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Nutrients Apr 2022We conducted a systematic review and meta-analysis of randomized clinical trials and pilot trial studies to compare the effectiveness of intermittent fasting (IF) and... (Meta-Analysis)
Meta-Analysis
We conducted a systematic review and meta-analysis of randomized clinical trials and pilot trial studies to compare the effectiveness of intermittent fasting (IF) and continuous calorie restriction (CCR) in overweight and obese people. The parameters included body mass index (BMI), body weight, and other metabolism-related indicators. A systematic search in PubMed, Embase, Cochrane Library, and Web of Science was conducted up to January 2022. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to measure the effectiveness. Publication bias was assessed using Egger's test. The stability of the results was evaluated using sensitivity analyses. The significance of body weight change (SMD = -0.21, 95% CI (-0.40, -0.02) = 0.028) was more significant after IF than CCR. There was no significant difference in BMI (SMD = 0.02, 95% CI (-0.16, 0.20) = 0.848) between IF and CCR. These findings suggest that IF may be superior to CCR for weight loss in some respects.
Topics: Body Weight; Caloric Restriction; Fasting; Humans; Overweight; Weight Loss
PubMed: 35565749
DOI: 10.3390/nu14091781 -
Obesity Reviews : An Official Journal... Feb 2023To update existing literature and fill the gap in meta-analyses, this meta-analysis quantitatively evaluated the worldwide economic burden (in 2022 US $) of childhood... (Meta-Analysis)
Meta-Analysis Review
To update existing literature and fill the gap in meta-analyses, this meta-analysis quantitatively evaluated the worldwide economic burden (in 2022 US $) of childhood overweight and obesity in comparison with healthy weight. The literature search in eight databases produced 7756 records. After literature screening, 48 articles met the eligibility criteria. The increased annual total medical costs were $237.55 per capita attributable to childhood overweight and obesity. Overweight and obesity caused a per capita increase of $56.52, $14.27, $46.38, and $1975.06 for costs in nonhospital healthcare, outpatient visits, medication, and hospitalization, respectively. Length of hospital stays increased by 0.28 days. Annual direct and indirect costs were projected to be $13.62 billion and $49.02 billion by 2050. Childhood obesity ascribed to much higher increased healthcare costs than overweight. During childhood, the direct medical expenditures were higher for males than for females, but, once reaching adulthood, the expenditures were higher for females. Overall, the lifetime costs attributable to childhood overweight and obesity were higher in males than in females, and childhood overweight and obesity resulted in much higher indirect costs than direct healthcare costs. Given the increased economic burden, additional efforts and resources should be allocated to support sustainable and scalable childhood obesity programs.
Topics: Male; Female; Humans; Child; Pediatric Obesity; Overweight; Financial Stress; Health Care Costs; Health Expenditures; Cost of Illness
PubMed: 36437105
DOI: 10.1111/obr.13535 -
Obesity Reviews : An Official Journal... Feb 2019Discerning the determinants of weight loss maintenance is important in the planning of future interventions and policies regarding overweight and obesity. We have...
BACKGROUND
Discerning the determinants of weight loss maintenance is important in the planning of future interventions and policies regarding overweight and obesity. We have therefore systematically synthesized recent literature on determinants of weight loss maintenance for individuals with overweight and obesity.
METHODS
With the use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, prospective studies were identified from searches in PubMed and PsycINFO from 2006 to 2016. We included articles investigating adults with overweight and obesity undergoing weight loss without surgery or medication. Included articles were scored on their methodological quality, and a best-evidence synthesis was applied to summarize the results.
RESULTS
Our search resulted in 8,222 articles of which 67 articles were selected. In total, 124 determinants were identified of which 5 were demographic, 59 were behavioural, 51 were psychological/cognitive and 9 were social and physical environmental determinants. We found consistent evidence that demographic determinants were not predictive of weight loss maintenance. Behavioural and cognitive determinants that promote a reduction in energy intake, an increase in energy expenditure and monitoring of this balance are predictive determinants.
CONCLUSION
This review identifies key determinants in weight loss maintenance. However, more research regarding cognitive and environmental determinants of weight loss maintenance is needed to advance our knowledge on determinants of weight loss maintenance.
Topics: Exercise; Humans; Life Style; Obesity; Weight Loss
PubMed: 30324651
DOI: 10.1111/obr.12772 -
Obesity Facts 2021The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low carbohydrate content (<50 g/day), 1-1.5 g of protein/kg of ideal body weight, 15-30 g of fat/day, and a daily intake of about 500-800 calories.
OBJECTIVES
The aim of the current document is to suggest a common protocol for VLCKD and to summarize the existing literature on its efficacy in weight management and weight-related comorbidities, as well as the possible side effects.
METHODS
This document has been prepared in adherence with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Literature searches, study selection, methodology development, and quality appraisal were performed independently by 2 authors and the data were collated by means of a meta-analysis and narrative synthesis.
RESULTS
Of the 645 articles retrieved, 15 studies met the inclusion criteria and were reviewed, revealing 4 main findings. First, the VLCKD was shown to result in a significant weight loss in the short, intermediate, and long terms and improvement in body composition parameters as well as glycemic and lipid profiles. Second, when compared with other weight loss interventions of the same duration, the VLCKD showed a major effect on reduction of body weight, fat mass, waist circumference, total cholesterol and triglyceridemia as well as improved insulin resistance. Third, although the VLCKD also resulted in a significant reduction of glycemia, HbA1c, and LDL cholesterol, these changes were similar to those obtained with other weight loss interventions. Finally, the VLCKD can be considered a safe nutritional approach under a health professional's supervision since the most common side effects are usually clinically mild and easily to manage and recovery is often spontaneous.
