29/05/2026
Exercise Plus Diet Lowers Leptin in Hypertensive Obesity
Edited by Javed Choudhury
May 22, 2026
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TOPLINE:
Among adults with hypertension and overweight or obesity, a 16-week supervised aerobic exercise program combined with a hypocaloric diet reduced leptin levels more than a hypocaloric diet plus physical activity advice alone.
METHODOLOGY:
Elevated circulating levels of leptin are linked to obesity-related hypertension through selective leptin resistance, impaired metabolic effects, and mitochondrial dysfunction.
Researchers conducted a substudy of a clinical trial to examine the effects of a 16-week supervised aerobic exercise program combined with a hypocaloric diet on serum leptin levels in 69 physically inactive adults (32 female, 37 male) with stage I/II hypertension and overweight or obesity. Sex-specific differences and the maintenance of leptin changes at 6 months were also assessed.
Participants were randomly assigned to supervised aerobic exercise (two nonconsecutive moderate- or high-intensity sessions weekly) or an attention control group that received physical activity advice alone; both groups followed a hypocaloric Dietary Approaches to Stop Hypertension diet, and 47 participants completed the intervention.
Researchers assessed serum leptin, insulin, C-reactive protein, glucose, BMI, waist and hip circumferences, total body mass, fat-free mass, fat mass, cardiorespiratory fitness (peak oxygen uptake [VO2] peak), blood pressure, and lipid profiles at baseline and after 16 weeks. Participants were followed for an additional 6 months without supervision.
TAKEAWAY:
After 16 weeks, leptin levels decreased by 36% from baseline in the supervised exercise group (P = .003) and by 23% in the attention control group (P = .06). Leptin levels declined in both sexes in the exercise-plus-diet group but returned to baseline at the 6-month follow-up.
BMI was the only independent factor associated with increased leptin levels in all participants (beta-coefficient, 0.339; P < .001), accounting for 12% of the variability. In sex-specific analyses, BMI explained roughly 15% of leptin variation in men and 24% in women.
Among women, a higher waist‑to‑hip ratio and lower fat‑free mass were also independently associated with higher leptin.
Changes in BMI and fat mass from baseline to post-intervention correlated significantly with changes in leptin levels (P = .013 and P = .006, respectively).
At 6 months, the supervised exercise group maintained reductions in fat mass percentage, systolic blood pressure, triglycerides, and C-reactive protein levels, along with improved VO2 peak. Both groups also maintained lower total body mass, BMI, and waist circumference vs baseline values.
IN PRACTICE:
“A hypocaloric diet combined with supervised aerobic exercise training appears to be an effective strategy for regulating leptin and improving metabolic health in individuals with [hypertension] and overweight or obesity,” the authors of the study wrote.
SOURCE:
The study was led by Virginia A. Aparicio, University of Granada, Granada, Spain. It was published online in Clinical Obesity.
LIMITATIONS:
The study lacked data on food intake and appetite. Menopausal status and menstrual cycle phase were not recorded for female participants. A completer-only analysis was used because some participants missed the postintervention assessment, resulting in missing follow-up data.
