Effects of Physical Exercise on Cardiometabolic Health in Individuals with Autism Spectrum Disorder: A Systematic Review

Background/Objectives: Individuals with autism spectrum disorder (ASD) are at increased risk of developing cardiometabolic diseases. Although physical exercise (PE) has emerged in the literature as an important modulator for reducing such risk, evidence remains unclear. This systematic review aimed to investigate the effects of PE on cardiometabolic health in individuals with ASD. Methods: A systematic review was carried out according to the PRISMA guidelines, from their inception until 18 July 2023, in the following electronic databases: Scopus, Medline, and Web of Science. Studies were included if they focused on ASD patients undergoing physical exercise, assessing cardiometabolic risk, exercise tolerance, and QoL. The following were excluded: non-exercise interventions, additional therapies, non-English studies, and reviews. The methodological quality of the included studies was assessed through the Downs and Black scale. Results: A total of four studies (149 participants) were included in this review, with the average methodological quality being rated as "fair". Interventions had mixed effects on cardiometabolic health. The BMI (down arrow 2.8 kg/m2), waist circumference (down arrow 1.86 cm), and lipid profiles improved in some cases. VO2max and HRbaseline showed moderate gains. Secondary outcomes included enhanced endurance, strength, and calorie expenditure, especially in mild ASD. Autistic traits and quality of life improved post-intervention, with better results in the experimental groups. Conclusions: This review indicates that aerobic and functional training improves cardiometabolic health, autistic traits, and QoL in individuals with ASD, particularly in mild cases. Further research is needed to explore the impact of ASD severity on these outcomes.