Twenty-one studies (1,011 participants, range 15 to 120) were included in the review. Trial follow-up ranged from six weeks to two years.
Diet: Two moderate quality and one low quality randomised crossover trials (86 participants).
Low-fat diets reduced mean values in total cholesterol (10.8 to 30.2mg/dL), low-density lipoprotein cholesterol (8.7 to 26.3mg/dL) and high-density lipoprotein cholesterol (3.4 to 10.1mg/dL). One trial reported reduced diastolic blood pressure (4.4mmHg) and arterial pressure (3.8mmHg) but not systolic blood pressure for participants on a low-fat diet.
Exercise: One high and 12 moderate quality trials (482 participants).
Three out of 10 trials reported significant reductions in mean total cholesterol after resistance training (12.8 to 16.3mg/dL) and aerobics (28.2 to 39.8mg/dL) compared to controls. Seven trials showed no significant changes.
Seven out of nine trials showed no significant changes in low-density lipoprotein cholesterol between exercise and control groups. Eight out of 10 trials demonstrated no significant changes in high-density lipoprotein cholesterol. One trial demonstrated improvements and one reported detrimental effects.
Four out of five trials showed no significant changes in blood pressure. No trials demonstrated significant changes in triglycerides.
Diet and exercise: One low, three moderate and one high quality trial (443 participants).
Four out of five trials each showed no effect of diet and exercise on low-density or high-density lipoprotein cholesterol.
Three out of five trials showed significant mean reductions in triglycerides (1.8 to 19.0mg/dL) among intervention participants. Two out of three trials reported significant mean reductions in systolic (3.0 to 4.1mmHg) and diastolic (2.0 to 3.0mmHg) blood pressure.