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Does exercise beneficially affect sex hormones when added to hypo-caloric diets in adults with overweight or obesity? A systematic review and meta-analysis of controlled clinical trials.

OBJECTIVE
There is no consensus of opinion if exercise beneficially affects sex hormones if added to weight-loss diets. The purpose of this study was to perform a systematic review and meta-analysis of controlled clinical trials to evaluate the effect of adding exercise to a hypo-caloric diet during a weight loss program, on serum testosterone, estradiol, and sex hormone binding globulin (SHBG) in adults with overweight/obesity.


DESIGN
Systematic review and meta-analysis of the literature.


METHODS
Online databases including PubMed/MEDLINE, EMBASE, Scopus, ISI Web of Science, and Google Scholar were searched up to April 2021. A random-effects model was applied to compare mean changes in sex hormones and SHBG between participants undergoing a hypo-caloric diet with or without exercise.


RESULTS
In total, nine eligible clinical trials with 462 participants were included. Out of these, seven, three, and four studies illustrated changes in testosterone, estradiol, and SHBG, respectively. The meta-analysis revealed that exercise had no significant effect on circulating testosterone (WMD = -0.03 nmol/L, 95% CI: -0.11, 0.06, P = 0.51), estradiol (WMD = -0.46 pg/mL, 95% CI: -1.57, 0.65, P = 0.42), and SHBG (WMD = 0.54 nmol/L, 95% CI: -2.63, 3.71, P = 0.74) when added to low-calorie diets.


CONCLUSION
The addition of exercise to a hypo-caloric diet provided no additional improvement in sex hormone profiles. Further well-designed randomized controlled trials with longer follow-up periods in both sexes are recommended to confirm and expand the current results.