Table 1.
Outcomes and subgroup analysis based on indicators related to CVD.
|
Type of research and meta–analyses variables |
Number of studies (included multi–arm study) |
Number of participants | Weighted mean difference | Heterogeneity | |||
|---|---|---|---|---|---|---|---|
| Intervention | CG | I2(%) | P | ||||
| RCT | |||||||
| Primary | |||||||
| Lipids | TG | 76 | 2,386 | 2,272 | −7.27 (−9.68 to −4.87) | 0 | 0.670 |
| TC | 79 | 2,298 | 2,214 | −6.84 (−9.15 to −4.52) | 38.4 | <0.001 | |
| HDL | 84 | 2,568 | 2,450 | 2.38 (1.00 to 3.76) | 84.7 | <0.001 | |
| LDL | 78 | 2,435 | 2,322 | −5.80 (−8.04 to −3.57) | 65.5 | <0.001 | |
| Secondary outcomes | |||||||
| Others | BMI | 89 | 3,204 | 3,016 | −0.36 (−0.43 to −0.30) | 0 | 0.998 |
| SBP | 65 | 1,820 | 1,680 | −3.63 (−4.62 to −2.64) | 58.0 | <0.001 | |
| DBP | 63 | 1,759 | 1,614 | −2.25 (−2.94 to −1.56) | 51.3 | <0.001 | |
| GlU | 65 | 1,743 | 1,670 | −4.40 (−5.44 to −3.36) | 86.5 | <0.001 | |
| Subgroup analysis based on TG | |||||||
| Region | Overall | 76 | 2,386 | 2,272 | −7.27 (−9.68 to −4.87) | 0 | 0.670 |
| Developing countries | 13 | 346 | 345 | −13.83 (−19.88 to −7.79) | 0 | 0.665 | |
| Developed countries | 63 | 2,040 | 1,927 | −6.04 (−8.66 to −3.41) | 0 | 0.727 | |
| Intervention time | Overall | 76 | 2,386 | 2,272 | −7.27 (−9.68 to −4.87) | 0 | 0.670 |
| ≤12weeks | 41 | 1,026 | 944 | −7.74 (−11.11 to −4.37) | 12.1 | 0.228 | |
| >12weeks | 35 | 1,360 | 1,328 | −6.79 (−10.23 to −3.35) | 0 | 0.929 | |
| Published year | Overall | 76 | 2,386 | 2,272 | −7.27 (−9.68 to −4.87) | 0 | 0.670 |
| ≤2015 | 54 | 1,651 | 1,582 | −9.30 (−12.46 to −6.15) | 0 | 0.522 | |
| >2015 | 22 | 735 | 690 | −4.34 (−8.16 to −0.71) | 0 | 0.884 | |
| Age | Overall | 75 | 2,366 | 2,224 | −7.31 (−9.72 to −4.90) | 0 | 0.653 |
| ≤60 | 54 | 1,782 | 1,596 | −6.27 (−9.24 to −3.30) | 0 | 0.928 | |
| >60 | 21 | 584 | 628 | −9.33 (−13.45 to −5.20) | 30.4 | 0.076 | |
| Male to female ratio | Overall | 72 | 2,264 | 1,982 | −7.26 (−9.744 to −4.77) | 0 | 0.555 |
| Female<male | 51 | 1,685 | 1,483 | −6.34 (−9.40 to −3.28) | 0 | 0.495 | |
| Male≥female | 21 | 579 | 499 | −9.03 (−13.29 to −4.78) | 0 | 0.574 | |
| Sedentary | Overall | 76 | 2,386 | 2,272 | −7.27 (−9.68 to −4.87) | 0 | 0.670 |
| Yes | 45 | 1,472 | 1,438 | −7.18 (−10.31 to −4.04) | 0 | 0.918 | |
| No/NR | 31 | 914 | 834 | −7.41 (−11.16 to −3.65) | 17.8 | 0.163 | |
| Exercise type | Overall | 76 | 2,386 | 2,272 | −7.27 (−9.68 to −4.87) | 0 | 0.670 |
| AE | 55 | 1,550 | 1,455 | −6.99 (−10.04 to −3.94) | 0 | 0.525 | |
