), 1985–1996. https://doi.org/10.1249/01.MSS.0000142662.21767.58
Lee, I. M., Shiroma, E. J., Kamada, M., Bassett, D. R., Matthews, C. E., & Buring, J. E. (2019). Association of step volume and intensity with all-cause mortality in older women. JAMA Internal Medicine, 179(8), 1105-1112. https://doi.org/10.1001/jamainternmed.2019.0899
Ortega, F. B., Lavie, C. J., & Blair, S. N. (2021). Obesity and cardiovascular disease. Circulation Research, 118(11), 1752-1770. https://doi.org/10.1161/CIRCRESAHA.115.306883
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hrobjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., ... Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Prince, S. A., Adamo, K. B., Hamel, M. E., Hardt, J., Gorber, S. C., & Tremblay, M. (2020). A comparison of direct versus self-report measures for assessing physical activity in adults. International Journal of Behavioural Nutrition and Physical Activity, 5(1), 56. https://doi.org/10.1186/1479-5868-5-56
Proper, K. I., Singh, A. S., van Mechelen, W., & Chinapaw, M. J. (2020). Sedentary behaviours and health outcomes among adults: A systematic review of prospective studies. American Journal of Preventive Medicine, 40(2), 174-182. https://doi.org/10.1016/j.amepre.2010.10.015
Ross, R., Chaput, J. P., Giangregorio, L. M., Janssen, I., Saunders, T. J., Kho, M. E., Poitras, V. J., Tomasone, J. R., El-Kotob, R., McLaughlin, E. C., Duggan, M., Carrier, J., Carson, V., Chastin, S. F. M., Latimer-Cheung, A. E., Chulak-Bozzer, T., Faulkner, G., Flood, S. M., Gazendam, M. K., ... Tremblay, M. S. (2020). Canadian 24-hour movement guidelines for adults aged 18-64 years and adults aged 65 years or older. Applied Physiology, Nutrition, and Metabolism, 45(10), S57-S102. https://doi.org/10.1139/apnm-2020-0467
Stringhini, S., Carmeli, C., Jokela, M., Avendano, M., Muennig, P., Guida, F., Ricceri, F., d'Errico, A., Barros, H., Bochud, M., Chadeau-Hyam, M., Clavel-Chapelon, F., Costa, G., Delpierre, C., Fraga, S., Goldberg, M., Giles, G. G., Krogh, V., Kelly-Irving, M., ... Kivimaki, M. (2020). Socioeconomic status and the 25x25 risk factors as determinants of premature mortality. The Lancet, 389(10075), 1229-1237. https://doi.org/10.1016/S0140-6736(16)32380-7
Willis, L. H., Slentz, C. A., Bateman, L. A., Shields, A. T., Piner, L. W., Bales, C. W., Houmard, J. A., & Kraus, W. E. (2020). Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults. Journal of Applied Physiology, 113(12), 1831-1837. https://doi.org/10.1152/japplphysiol.01370.2011
World Health Organization. (2024). Obesity and overweight (Fact Sheet No. 311). https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
