Comparing caloric restriction regimens for effective weight management in adults: a systematic review and network meta-analysis.

IF 5.6 1区医学 Q1 NUTRITION & DIETETICS

International Journal of Behavioral Nutrition and Physical Activity Pub Date : 2024-09-26 DOI:10.1186/s12966-024-01657-9

Jinming Huang, Yi Li, Maohua Chen, Zhaolun Cai, Zhen Cai, Zhiyuan Jiang

{"title":"Comparing caloric restriction regimens for effective weight management in adults: a systematic review and network meta-analysis.","authors":"Jinming Huang, Yi Li, Maohua Chen, Zhaolun Cai, Zhen Cai, Zhiyuan Jiang","doi":"10.1186/s12966-024-01657-9","DOIUrl":null,"url":null,"abstract":"Background: Randomized controlled trials have confirmed the effectiveness of four prevalent caloric restriction regimens in reducing obesity-related health risks. However, there is no consensus on the optimal regimen for weight management in adults.Methods: We systematically searched PubMed, Embase, Web of Science, and Cochrane CENTRAL up to January 15, 2024, for randomized controlled trials (RCT) involving adults, evaluating the weight-loss effects of alternate day fasting (ADF), short-term fasting (STF), time-restricted eating (TRE), and continuous energy restriction (CER). The primary outcome was body weight, with secondary outcomes including BMI, fat mass, lean mass, waist circumference, fasting glucose, HOMA-IR, and adverse events. Bayesian network meta-analysis was conducted, ranking regimens using the surface under the cumulative ranking curve and the probability of being the best. Study quality was assessed using the Confidence in Network Meta-Analysis tool.Results: Data from 47 RCTs (representing 3363 participants) were included. ADF showed the most significant body weight loss (Mean difference (MD): -3.42; 95% Confidence interval (CI): -4.28 to -2.55), followed by TRE (MD: -2.25; 95% CI: -2.92 to -1.59). STF (MD: -1.87; 95% CI: -3.32 to -0.56) and CER (MD: -1.59; 95% CI: -2.42 to -0.79) rank third and fourth, respectively. STF lead to decline in lean mass (MD: -1.26; 95% CI: -2.16, -0.47). TRE showed benefits on fasting glucose (MD: -2.98; 95% CI: -4.7, -1.26). Subgroup analysis revealed all four caloric restriction regimens likely lead to modest weight loss after 1-3 months, with ADF ranked highest, but by 4-6 months, varying degrees of weight regain occur, particularly with CER, while interventions lasting 7-12 months may result in effective weight loss, with TRE potentially ranking first during both the 4-6 months and 7-12 months periods. ADF showing fewer and shorter-lasting physical symptoms.Conclusion: All four included regiments were effective in reducing body weight, with ADF likely having the most significant impact. Each regimen likely leads to modest weight loss after 1-3 months, followed by weight regain by 4-6 months. However, interventions lasting 7-12 months achieve greater weight loss overall.Trial registration: PROSPERO: CRD42022382478.","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425986/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Behavioral Nutrition and Physical Activity","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12966-024-01657-9","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Randomized controlled trials have confirmed the effectiveness of four prevalent caloric restriction regimens in reducing obesity-related health risks. However, there is no consensus on the optimal regimen for weight management in adults.

Methods: We systematically searched PubMed, Embase, Web of Science, and Cochrane CENTRAL up to January 15, 2024, for randomized controlled trials (RCT) involving adults, evaluating the weight-loss effects of alternate day fasting (ADF), short-term fasting (STF), time-restricted eating (TRE), and continuous energy restriction (CER). The primary outcome was body weight, with secondary outcomes including BMI, fat mass, lean mass, waist circumference, fasting glucose, HOMA-IR, and adverse events. Bayesian network meta-analysis was conducted, ranking regimens using the surface under the cumulative ranking curve and the probability of being the best. Study quality was assessed using the Confidence in Network Meta-Analysis tool.