| RE | 16 | 314 | 303 | −10.02 (−16.36 to −3.68) | 0 | 0.823 | |
| ME | 16 | 499 | 491 | −6.80 (−12.15 to −1.45) | 10.6 | 0.332 | |
| MBE | 2 | 23 | 23 | −3.40 (−16.84 to −10.04) | 10.0 | 0.292 | |
| Subgroup analysis based on TC | |||||||
| Region | Overall | 79 | 2,298 | 2,214 | −6.84 (−9.15 to −4.52) | 38.4 | <0.001 |
| Developing countries | 15 | 385 | 382 | −11.03 (−18.47 to −3.60) | 64.0 | <0.001 | |
| Developed countries | 64 | 1,913 | 1,832 | −5.93 (−8.08 to −3.78) | 19.3 | <0.1 | |
| Intervention time | Overall | 79 | 2,298 | 2,214 | −6.84 (−9.15 to −4.52) | 38.4 | <0.001 |
| ≤12weeks | 43 | 1,054 | 971 | −7.72 (−11.56 to −3.89) | 45.7 | <0.001 | |
| >12weeks | 36 | 1,244 | 1,243 | −6.06 (−8.79 to −3.33) | 27.0 | <0.1 | |
| Published year | Overall | 79 | 2,298 | 2,214 | −6.84 (−9.15 to −4.52) | 38.4 | <0.001 |
| ≤2015 | 56 | 1,720 | 1,681 | −6.82 (−9.54 to −4.09) | 38.0 | <0.01 | |
| >2015 | 33 | 578 | 533 | −6.84 (−11.24 to −2.45) | 39.2 | <0.1 | |
| Age | Overall | 77 | 2,269 | 2,188 | −6.54 (−8.83 to −4.26) | 36.8 | <0.001 |
| ≤60 | 54 | 1,641 | 1,509 | −6.81 (−9.40 to −4.22) | 31.9 | <0.01 | |
| >60 | 23 | 628 | 679 | −6.56 (−11.41 to −1.70) | 48.2 | <0.01 | |
| Male to female ratio | Overall | 75 | 2,067 | 1,915 | −6.99 (−9.37 to −4.60) | 37.6 | <0.001 |
| Female<male | 51 | 1,557 | 1,465 | −6.52 (−9.49 to −3.55) | 43.5 | <0.001 | |
| Male≥female | 24 | 510 | 450 | −8.47 (−12.38 to −4.56) | 20.4 | 0.164 | |
| Sedentary | Overall | 79 | 2,298 | 2,214 | −6.84 (−9.15 to −4.52) | 38.4 | <0.001 |
| Yes | 48 | 1,462 | 1,423 | −5.05 (−7.92 to −2.19) | 31.1 | 0.011 | |
| No/NR | 31 | 836 | 791 | −9.31 (−12.96 to −5.67) | 41.5 | 0.004 | |
| Exercise type | Overall | 79 | 2,298 | 2,214 | −6.84 (−9.15 to −4.52) | 38.4 | <0.001 |
| AE | 58 | 1503 | 1417 | −5.70 (−8.53 to −2.88) | 35.4 | <0.01 | |
| RE | 16 | 306 | 296 | −8.77 (−16.51 to −1.04) | 53.1 | <0.01 | |
| ME | 17 | 466 | 478 | −8.58 (−13.32 to −3.84) | 34.5 | <0.1 | |
| MBE | 2 | 23 | 23 | −14.39 (−34.10 to 5.32) | 62.4 | 0.103 | |
| Subgroup analysis based on HDL | |||||||
| Region | Overall | 84 | 2,568 | 2,450 | 2.38 (1.00 to 3.76) | 84.7 | <0.001 |
| Developing countries | 18 | 406 | 406 | 2.34 (0.77 to 3.90) | 27.3 | 0.117 | |
| Developed countries | 76 | 2,162 | 2,044 | 2.35 (0.68 to 4.01) | 87.2 | <0.001 | |
| Intervention time | Overall | 84 | 2,568 | 2,450 | 2.38 (1.00 to 3.76) | 84.7 | <0.001 |
| ≤12weeks | 45 | 1,150 | 1,058 | 2.28 (−0.16 to 4.72) | 89.3 | <0.001 | |
| >12weeks | 39 | 1,418 | 1,392 | 2.43 (1.04 to 3.83) | 70.4 | <0.001 | |
