The Effect of Aerobic or Resistance Exercise Combined With a Low-Calorie Diet Versus Diet Alone on Cardiometabolic Outcomes in Adults with Overweight and Obesity: A Systematic Review and Meta-Analysis.
Sepideh Soltani, Zeinab Yazdanpanah, Elham Razmpoosh, Azam Ahmadi Vasmehjani, Kimia Rostampour, Mahshid Lotfi, Mojtaba Kaviani, Scott C Forbes, Julien Steven Baker, Amin Salehi-Abargouei
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Abstract
Context: Individual studies examining the combined effects of exercise and a low-calorie diet on cardiometabolic factors have yielded inconsistent results.
Objective: In this systematic review and meta-analysis of randomized controlled trials we aimed to determine whether adding exercise to a low-calorie diet has impacts on glucose homeostasis, lipid profiles, and blood pressure in adults with overweight and obesity.
Data sources: We searched the PubMed/MEDLINE, EMBASE, Web of Sciences, and Scopus databases from their inception to August 2024 to identify trials comparing the effects of exercise plus diet versus a low-calorie diet on cardiometabolic factors in adults with overweight and obesity.
Data extraction: Six reviewers independently performed title/abstract screening, data extraction, and quality assessment in duplicate. Meta-analyses were conducted using random-effects models to calculate summary estimates.
Data analysis: Ninety-seven eligible studies were included. Our findings demonstrated that incorporating exercise into a weight-loss diet significantly improved serum glucose, insulin levels, homeostatic model of insulin resistance, triglycerides, high-density lipoprotein cholesterol, and both systolic and diastolic blood pressure compared to diet alone. The analysis results highlighted the primary association of these benefits with aerobic exercise, rather than resistance training or combined aerobic and resistance exercises. Most improvements in cardiovascular risk factors were observed in supervised, high-intensity exercise programs, particularly cycling. The combination of aerobic exercise and a weight-loss diet was especially effective for metabolically healthy obese individuals.
Conclusion: The moderate to low certainty of evidence found in this review suggests that to mitigate metabolic risk in individuals with overweight or obesity, dietary intervention combined with high-intensity aerobic exercise, particularly cycling, may offer greater benefits than resistance training.
背景：个别研究考察了运动和低热量饮食对心脏代谢因素的综合影响，得出了不一致的结果。目的：在这项随机对照试验的系统回顾和荟萃分析中，我们旨在确定在低热量饮食中加入运动是否对超重和肥胖成人的葡萄糖稳态、脂质谱和血压有影响。数据来源：我们检索了PubMed/MEDLINE、EMBASE、Web of Sciences和Scopus数据库，从其建立到2024年8月，以确定比较运动加饮食与低热量饮食对超重和肥胖成人心脏代谢因子影响的试验。数据提取：六名审稿人独立进行标题/摘要筛选、数据提取和质量评估，一式两份。使用随机效应模型进行meta分析以计算汇总估计值。数据分析：纳入97项符合条件的研究。我们的研究结果表明，与单独饮食相比，将运动纳入减肥饮食可显著改善血清葡萄糖、胰岛素水平、胰岛素抵抗稳态模型、甘油三酯、高密度脂蛋白胆固醇以及收缩压和舒张压。分析结果强调了这些益处与有氧运动的主要联系，而不是阻力训练或有氧和阻力结合训练。大多数心血管危险因素的改善是在监督下的高强度运动项目中观察到的，尤其是骑自行车。有氧运动和减肥饮食相结合对代谢健康的肥胖者尤其有效。结论：本综述中发现的证据的中低确定性表明，为了减轻超重或肥胖个体的代谢风险，饮食干预结合高强度有氧运动，特别是骑自行车，可能比阻力训练更有益。系统评价注册：PROSPERO注册号：CRD42020173434。
期刊介绍：
Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
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