Saco Ledo, GonzaloValenzuela Ruiz, Pedro LuisCastillo García, AdriánArenas, JoaquínLeón Sanz, MiguelRuilope Urioste, Luis MiguelLucía Mulas, Alejandro2020-11-202020-11-202021Saco, G., Valenzuela, P. L., Castillo, A., Arenas, J., León, M., Ruilope, L. M., & Lucía, A. (2021). Physical exercise and epicardial adipose tissue: A systematic review and meta‐analysis of randomized controlled trials. Obesity Reviews, 22(1), e13103. https://doi.org/10.1111/obr.131031467-78811467-789Xhttp://hdl.handle.net/11268/9503We performed a meta-analysis of the effects of exercise on epicardial adipose tissue (EAT). A systematic search was conducted in PubMed and Scopus (since inception to 1 February 2020) of randomized controlled trials assessing the effects of exercise interventions alone (with no concomitant weight loss intervention) on EAT. The standardized mean difference (Hedges' g) and 95% confidence interval between interventions were computed using a random effects model. Ten studies (including 521 participants who had, on average, overweight/obesity) met all inclusion criteria. Interventions were supervised and lasted 2 to 16 weeks (≥3 sessions·per week). Exercise significantly reduced EAT (g = 0.82 [0.57-1.07]) irrespective of the duration of the intervention or the EAT imaging assessment method. Exercise benefits were separately confirmed for endurance (six studies, n = 287; g = 0.83 [0.52-1.15]) but not for resistance exercise training (due to insufficient data for quantitative synthesis). It was not possible to compare the effect of high-intensity interval training (HIIT) versus moderate-intensity continuous training (two studies, one reporting higher benefits with HIIT and the other no differences). Physical exercise interventions-particularly endurance training, with further evidence needed for other exercise modalities-appear as an effective strategy for reducing EAT in individuals with overweight/obesity, which supports their implementation for cardiovascular risk reduction.engjournal article10.1111/obr.13103restricted accessTejido adiposoObesidadEjercicio físicoEnfermedad cardiovascularDeporteObesidad