Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight-obese participants: a systematic review and network meta-analysisReport as inadecuate




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Systematic Reviews

, 3:130

Developments in Network Meta-Analyses

Abstract

BackgroundThe 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.

MethodsElectronic searches were performed in MEDLINE and the Cochrane Central Register of controlled trials. Inclusion criteria were as follows: body mass index ≥25 kg-m 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.

ResultsOverall, 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.

ConclusionsModerate-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 registrationPROSPERO CRD42013003906

KeywordsLifestyle Obesity Network meta-analysis Systematic review Diet Exercise Electronic supplementary materialThe online version of this article doi:10.1186-2046-4053-3-130 contains supplementary material, which is available to authorized users.

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Author: Lukas Schwingshackl - Sofia Dias - Georg Hoffmann

Source: https://link.springer.com/







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