Exercise training performed at the maximal fat oxidation intensity (FMT) stands out as a potential treatment of overweight and obesity. This work is a meta-analysis of randomized clinical trials of studies about the effect of FMT on fat mass and maximal oxygen consumption using PubMed, SCOPUS, EBSCOhost, and ScienceDirect as databases. Two independent reviewers selected 11 trials from 356 publications identified by the following keywords: fatmax, lipoxmax, maximal fat oxidation, peak of fat oxidation, physical training, physical exercise, body fat (BF), fat mass, overweight, and obesity. The risk of bias was assessed following the Cochrane Guidelines. The pooled mean difference was computed for each outcome with the random-effects model and the inverse-variance method. The meta-analysis was performed with the RevMan software v 5.3, and the heterogeneity across studies by the I². The statistical significance was accepted at p < 0.05. Results showed that the FMT reduced body weight (MD = −4.30 kg, p < 0.01, I² = 0%), fat mass (MD = −4.03 kg, p < 0.01, I² = 0%), and waist circumference (MD = −3.34 cm, p < 0.01). Fat-free mass remains unchanged (MD = 0.08 kg, p = 0.85), but maximal oxygen consumption increased (MD = 2.96 mL∙kg⁻¹∙min⁻¹, p < 0.01, I² = 0%). We conclude that FMT at short and medium-term (eight to twenty weeks) reduces body weight and BF, increasing cardiovascular fitness in low physical fitness people with obesity.

Obesity is thought to be associated with a reduced capacity to increase fat oxidation in response to physical exercise; however, scientific evidence supporting this paradigm remains scarce. This study aimed to determine the interrelationship of different submaximal exercise metabolic flexibility (Metflex) markers and define its association with body fatness on subjects with obesity. Twenty-one male subjects with obesity performed a graded-intensity exercise protocol (Test 1) during which cardiorespiratory fitness (CRF), maximal fat oxidation (MFO) and its corresponding exercise intensity (FATmax) were recorded. A week afterward, each subject performed a 60-min walk (treadmill) at FATmax (Test 2), and the resulting fat oxidation area under the curve (TFO) and maximum respiratory exchange ratio (RER_peak) were recorded. Blood lactate (LA_b) levels was measured during both exercise protocols. Linear regression analysis was used to study the interrelationship of exercise Metflex markers. Pearson’s correlation was used to evaluate all possible linear relationships between Metflex and anthropometric measurement, controlling for CRF). The MFO explained 38% and 46% of RER_peak and TFO’s associated variance (p < 0.01) while TFO and RER_peak were inversely related (R² = 0.54, p < 0.01). Body fatness positively correlated with MFO (r = 0.64, p < 0.01) and TFO (r = 0.63, p < 0.01) but inversely related with RER_peak (r = −0.67, p < 0.01). This study shows that MFO and RER_peak are valid indicators of TFO during steady-state exercise at FATmax. The fat oxidation capacity is directly associated with body fatness in males with obesity.

Regular exercise at the intensity matching maximal fat oxidation (FAT_max) has been proposed as a key element in both athletes and clinical populations when aiming to enhance the body’s ability to oxidize fat. In order to allow a more standardized and tailored training approach, the connection between FAT_max and the individual aerobic thresholds (AerT) has been examined. Although recent findings strongly suggest that a relationship exists between these two intensities, correlation alone is not sufficient to confirm that the intensities necessarily coincide and that the error between the two measures is small. Thus, this systematic review and meta-analysis aim to examine the agreement levels between the exercise intensities matching FAT_max and AerT by pooling limits of agreement in a function of three parameters: (i) the average difference, (ii) the average within-study variation, and (iii) the variation in bias across studies, and to examine the influence of clinical and methodological inter- and intra-study differences on agreement levels. This study was registered with PROSPERO (CRD42021239351) and ClinicalTrials (NCT03789045). PubMed and Google Scholar were searched for studies examining FAT_max and AerT connection. Overall, 12 studies with forty-five effect sizes and a total of 774 subjects fulfilled the inclusion criteria. The ROBIS tool for risk of bias assessment was used to determine the quality of included studies. In conclusion, the overall 95% limits of agreement of the differences between FAT_max and AerT exercise intensities were larger than the a priori determined acceptable agreement due to the large variance caused by clinical and methodological differences among the studies. Therefore, we recommend that future studies follow a strict standardization of data collection and analysis of FAT_max- and AerT-related outcomes.