| Published year | Overall | 84 | 2,568 | 2,450 | 2.38 (1.00 to 3.76) | 84.7 | <0.001 |
| ≤2015 | 60 | 1,790 | 1,715 | 2.83 (0.95 to 4.71) | 88.0 | <0.001 | |
| >2015 | 24 | 778 | 735 | 0.95 (−0.18 to 2.08) | 26.0 | 0.101 | |
| Age | Overall | 83 | 2,548 | 2,433 | 2.34 (0.96 to 3.72) | 84.6 | <0.001 |
| ≤60 | 59 | 1,898 | 1,731 | 2.07 (1.05 to 3.10) | 56.6 | <0.001 | |
| >60 | 24 | 650 | 702 | 2.90 (−1.50 to 7.31) | 94.7 | <0.001 | |
| Male to female ratio | Overall | 82 | 2,346 | 2,160 | 2.63(1.17 to 4.08) | 85.2 | <0.001 |
| Female<male | 58 | 1,722 | 1,620 | 2.43 (0.37 to 4.49) | 89.0 | <0.001 | |
| Male≥female | 24 | 624 | 540 | 2.76 (1.53 to 3.98) | 32.9 | <0.100 | |
| Sedentary | Overall | 84 | 2,568 | 2,450 | 2.38 (1.00 to 3.76) | 84.7 | <0.001 |
| Yes | 47 | 1,515 | 1,474 | 1.17 (−0.75 to 3.09) | 85.5 | <0.001 | |
| No/NR | 37 | 1,053 | 976 | 3.84 (1.90 to 5.80) | 82.1 | <0.001 | |
| Exercise type | Overall | 84 | 2,568 | 2,450 | 2.38 (1.00 to 3.76) | 84.7 | <0.001 |
| AE | 61 | 1715 | 1590 | 2.71 (0.79 to 4.64) | 88.6 | <0.001 | |
| RE | 19 | 362 | 353 | 3.37 (1.09 to 5.66) | 43.4 | <0.1 | |
| ME | 18 | 468 | 484 | 0.49 (−2.06 to 3.04) | 75.8 | <0.001 | |
| MBE | 2 | 23 | 23 | 0.45 (−8.15 to 9.04) | 55.9 | 0.132 | |
| Subgroup analysis based on LDL | |||||||
| Region | Overall | 78 | 2,435 | 2,322 | −5.80 (−8.04 to −3.57) | 65.5 | <0.001 |
| Developing countries | 14 | 354 | 357 | −7.68 (−12.85 to −2.52) | 58.8 | <0.1 | |
| Developed countries | 64 | 2,081 | 1,965 | −5.38 (−7.87 to −2.88) | 66.9 | <0.001 | |
| Intervention time | Overall | 78 | 2,435 | 2,322 | −5.80 (−8.04 to −3.57) | 65.5 | <0.001 |
| ≤12weeks | 39 | 1,003 | 921 | −7.14 (−11.20 to −3.08) | 77.1 | <0.001 | |
| >12weeks | 39 | 1,432 | 1,401 | −3.58 (−5.68 to −1.47) | 31.6 | <0.1 | |
| Published year | Overall | 78 | 2,435 | 2,322 | −5.80 (−8.04 to −3.57) | 65.5 | <0.001 |
| ≤2015 | 57 | 1,868 | 1,798 | −4.75 (−7.33 to −2.16) | 66.9 | <0.001 | |
| >2015 | 21 | 567 | 524 | −8.94 (−13.47 to −4.41) | 61.0 | <0.001 | |
| Age | Overall | 77 | 2,405 | 2,305 | −5.72 (−7.95 to −3.49) | 65.5 | <0.001 |
| ≤60 | 55 | 1,801 | 1,641 | −3.71 (−5.44 to −1.98) | 17.7 | 0.103 | |
| >60 | 22 | 614 | 664 | −8.25 (−14.06 to −2.44) | 86.9 | <0.001 | |
| Male to female ratio | Overall | 74 | 2,213 | 2,032 | −6.32 (−8.65 to −3.98) | 67.1 | <0.001 |
| Female<male | 51 | 1,626 | 1,527 | −6.44 (−9.37 to −3.51) | 72.5 | <0.001 | |
| Male≥female | 23 | 587 | 505 | −5.73 (−9.43 to −2.02) | 44.4 | <0.01 | |
