Effect of combined lifestyle intervention on cardiometabolic risk in cancer survivors: A systematic review and meta-analysis of randomized controlled trials
In brief
Cut BMI by 0.27 SD and fasting glucose by 0.29 SD with combined diet-exercise programs in
A meta-analysis of 21 randomized trials found that lifestyle programs targeting diet and exercise produced modest but significant reductions in body-mass-index (standardized mean difference ≈ -0.27) and fasting blood glucose (≈ -0.29) among breast and prostate cancer survivors. Benefits were also seen for LDL, diastolic pressure and triglycerides, though the overall effect size was small and varied by program design, highlighting the need for more standardized, digitally supported interventions.
- Journal
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Q1)
- Published
- 15 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Yimin Tang, Yuxuan Huang, Weijie Xing
- PMID
- 42455364
- DOI
- 10.1007/s00520-026-10982-7
Why clinicians should know about it
- Picked for Rehabilitation (top studies of the week, 19 July 2026).
- Picked for Urology (top studies of the week, 19 July 2026).
Abstract
PURPOSE: Unhealthy lifestyle behaviors are significant and adjustable contributors to cardiometabolic abnormalities among cancer survivors. Combined lifestyle interventions (CLIs), addressing multiple behaviors simultaneously, may offer superior cardioprotective effects. This systematic review and meta-analysis synthesized evidence on existing CLIs and evaluated their effectiveness in reducing cardiometabolic risk. METHODS: A comprehensive search was performed in PubMed, Web of Science, EMBASE, CINAHL, the Cochrane Library, CNKI, Wanfang, SinoMed, and Yiigle until December 3, 2025, following the PRISMA checklist. Standardized mean difference (SMD) and 95% confidence intervals (95% CI) were estimated using random-effects models. Heterogeneity and publication bias were also assessed. RESULTS: Of the 7649 articles screened, 25 met criteria, and 21 were included in meta-analysis. Interventions primarily focused on diet and exercise, with several also incorporating psychological support, alcohol abstinence, or weight management. Studies mainly targeted breast and prostate cancer survivors, with varied cardiometabolic outcomes. CLIs demonstrated greater improvements in body mass index (n = 16, SMD = -0.27, 95% CI = -0.38 to -0.15, P < 0.001), fasting blood glucose (n = 12, SMD = -0.29, 95% CI = -0.54 to -0.04, P = 0.021), low-density lipoprotein (n = 8, SMD = -0.15, 95% CI = -0.30 to -0.01, P = 0.039), diastolic blood pressure (n = 10, SMD = -0.12, 95% CI = -0.20 to -0.04, P = 0.003), and triglycerides (n = 10, SMD = -0.26, 95% CI = -0.43 to -0.08, P = 0.004). Subgroup analyses showed limited differences across intervention types, except for effects on fasting blood glucose levels. CONCLUSIONS: CLIs are associated with modest but statistically significant improvements in cardiometabolic risk management among cancer survivors. Further studies may prioritize more consistent frameworks for defining CLIs, while incorporating digital health technologies and evidence-based behavior change strategies to enhance intervention effectiveness and sustainability. REVIEW REGISTRATION: Registered on PROSPERO (CRD420251013007).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.