A network meta-analysis published in iScience compared 10 exercise types across 10 metabolic health markers, according to the study's authors. The report drew on 53 randomized controlled trials involving 2,948 participants, researchers said. The authors reported that no single exercise modality ranked highest for all outcomes, with the top-ranked approach varying depending on the marker being measured. The analysis focused on metabolic syndrome, a cluster of conditions that includes central obesity, high blood pressure, elevated blood sugar, and abnormal cholesterol or triglyceride levels, according to the report. Exercise is widely recognized as a tool for managing the condition. Prior research has linked regular exercise to increased circulating levels of irisin, a signaling protein released by skeletal muscle, and to metabolic improvements in adults with overweight or obesity. Researchers evaluated aerobic training, resistance training, combined aerobic and resistance training, high-intensity interval training (HIIT), yoga, and traditional Chinese exercise practices such as Tai Chi and Qigong, the report stated. The exercise modalities included both high-volume and low-volume HIIT protocols, according to the study. Outcome measures included body mass index, waist circumference, body fat percentage, total cholesterol, HDL and LDL cholesterol, triglycerides, systolic and diastolic blood pressure, and fasting blood glucose, the report stated. The authors said the certainty of evidence was very low for most comparisons across all ten outcomes. The analysis used network meta-analysis methods to compare the exercise modalities across the pooled trial data, according to the report. The researchers said the rankings reflect the probability that each exercise type performed best for a given marker. Combined aerobic and resistance training ranked highest for body mass index, waist circumference, LDL cholesterol, and fasting blood glucose, according to the analysis. High-volume HIIT ranked highest for body fat percentage, the report stated. Low-volume HIIT ranked first for total cholesterol, triglycerides, and diastolic blood pressure, study authors said. Resistance training alone followed closely for LDL cholesterol, according to the report.