| Sedentary | Overall | 78 | 2,435 | 2,322 | −5.80 (−8.04 to −3.57) | 65.5 | <0.001 |
| Yes | 47 | 1,518 | 1,475 | −2.80 (−5.09 to −0.52) | 35.1 | <0.01 | |
| No/NR | 31 | 917 | 847 | −9.06 (−12.81 to −5.31) | 74.6 | <0.001 | |
| Exercise type | Overall | 78 | 2,435 | 2,322 | −5.80 (−8.04 to −3.57) | 65.5 | <0.001 |
| AE | 55 | 1,503 | 1,412 | −3.93 (−6.31 to −1.54) | 50.6 | <0.001 | |
| RE | 17 | 330 | 320 | −10.87 (−19.49 to −2.25) | 83.2 | <0.001 | |
| ME | 20 | 579 | 567 | −4.47 (−7.04 to −1.90) | 3.5 | 0.413 | |
| MBE | 2 | 23 | 23 | −9.76 (−21.79 to 2.26) | 0 | 0.336 | |
|
Type of research and meta–analyses variables |
Number of studies (included multi–arm study) |
Number of participants |
Hazard ratio | Heterogeneity | |||
| Exposure | REF | I 2 (%) | P | ||||
| LS | |||||||
| SB | HR | 18 | 166,816 | 216,796 | 1.34 (1.26 to 1.43) | 52.3 | <0.01 |
| PA | HR | 21 | 239,479 | 380,216 | 0.71 (0.66 to 0.77) | 78.0 | <0.001 |
| Subgroup analysis based on SB | |||||||
| Region | Overall | 18 | 166,816 | 216,796 | 1.34 (1.26 to 1.43) | 52.3 | <0.01 |
| United States | 11 | 152,605 | 184,233 | 1.33 (1.25 to 1.42) | 52.4 | <0.01 | |
| Others | 7 | 14,211 | 32,563 | 1.42 (1.11 to 1.81) | 60.0 | <0.1 | |
| Published year | Overall | 18 | 166,816 | 216,796 | 1.34 (1.26 to 1.43) | 52.3 | <0.01 |
| ≤2016 | 13 | 135,478 | 187,115 | 1.32 (1.23 to 1.42) | 59.8 | <0.01 | |
| >2016 | 5 | 31,338 | 29,681 | 1.44 (1.23 to1.68) | 23.0 | 0.261 | |
| Follow–up time | Overall | 18 | 166,816 | 216,796 | 1.34 (1.26 to 1.43) | 52.3 | <0.01 |
| ≤10 years | 12 | 125,900 | 173,235 | 1.32 (1.23 to 1.42) | 47.4 | <0.1 | |
| >10 years | 6 | 40,916 | 43,561 | 1.39 (1.23 to 1.59) | 64.1 | <0.1 | |
| Number of follow–up participants | Overall | 17 | 166,816 | 216,796 | 1.34 (1.26 to 1.43) | 55.1 | <0.01 |
| ≤10,000 | 9 | 9,817 | 11,497 | 1.56 (1.37 to 1.77) | 21.2 | 0.255 | |
| >10,000 | 8 | 156,999 | 205,299 | 1.28 (1.20 to 1.36) | 49.1 | <0.1 | |
| Disease type | Overall | 18 | 166,816 | 216,796 | 1.34 (1.26 to 1.43) | 52.3 | <0.01 |
| CVM | 7 | 90,730 | 94,255 | 1.32 (1.22 to 1.44) | 36.5 | 0.126 | |
| CVD | 12 | 76,086 | 122,541 | 1.36 (1.24 to 1.50) | 70.9 | <0.01 | |
| Male to female ratio | Overall | 16 | 165,944 | 215,954 | 1.34 (1.26 to 1.43) | 55.1 | <0.01 |
| Female<male | 11 | 99,358 | 116,547 | 1.33 (1.22 to 1.44) | 61.7 | 0.001 | |
| Male≥female | 5 | 66,586 | 99,407 | 1.37 (1.28 to 1.46) | 0 | 0.575 | |
| Quality of literature | Overall | 17 | 166,816 | 216,796 | 1.34 (1.26 to 1.43) | 52.3 | <0.01 |
| <7 | 9 | 128,139 | 175,653 | 1.39 (1.29 to 1.49) | 8.4 | 0.365 | |
