Exercise and Dietary Interventions for Metabolic Diseases: Synergistic Effects, Biomarker Responses, and Population-Level Evidence

Metabolic diseases, including type 2 diabetes mellitus, metabolic syndrome, and metabolic-associated fatty liver disease, have become a global public health burden with rapidly rising prevalence worldwide, driven largely by overnutrition, poor diet quality, and sedentary lifestyles, and imposing enormous clinical and economic burden on healthcare systems. The combined intervention of diet and exercise is widely regarded as a first-line lifestyle strategy for the prevention and management of metabolic diseases: nutritional interventions, including optimized dietary patterns, macronutrient balance, and bioactive food components, directly target metabolic homeostasis, while exercise training amplifies these effects by enhancing insulin sensitivity, energy expenditure, and cardiometabolic adaptation. Accumulating evidence demonstrates that integrated exercise-dietary interventions yield greater improvements in glucolipid metabolism, body composition, and cardiometabolic risk reduction than either strategy alone, underscoring the promise of combined lifestyle approaches.Despite this promise, three critical gaps limit translation into practice. First, high-quality evidence on optimal combination regimens—pairing novel exercise modalities (e.g., blood flow restriction training, high-intensity interval training) with specific dietary strategies—remains scarce, including dose-response and long-term efficacy data. Second, population-level evidence on how combined exercise-dietary exposure affects metabolic disease incidence across different populations is limited, and why individuals respond differently is poorly understood. Third, exercise-induced biomarkers such as N-lactoylphenylalanine (Lac-Phe), also regulated by dietary protein intake, represent a potential connection among exercise, diet and metabolic outcomes —but their role in appetite regulation and metabolic outcomes remains unexplored. This Research Topic will address these three gaps directly. This Research Topic aims to advance understanding of combined exercise and dietary interventions for metabolic diseases by compiling the latest findings from clinical trials, community-based intervention studies, prospective population cohorts, and systematic reviews. It seeks to bridge key evidence gaps regarding the efficacy, real-world applicability, and population-specific effects of integrated exercise-dietary strategies. The core objectives are to identify optimal combined intervention regimens, characterize determinants of intervention response heterogeneity, explore the mechanistic role of specific dietary patterns and exercise-induced biomarkers in metabolic regulation, and clarify long-term metabolic benefits, ultimately providing evidence-based support for clinical decision-making and public health policy for metabolic disease control.This Research Topic focuses exclusively on human studies examining exercise and dietary interventions for metabolic diseases; animal studies are not within scope. We welcome Original Research, Randomized Controlled Trials, prospective cohort studies, Systematic Reviews, Meta-Analyses, and Brief Research Reports. Manuscripts using public data repositories, such as NHANES or Mendelian Randomization, must include appropriate validation. Relevant themes include, but are not limited to: ● Clinical efficacy of combined exercise and dietary interventions on glucolipid homeostasis, body composition, and cardiometabolic outcomes in patients with type 2 diabetes, metabolic syndrome, or metabolic-associated fatty liver disease, including novel modalities such as blood flow restriction training, snacking exercise, and high-intensity interval training combined with dietary strategies● Population-based evidence from prospective cohorts and randomized controlled trials on the association between combined physical activity and dietary patterns and the long-term incidence and progression of metabolic disorders across diverse age, sex, and ethnic groups● Dose-response relationships, optimal combination modalities, and comparative effectiveness of different exercise types paired with distinct dietary patterns for metabolic disease management ● Real-world implementation, adherence, and long-term effectiveness of community- or clinic-based integrated exercise-dietary programs for metabolic disease prevention and control ● Predictive biomarkers and determinants of response heterogeneity to combined exercise-dietary interventions, and their application in personalized lifestyle management for metabolic disorders● Exercise-induced biomarkers and exerkines—including N-lactoylphenylalanine (Lac-Phe), whose production is modulated by exercise and dietary protein intake, appetite-regulating hormones (ghrelin, GLP-1), and other metabolic mediators—and their role as mechanistic links at the intersection of exercise, diet, and metabolic outcomes● Efficacy and feasibility of digitally mediated or remote combined exercise-dietary interventions in real-world metabolic disease care ● Early preventive effects of combined exercise and dietary strategies on subclinical metabolic abnormalities, such as prediabetes and dyslipidemia, in population cohorts Topic editors: Shuoqi Li, Fui Chee Woon, Feifei Li Source: https://www.frontiersin.org/research-topics/84221/exercise-and-dietary-interventions-for-metabolic-diseases-synergistic-effects-biomarker-responses-and-population-level-evidence