Cardio or Weights: Which Is Better for Your Metabolic Health?
By Adi · September 29, 2026
Both. In adults with type 2 diabetes and obesity, cardio did more for fasting blood sugar and fitness, and lifting did more for muscle and body fat.
Do both. In adults with type 2 diabetes and obesity, cardio did more for fasting blood sugar and fitness, while lifting did more for muscle and body fat.
On blood pressure, cholesterol, body weight and waist size, the two came out even. So the useful question isn't which one wins, but what you need most right now.
By "metabolic health" I mean the risk markers your doctor checks: blood sugar, cholesterol, blood pressure, body fat and fitness. They are warning lights, not a diagnosis.
What the study did
A research team that included Brad Schoenfeld and McMaster University's Stuart Phillips pooled 23 randomized trials with 1,184 adults who had both type 2 diabetes and obesity. Every trial put one group on cardio and another on weights, and compared them head to head.
Participants were 30 to 70 years old, and 58% were women. The trials lasted 8 to 52 weeks.
The most common cardio plan was walking or a stationary bike, 3 times a week for 60 minutes. The most common lifting plan was a supervised full-body routine, 3 times a week for 45 minutes: 3 sets of 8–12 reps per exercise, stopping short of failure.
What they found
- Fitness: cardio raised VO2max, the standard measure of aerobic fitness, by 1.78 mL/kg/min more than lifting.
- Fasting blood sugar: 0.89 mmol/L lower with cardio than with lifting.
- Muscle: the lifting groups kept 0.86 kg more lean mass (muscle, plus bone, organs and water).
- Body fat: 0.34 percentage points lower with lifting.
- A tie: body weight, BMI, waist, blood pressure, cholesterol, triglycerides and HbA1c (your longer-term blood sugar average).
The authors call the fitness edge "small but consistent", and none of these gaps is large. Each type of training had its own strengths, and on most markers neither beat the other.
🏋️♂️ Key takeaways
- Do both every week. Each one won on different markers, and they tied on the rest.
- Lift 2 or 3 days a week to protect your muscle. That's what most of these trials did, and lifting kept more lean mass.
- Add cardio for fitness and blood sugar. Walking and cycling were the most common choices in these trials.
- Don't pick your training to move the scale. Neither changed body weight or waist more than the other, so look at your food for that.
📲 Try it this week in Adi.fit
Here's how I'd set up a week around a busy family schedule.
- Open Programs and start a plan with 2 or 3 lifting days. Log every set in your workout, and the Personal Bests tab records every new best.
- Ask Coach Adi where 2 or 3 brisk walks or bike rides fit around those lifting days. The coach can see your program, so the plan fits your real week.
- Join this month's challenge to keep the habit going. You'll see your progress add up and where you stand on the leaderboard.
- Log your food and your weigh-ins in Macros. With regular weigh-ins, the weekly review tells you whether your calorie target needs to change.
⚠️ The catch
- Everyone had type 2 diabetes and obesity. If that isn't you, the exact numbers may not apply. The next section looks at a trial that wasn't limited to diabetes.
- The cardio groups often trained longer. The most common cardio plan took 180 minutes a week; the most common lifting plan took 135.
- Most trials are old, and many are small. 18 of the 23 were published between 2005 and 2014, before today's diabetes care, and medication and diet were reported unevenly.
- Certainty is moderate at best. The authors rated the blood sugar result moderate certainty, and the fitness result low.
The authors reported no grant funding and no competing interests. If you have diabetes, or take medication for blood sugar or blood pressure, talk to your doctor before you change how you exercise.
How this fits with other research
A Canadian trial put 251 adults with type 2 diabetes, aged 39 to 70, through 22 weeks of training 3 times a week. Doing both lowered HbA1c by a further 0.46 percentage points compared with cardio alone, and 0.59 compared with weights alone (Sigal 2007). The combined group also exercised longer, which the authors point out.
A trial that wasn't limited to diabetes points the same way. Over 8 months, 119 sedentary adults with overweight or obesity who did cardio lost more weight and fat than those who lifted, while lifting added more lean mass (Willis 2012). Doing both got both, at double the time.
That doesn't clash with the review, which measured body fat as a percentage: keeping muscle lowers that number too. Cardio and lifting do different jobs, and you want both jobs done.
Quick answers
Is walking enough cardio?
It can be. Walking or a stationary bike was the most common cardio in these trials, at 70–75% of maximum heart rate. For most people that's a brisk pace: you can talk, but you wouldn't want to sing.
Does lifting help blood pressure and cholesterol?
In this review, lifting and cardio did equally well on blood pressure and cholesterol. It compared them with each other, not with doing nothing, so it can't tell you how much either one lowers them.
Will cardio make me lose muscle?
Not if you lift as well. In these trials, the cardio groups ended with 0.86 kg less lean mass than the lifting groups. Here's why lean mass matters more than the scale.
Scientific reference: Comparative Effectiveness of Aerobic Exercise versus Resistance Training on Cardiometabolic Health in Patients with Diabesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Al-Mhanna SB, Franklin BA, Papadakis Z, Phillips SM, Jakicic JM, Stamatakis E, Schoenfeld BJ, et al. 2026. Journal of Sports Science and Medicine.
PubMed 42713583 · doi.org/10.52082/jssm.2026.637