Supervised Exercise Plus Diet Lowers Leptin Levels in Hypertensive Adults With Obesity: Study
Spain: In adults with hypertension and overweight or obesity, a 16-week supervised aerobic exercise program combined with a hypocaloric diet produced greater reductions in leptin levels compared with a hypocaloric diet and standard physical activity advice alone.
The findings are from a substudy of the EXERDIET-HTA trial, led by Virginia A. Aparicio and colleagues, published in Clinical Obesity. The study explored how structured lifestyle interventions influence serum leptin concentrations, a hormone increasingly recognized for its role in obesity-related hypertension.
Researchers enrolled 69 physically inactive adults with primary hypertension and overweight or obesity. Participants were assigned either to a supervised aerobic exercise program (two sessions per week) combined with a hypocaloric diet, or to an attention-control group receiving only physical activity advice alongside the same dietary intervention. Outcomes were assessed at baseline, after 16 weeks, and at six-month follow-up.
The following were the key findings from the trial:
- Both groups showed a reduction in leptin levels after the intervention, with a greater decrease in the supervised exercise group (36%) compared with the control group (23%).
- These improvements were not sustained, as leptin levels returned to baseline in both groups after six months.
- No significant differences were observed between men and women in overall changes in leptin levels.
- Body mass index emerged as the strongest independent predictor of leptin concentrations across the study population, explaining a modest proportion of variability.
- In women, waist-to-hip ratio and fat-free mass also independently influenced leptin levels, suggesting a stronger role of body fat distribution and composition in leptin regulation.
- Despite short-term metabolic improvements, no lasting differences were observed between the intervention and control groups at follow-up, indicating difficulty in maintaining hormonal benefits without ongoing structured intervention.
The authors noted several limitations, including the absence of detailed dietary intake and appetite data, lack of information on menstrual or menopausal status, and missing post-intervention physical activity data in the control group. In addition, some participants did not complete follow-up assessments, which may introduce bias. The use of multiple exercise protocols within the intervention group and the inability to establish causality were also acknowledged.
Nevertheless, the study provides important evidence that combining aerobic exercise with caloric restriction can effectively reduce leptin levels in the short term, reinforcing its role in improving metabolic health among individuals with hypertension and obesity. However, sustained lifestyle adherence appears necessary to maintain these benefits over time.
The authors conclude that future research should further explore sex-specific mechanisms and the role of fat distribution in leptin regulation, enabling more personalized lifestyle interventions for cardiometabolic risk reduction.
Reference:
Aparicio, V. A., Corres, P., Gorostegi-Anduaga, I., Margareto, J., & Maldonado-Martín, S. (2026). Aerobic Exercise Plus Hypocaloric Diet on Serum Leptin Concentrations in Adults With Primary Hypertension and Overweight/Obesity: Results From the EXERDIET-HTA Trial. Clinical Obesity, 16(3), e70080. https://doi.org/10.1111/cob.70080
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