Endurance training
Raises HDL modestly and lowers triglycerides, LDL and HOMA-IR. The HDL rise is not a treatment goal. There is no defensible percentage for fasting glucose, ApoB, ferritin or uric acid.
Order of magnitude
Around one hundred and fifty minutes per week at moderate intensity, spread across at least three sessions of more than thirty minutes each.
Moderate means: talking is still possible, singing is not. Kodama 2007 puts the floor at about 120 minutes per week. Smart 2025 found the lipid benefit mainly with aerobic and combined training, not resistance alone. Fasting glucose was not significant in Lin 2015 (p = 0.06). Intense training can raise urate acutely; there is no pooled size, so there is no offset row.
Effects in detail
Each row is a directed edge from our database, with range, latency, evidence grade and the condition under which it applies at all.
| Marker | Effect | Latency | Mode of action | Outcome | Evidence | Condition | Sources |
|---|---|---|---|---|---|---|---|
| LDL cholesterol | helps. Lowers -7.22 mg/dL confidence interval of the estimate, not the range one person can expect Smart 2025 −7.22 mg/dL (95 % CI −9.08 to −5.35) at LDL 100 mg/dL. ApoB in Downes 2025 is not a credible magnitude, so there is no separate ApoB row. Trial proxy: ldl_c. | 8–20 weeks | chronic | unclear | Evidence grade A | applies regardless of the starting value | |
| Triglycerides | helps. Lowers -8.01 mg/dL confidence interval of the estimate, not the range one person can expect Smart 2025 −8.01 mg/dL, Lin 2015 −5.31 mg/dL, at a 150 mg/dL baseline. At higher baselines the absolute fall is larger. Resistance training alone did not move triglycerides in Smart 2025. | 4–12 weeks | chronic | unclear | Evidence grade A | TG at or above 150 mg/dL | |
| Apolipoprotein B | helps. Lowers Direction known, size not established A meta-analysis of 25 studies found apolipoprotein B fell significantly with exercise training, and lipoprotein(a) fell by 2.52 mg/dL. No effect size is entered because the abstract prints the apoB reduction as -0.11 mg/dL, which is implausibly small for that unit and is almost certainly g/L (about -11 mg/dL). | not specified | chronic | unclear | Evidence grade C | applies regardless of the starting value | |
| Diastolic blood pressure | helps. Lowers -2.53 mmHg one bound only: the source prints the pairwise reduction without an interval A pairwise and network meta-analysis of 270 randomised trials in 15,827 participants gives aerobic training a resting blood pressure reduction of 4.49/2.53 mmHg (p<0.001). Point estimates only; the source reports the pairwise reductions without confidence intervals in the abstract, so a single bound is entered for each. | not specified | chronic | unclear | Evidence grade A | applies regardless of the starting value | |
| Systolic blood pressure | helps. Lowers -4.49 mmHg one bound only: the source prints the pairwise reduction without an interval A pairwise and network meta-analysis of 270 randomised trials in 15,827 participants gives aerobic training a resting blood pressure reduction of 4.49/2.53 mmHg (p<0.001). Point estimates only; the source reports the pairwise reductions without confidence intervals in the abstract, so a single bound is entered for each. | not specified | chronic | unclear | Evidence grade A | applies regardless of the starting value | |
| HbA1c | helps. Lowers -0.58 percentage points of HbA1c confidence interval of the estimate, not the range one person can expect A network meta-analysis of 158 randomised trials in 17,059 people with type 2 diabetes gives aerobic training an HbA1c reduction of 0.58 percentage points (95 % CrI -0.70 to -0.45). Note how close the modalities are: interval training 0.61, combined 0.58, aerobic 0.58, resistance 0.40, and simply being advised to be active 0.35. | 12–12 weeks | chronic | unclear | Evidence grade A | applies regardless of the starting value |
What this measure costs
Counteracting effects of the same measure.
No counteracting effect is on file for this measure. That does not mean there is none, only that we found no defensible edge.
Moves without implying progress
Informational or no established effect: the marker moves or was checked, and that is not progress.
| Marker | Effect | Latency | Mode of action | Outcome | Evidence | Condition | Sources |
|---|---|---|---|---|---|---|---|
| HDL cholesterol | moves, and does not count. Raises 2.11 mg/dL confidence interval of the estimate, not the range one person can expect About +2.1 to +2.5 mg/dL (Smart 2025, Kodama 2007, Lin 2015) at a baseline of 45 mg/dL. Raising HDL is not a treatment goal. | 8–20 weeks | chronic | no | Evidence grade A | applies regardless of the starting value | |
| Alanine aminotransferase | checked, nothing happens. No established effect Across 21 randomised trials in 1530 people, exercise training reduced intrahepatic fat by 3.46 percentage points where the programme workload exceeded 10,000 kcal, but ALT, AST and gamma-GT were not significantly altered. One of the more useful rows in this database. | not specified | chronic | unclear | Evidence grade B | applies regardless of the starting value | |
| Gamma-glutamyltransferase | checked, nothing happens. No established effect In the same 21 trials, gamma-glutamyl transpeptidase was not significantly altered by exercise training. A deliberate no-effect row. | not specified | chronic | unclear | Evidence grade B | applies regardless of the starting value | |
| high-sensitivity CRP | moves, and does not count. Lowers Effect size, not in the marker's unit confidence interval of the estimate, not the range one person can expect Across 83 controlled trials with 143 effects in 3769 people, exercise training lowered CRP with a mean effect size of 0.26 (95 % CI 0.18 to 0.34). No mg/L figure: the source reports standardised effect sizes only, so this row carries direction and no magnitude. | not specified | chronic | unclear | Evidence grade B | applies regardless of the starting value | |
| Lipoprotein(a) | checked, nothing happens. No established effect The consensus table of non-genetic influences on Lp(a) lists physical activity as having no or minimal effect, and fasting as having none. A deliberate no-effect row. | not specified | chronic | unclear | Evidence grade C | applies regardless of the starting value |
Sources
Full details of every study the rows above rely on.
Effects of exercise training on blood lipids: a systematic review and meta-analysis of randomised controlled trials
Smart et al. · Sports Medicine · 2025 · Meta-analysis
Effects of exercise training on apolipoproteins and lipoprotein(a): a systematic review and meta-analysis
Downes et al. · International Journal of Sports Medicine · 2025 · Review
Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials
Boussageon et al. · BMJ · 2011 · Meta-analysis
Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials
Fedewa et al. · British Journal of Sports Medicine · 2017 · Meta-analysis
Effects of exercise training and physical activity advice on HbA1c in people with type 2 diabetes: a network meta-analysis of randomized controlled trials
Garcia et al. · Diabetes Research and Clinical Practice · 2025 · Meta-analysis
Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement
Kronenberg et al. · European Heart Journal · 2022 · Guideline
Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials
Edwards et al. · British Journal of Sports Medicine · 2023 · Meta-analysis
Effect of exercise training on liver function in adults who are overweight or exhibit fatty liver disease: a systematic review and meta-analysis
Smart et al. · British Journal of Sports Medicine · 2018 · Meta-analysis
Comparative efficacy of exercise modalities on cardiometabolic risk factors in overweight and obesity: a network meta-analysis
Wang H et al. · Frontiers in Endocrinology · 2024 · Review
Lifestyle interventions for patients with nonalcoholic fatty liver disease: a network meta-analysis
Zou et al. · European Journal of Gastroenterology & Hepatology · 2018 · Meta-analysis