Results: Data from 47 RCTs (representing 3363 participants) were included. ADF showed the most significant body weight loss (Mean difference (MD): -3.42; 95% Confidence interval (CI): -4.28 to -2.55), followed by TRE (MD: -2.25; 95% CI: -2.92 to -1.59). STF (MD: -1.87; 95% CI: -3.32 to -0.56) and CER (MD: -1.59; 95% CI: -2.42 to -0.79) rank third and fourth, respectively. STF lead to decline in lean mass (MD: -1.26; 95% CI: -2.16, -0.47). TRE showed benefits on fasting glucose (MD: -2.98; 95% CI: -4.7, -1.26). Subgroup analysis revealed all four caloric restriction regimens likely lead to modest weight loss after 1-3 months, with ADF ranked highest, but by 4-6 months, varying degrees of weight regain occur, particularly with CER, while interventions lasting 7-12 months may result in effective weight loss, with TRE potentially ranking first during both the 4-6 months and 7-12 months periods. ADF showing fewer and shorter-lasting physical symptoms.

Conclusion: All four included regiments were effective in reducing body weight, with ADF likely having the most significant impact. Each regimen likely leads to modest weight loss after 1-3 months, followed by weight regain by 4-6 months. However, interventions lasting 7-12 months achieve greater weight loss overall.

Trial registration: PROSPERO: CRD42022382478.

查看原文本刊更多论文

比较热量限制方案以有效控制成人体重：系统综述和网络荟萃分析。

背景：随机对照试验证实了四种流行的热量限制方案在降低与肥胖相关的健康风险方面的有效性。然而，对于成人体重管理的最佳方案，目前还没有达成共识：我们系统检索了 PubMed、Embase、Web of Science 和 Cochrane CENTRAL（截至 2024 年 1 月 15 日）中涉及成人的随机对照试验（RCT），评估了隔日禁食（ADF）、短期禁食（STF）、限时进食（TRE）和持续能量限制（CER）的减肥效果。主要结果是体重，次要结果包括体重指数、脂肪量、瘦肉量、腰围、空腹血糖、HOMA-IR 和不良事件。采用贝叶斯网络荟萃分析法，利用累积排序曲线下的曲面和成为最佳方案的概率对方案进行排序。研究质量采用网络荟萃分析工具（Confidence in Network Meta-Analysis）进行评估：结果：纳入了 47 项 RCT（代表 3363 名参与者）的数据。ADF显示出最显著的体重减轻效果（平均差（MD）：-3.42；95% 置信区间（CI）：-4.28 至 -2.55），其次是TRE（MD：-2.25；95% CI：-2.92 至 -1.59）。STF（MD：-1.87；95% CI：-3.32 至 -0.56）和 CER（MD：-1.59；95% CI：-2.42 至 -0.79）分别排在第三和第四位。STF 导致瘦体重下降（MD：-1.26；95% CI：-2.16，-0.47）。TRE对空腹血糖有益处（MD：-2.98；95% CI：-4.7，-1.26）。亚组分析显示，所有四种热量限制方案在1-3个月后都可能导致适度的体重减轻，其中ADF排名最高，但到了4-6个月，体重会出现不同程度的反弹，尤其是CER，而持续7-12个月的干预措施可能会有效减轻体重，TRE在4-6个月和7-12个月期间都可能排名第一。ADF显示的身体症状较少且持续时间较短：结论：所有四种方案都能有效减轻体重，其中 ADF 的效果可能最为显著。每种方案都可能在 1-3 个月后导致体重适度下降，然后在 4-6 个月后体重回升。然而，持续7-12个月的干预措施总体上能实现更大程度的体重减轻：试验注册：PROCROPERO：CRD42022382478。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Behavioral Nutrition and Physical Activity 医学-生理学

CiteScore

13.80

自引率

3.40%

发文量

138

审稿时长

4-8 weeks

期刊介绍： International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) is an open access, peer-reviewed journal offering high quality articles, rapid publication and wide diffusion in the public domain. IJBNPA is devoted to furthering the understanding of the behavioral aspects of diet and physical activity and is unique in its inclusion of multiple levels of analysis, including populations, groups and individuals and its inclusion of epidemiology, and behavioral, theoretical and measurement research areas.