The fitness community often debates which workout offers the most health benefits. Common contenders include running, weight training, HIIT, and yoga. However, a recent review indicates this may be the wrong question for individuals with metabolic syndrome. Research suggests different exercises benefit different aspects of this condition.

Published in the journal iScience, the study proposes more personalized exercise recommendations. Metabolic syndrome involves a combination of risk factors tied to poor metabolic health, such as high blood pressure, elevated blood sugar, excess waist fat, high triglycerides, and low HDL cholesterol. These factors raise risks for cardiovascular disease, stroke, and type 2 diabetes.

Exercise is widely recognized as beneficial. However, there’s uncertainty over which types are best for specific metabolic issues. People attempting to lower blood pressure might not benefit from the same exercises as those reducing abdominal fat or improving cholesterol.

This prompted a review of dozens of clinical trials including adults with metabolic syndrome. Researchers analyzed 53 randomized controlled trials with 2,948 participants. These studies explored various exercise methods, like aerobic exercise, resistance training, yoga, tai chi, qigong, and high-intensity interval training. The findings revealed no single exercise was best for all aspects of metabolic syndrome. Instead, different workouts had distinct strengths.

For weight and metabolic control, aerobic exercise combined with resistance training was most effective. This approach reduced waist circumference and BMI while improving LDL cholesterol and blood sugar.

Exercises incorporating breath control and mental focus, such as tai chi and qigong, showed notable improvements in HDL cholesterol and systolic blood pressure. These findings suggest low-impact activities play an essential role in metabolic health.

The analysis of high-intensity interval training revealed further details. Longer HIIT sessions were most effective in lowering body fat percentage. Meanwhile, shorter HIIT workouts excelled in reducing triglycerides, total cholesterol, and diastolic blood pressure.

The study suggests viewing metabolic syndrome as a collection of health challenges rather than a single issue. This reflects growing global concerns as approximately 1.54 billion adults lived with metabolic syndrome in 2023. Health consequences are significant, with an increased risk of cardiovascular disease and premature death. Metabolic syndrome also links to other conditions like nonalcoholic fatty liver disease, polyendocrine metabolic ovarian syndrome, and certain cancers.

Though medications can treat individual symptoms like high blood pressure or elevated blood sugar, they usually focus on specific problems rather than addressing the syndrome comprehensively. Exercise and diet influence multiple risk factors simultaneously.

The authors of the study warn that results shouldn’t be seen as definitive. The evidence for most comparisons was low or very low certainty due to differences in study design, exercise programs, and participant groups. Future trials should compare exercise methods more directly with standardized conditions.

Xinyu Shen et al, Comparative efficacy of various exercise therapies for metabolic syndrome: a systematic review and network meta-analysis, iScience (2026). DOI: 10.1016/j.isci.2026.116801