Effectiveness of moderate-to-low intensity exercise snacks on glucose and lipid metabolism in sedentary adults: a systematic review and meta-analysis.

Background: This study aims to examine the effects of moderate-to-low-intensity exercise snacks on glucose and lipid metabolism in sedentary adults and to identify the optimal exercise intervention protocol. Methods: We systematically searched five databases (PubMed, Web of Science, Google Scholar, Wan fang, and China National Knowledge Infrastructure) from their inception to July 28, 2025, to identify randomized controlled trials evaluating exercise-based snacking interventions. Meta-analyses were performed using Stata (version 12.0) and R (version 4.5.0), with additional subgroup analyses, meta-regression, sensitivity analyses, and assessments of publication bias. Results: A total of 15 studies comprising 334 participants were included. Meta-analysis demonstrated statistically significant effects of moderate-to-low intensity exercise on fasting plasma glucose [SMD=-0.52, 95%CI=(-0.93,-0.12), P = 0.012], total cholesterol [SMD=-0.33, 95%CI=(-0.62,-0.04), P = 0.026], triglycerides [SMD=-0.42, 95%CI=(-0.81,-0.02), P = 0.041] and low-density lipoprotein cholesterol [SMD=-0.51, 95%CI=(-0.84,-0.18), P = 0.003]. In contrast, no significant effects were observed for fasting insulin[SMD=-0.13, 95%CI=(-0.68,0.43), P = 0.652] or high-density lipoprotein cholesterol [SMD = 0.31, 95% CI=(-0.15,0.78), P = 0.104]. Subgroup analyses showed that walking, exercising more than five times per day, and acute interventions lasting ≤3 weeks were associated with greater improvements in fasting plasma glucose and triglycerides levels. In addition, total cholesterol improved more markedly when interruptions of sedentary behavior lasted >30 minutes and exercise bouts lasted >3 minutes. Meta-regression analyses further identified sample size and body mass index as significant moderators of fasting plasma glucose and triglycerides levels. Conclusion: Moderate-to-low-intensity exercise combined with exercise snacks significantly improved fasting plasma glucose, total cholesterol, triglycerides, and low-density lipoprotein cholesterol levels in sedentary adults, but had no significant effects on fasting insulin or high-density lipoprotein cholesterol levels. Moreover, walking, exercising more than five times per day, and maintaining the intervention for 1 to 3 weeks may be associated with greater improvements in glucose and lipid metabolism in this population. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251090803.