Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight/obese participants: A systematic review and network meta-analysis

被引：81

作者：

Schwingshackl L. ^{[1
]}

Dias S. ^{[2
]}

Hoffmann G. ^{[1
]}

机构：

[1] Faculty of Life Sciences, Department of Nutritional Sciences, University of Vienna, Althanstraße 14 UZA II, Vienna

[2] School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol

来源：

Systematic Reviews | / 3卷 / 1期

基金：

英国医学研究理事会;

关键词：

Diet; Exercise; Lifestyle; Network meta-analysis; Obesity; Systematic review;

D O I：

10.1186/2046-4053-3-130

中图分类号：

学科分类号：

摘要：

Background: The aim of this meta-analysis was to compare the long-term efficacy of diet plus exercise (D + E) vs. diet (D), D + E vs. exercise (E) and D vs. E on anthropometric outcomes and cardiovascular risk factors in overweight and obese participants. Methods: Electronic searches were performed in MEDLINE and the Cochrane Central Register of controlled trials. Inclusion criteria were as follows: body mass index ≥25 kg/m2 and a minimum intervention period including follow-up of ≥12 months. Outcomes of interest were as follows: anthropometric parameters, blood lipids, blood pressure and cardiorespiratory fitness. Pooled effects were calculated using pairwise random effects and Bayesian random effects network meta-analysis. Results of the corresponding fixed effects models were compared in sensitivity analyses. Results: Overall, 22 trials (24 reports) met the inclusion criteria and 21 (including 3,521 participants) of them were included in the quantitative analysis. As compared with D, D + E resulted in a significantly more pronounced reduction in body weight [mean differences (MD): -1.38 kg, 95% confidence interval (CI) -1.98 to -0.79], and fat mass (MD: -1.65 kg, 95% CI -2.81 to -0.49], respectively. When comparing D + E with E, MD in change of body weight (-4.13 kg, 95% CI -5.62 to -2.64), waist circumference (-3.00 cm, 95% CI -5.81 to -0.20), and fat mass (-3.60 kg, 95% CI -6.15 to -1.05) was in favour of combined diet and exercise, respectively. Comparing E vs. D, diet resulted in a significantly more pronounced decrease in body weight (MD: -2.93 kg, 95% CI -4.18 to -1.68), and fat mass (MD: -2.20 kg, 95% CI -3.75 to -0.66). D + E yielded also the greatest reductions with respect to blood lipids and blood pressure when compared to single applications of D and E, respectively. Results from the network meta-analyses confirmed these findings. Conclusions: Moderate-quality evidence from the present network meta-analysis suggests that D + E can be highly recommended for long-term obesity management. Furthermore, the evidence suggests a moderate superiority of D over E with respect to anthropometric outcomes. Systematic review registration: PROSPERO CRD42013003906. © 2014 Schwingshackl et al.; licensee BioMed Central Ltd.

引用

共 66 条

[1]

Obesity and Overweight. Fact sheet No. 311, (2011)

[2]

Guh D.P., Zhang W., Bansback N., Amarsi Z., Birmingham C.L., Anis A.H., The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis, BMC Public Health, 9, (2009)

[3]

Renehan A.G., Tyson M., Egger M., Heller R.F., Zwahlen M., Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies, Lancet, 371, 9612, pp. 569-578, (2008)

[4]

Schwingshackl L., Dias S., Strasser B., Hoffmann G., Impact of different training modalities on anthropometric and metabolic characteristics in overweight/obese subjects: a systematic review and network meta-analysis, PLoS One, 8, 12, (2013)

[5]

Andersen R.E., Wadden T.A., Bartlett S.J., Zemel B., Verde T.J., Franckowiak S.C., Effects of lifestyle activity vs structured aerobic exercise in obese women: a randomized trial, JAMA, 281, 4, pp. 335-340, (1999)

[6]

Bueno N.B., de Melo I.S., de Oliveira S.L., da Rocha Ataide T., Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials, Br J Nutr, 110, 7, pp. 1178-1187, (2013)

[7]

Schwingshackl L., Hoffmann G., Comparison of effects of long-term low-fat vs high-fat diets on blood lipid levels in overweight or obese patients: a systematic review and meta-analysis, J Acad Nutr Diet, 113, 12, pp. 1640-1661, (2013)

[8]

Santos F.L., Esteves S.S., da Costa P.A., Yancy W.S., Nunes J.P., Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors, Obes Rev, 13, 11, pp. 1048-1066, (2012)

[9]

Schwingshackl L., Hoffmann G., Comparison of the long-term effects of high-fat v. low-fat diet consumption on cardiometabolic risk factors in subjects with abnormal glucose metabolism: a systematic review and meta-analysis, Br J Nutr, 111, 12, pp. 2047-2058, (2014)

[10]

Schwingshackl L., Missbach B., Dias S., Konig J., Hoffmann G., Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis, Diabetologia, 57, 9, pp. 1789-1797, (2014)

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