| ≥7 | 8 | 38,677 | 44,143 | 1.30 (1.20 to 1.42) | 58.9 | <0.01 | |
| Subgroup analysis based on PA | |||||||
| Region | Overall | 21 | 239,479 | 380,216 | 0.71 (0.66 to 0.77) | 78.0 | <0.001 |
| United States | 8 | 180,416 | 262,215 | 0.67 (0.58 to 0.78) | 82.0 | <0.001 | |
| Others | 13 | 59,063 | 118,001 | 0.75 (0.70 to 0.81) | 55.0 | <0.01 | |
| Published year | Overall | 21 | 239,479 | 380,216 | 0.71 (0.66 to 0.77) | 78.0 | <0.001 |
| ≤2016 | 10 | 56,980 | 72,557 | 0.70 (0.65 to 0.76) | 0 | 0.683 | |
| >2016 | 11 | 182,499 | 307,659 | 0.73 (0.65 to 0.82) | 88.0 | <0.001 | |
| Follow–up time | Overall | 21 | 239,479 | 380,216 | 0.71 (0.66 to 0.77) | 78.0 | <0.001 |
| ≤10 years | 11 | 65,724 | 159,415 | 0.74 (0.68 to 0.80) | 56.2 | <0.1 | |
| >10 years | 10 | 173,755 | 220,801 | 0.69 (0.61 to 0.79) | 83.2 | <0.001 | |
| Number of follow–up participants | Overall | 19 | 239,479 | 380,216 | 0.71 (0.66 to 0.77) | 78.0 | <0.001 |
| ≤10,000 | 8 | 14,011 | 178,75 | 0.66 (0.56 to 0.79) | 75.9 | <0.001 | |
| >10,000 | 11 | 225,468 | 362,341 | 0.78 (0.73 to 0.83) | 51.9 | <0.1 | |
| Disease type | Overall | 21 | 239,479 | 380,216 | 0.71 (0.66 to 0.77) | 78.0 | <0.001 |
| CVM | 11 | 188,625 | 266,336 | 0.72 (0.65 to 0.80) | 54.4 | <0.1 | |
| CVD | 10 | 50,854 | 76,256 | 0.71 (0.63 to 0.80) | 85.8 | <0.001 | |
| Male to female ratio | Overall | 21 | 239,479 | 380,216 | 0.71 (0.66 to 0.77) | 78.0 | <0.001 |
| Female<male | 13 | 210,071 | 231,408 | 0.71 (0.64 to 0.78) | 81.7 | <0.001 | |
| Male≥female | 4 | 29,408 | 38,799 | 0.81 (0.69 to 0.96) | 61.7 | <0.1 | |
| Quality of literature | Overall | 21 | 239,479 | 380,216 | 0.71 (0.66 to 0.77) | 78.0 | <0.001 |
| <7 | 7 | 29,513 | 83,560 | 0.77 (0.70 to 0.86) | 22.5 | 0.243 | |
| ≥7 | 14 | 209,966 | 296,656 | 0.70 (0.63 to 0.77) | 84.1 | <0.001 | |
If studies reported with more than two categories of different SB, PA levels, they were converted into two groups, namely high-level SB, PA and low-level SB, PA while the later group was used as the reference category. Pool effect size: pooled WMDs (95% Confidence interval [CI]); pooled HRs(95% CI). BMI, Body mass index; CVD, Cardiovascular disease; CVM, Cardiovascular mortality; CG, Control Group; DBP, Diastolic blood pressure; HDL, High density lipoprotein; HR, Hazard Ratio; GlU, Glucose; LS, Longitudinal study; PA, Physical activity; REF, Reference; RCT, Randomized controlled trial; SBP, Systolic blood pressure; TG, Triglyceride; TC, Total cholesterol; LDL, Low density lipoprotein.