CONCLUSIONS
The VLCKD can be recommended as an effective dietary treatment for individuals with obesity after considering potential contra-indications and keeping in mind that any dietary treatment has to be personalized. Prospero Registry: The assessment of the efficacy of VLCKD on body weight, body composition, glycemic and lipid parameters in overweight and obese subjects: a meta-analysis (CRD42020205189).
Topics: Adult; Diet, Ketogenic; Humans; Obesity; Obesity Management; Overweight; Weight Loss
PubMed: 33882506
DOI: 10.1159/000515381 -
Advances in Nutrition (Bethesda, Md.) May 2023The retirement phase is an opportunity to integrate healthy (nutrition/exercise) habits into daily life. We conducted this systematic review to assess which nutrition... (Meta-Analysis)
Meta-Analysis Review
Nutrition and Exercise Interventions to Improve Body Composition for Persons with Overweight or Obesity Near Retirement Age: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
The retirement phase is an opportunity to integrate healthy (nutrition/exercise) habits into daily life. We conducted this systematic review to assess which nutrition and exercise interventions most effectively improve body composition (fat/muscle mass), body mass index (BMI), and waist circumference (WC) in persons with obesity/overweight near retirement age (ages 55-70 y). We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials, searching 4 databases from their inception up to July 12, 2022. The NMA was based on a random effects model, pooled mean differences, standardized mean differences, their 95% confidence intervals, and correlations with multi-arm studies. Subgroup and sensitivity analyses were also conducted. Ninety-two studies were included, 66 of which with 4957 participants could be used for the NMA. Identified interventions were clustered into 12 groups: no intervention, energy restriction (i.e., 500-1000 kcal), energy restriction plus high-protein intake (1.1-1.7 g/kg/body weight), intermittent fasting, mixed exercise (aerobic and resistance), resistance training, aerobic training, high protein plus resistance training, energy restriction plus high protein plus exercise, energy restriction plus resistance training, energy restriction plus aerobic training, and energy restriction plus mixed exercise. Intervention durations ranged from 8 wk to 6 mo. Body fat was reduced with energy restriction plus any exercise or plus high-protein intake. Energy restriction alone was less effective and tended to decrease muscle mass. Muscle mass was only significantly increased with mixed exercise. All other interventions including exercise effectively preserved muscle mass. A BMI and/or WC decrease was achieved with all interventions except aerobic training/resistance training alone or resistance training plus high protein. Overall, the most effective strategy for nearly all outcomes was combining energy restriction with resistance training or mixed exercise and high protein. Health care professionals involved in the management of persons with obesity need to be aware that an energy-restricted diet alone may contribute to sarcopenic obesity in persons near retirement age. This network meta-analysis is registered at https://www.crd.york.ac.uk/prospero/ as CRD42021276465.
Topics: Humans; Overweight; Network Meta-Analysis; Retirement; Randomized Controlled Trials as Topic; Obesity; Body Mass Index; Body Composition; Resistance Training
PubMed: 37028708
DOI: 10.1016/j.advnut.2023.04.001 -
Obesity Reviews : An Official Journal... Jul 2021This systematic review examined the effect of exercise training interventions on physical fitness in adults with overweight or obesity and compared the effectiveness of... (Meta-Analysis)
Meta-Analysis
This systematic review examined the effect of exercise training interventions on physical fitness in adults with overweight or obesity and compared the effectiveness of different types of exercise training. Four electronic databases were searched. Articles were included if they described randomized controlled trials of exercise training interventions and their effect on maximal oxygen consumption or muscle strength in adults with overweight or obesity. Changes in outcome parameters were analyzed using random effects meta-analyses for different training types (aerobic, resistance, combined aerobic plus resistance, and high-intensity interval training). Eighty-eight articles satisfied the inclusion criteria of which 66 (3964 participants) could be included in the meta-analyses. All training types increased VO (mean difference 3.82 ml/min/kg (95% CI 3.17, 4.48), P < 0.00001; I = 48%). In direct comparisons, resistance training was less effective in improving VO than aerobic training, HIIT was slightly more effective than aerobic training, and no difference between aerobic and combined aerobic plus resistance training was found. For muscle strength benefits, incorporation of resistance exercise in the training program is indicated. Exercise training increases VO and muscle strength in adults with overweight or obesity. Differences between training types should be weighed with other needs and preferences when health professionals advise on exercise training to improve physical fitness.
Topics: Adult; Exercise; Humans; Obesity; Overweight; Oxygen Consumption; Physical Fitness; Resistance Training
PubMed: 33939229
DOI: 10.1111/obr.13239 -
La Clinica Terapeutica 2018Shift work may have significant repercussions on the health of the worker, and has been linked to unhealthy lifestyles. The aim was to conduct a systematic review of the... (Meta-Analysis)
Meta-Analysis Review
Shift work may have significant repercussions on the health of the worker, and has been linked to unhealthy lifestyles. The aim was to conduct a systematic review of the literature and to assess the relationship between night shift and overweight and obesity among health professionals. A literature search was performed using PubMed and Scopus. The keywords used included: "shift work", "night work", "obesity", "overweight", "nurses" "doctors" "physicians". The whole process of revision followed the PRISMA Statement. Two researchers independently, reviewed the search results, assessed the quality and extracted data. Six transversal and a cohort studies were found for the population of nurses. The meta-analysis did not produce significant results on the prevalence of obesity in the population of nurses (OR: 1.00; 95% CI 0.66-1.50). More high-quality studies and including a larger number of participants should be conducted, in order to assess whether there is real cause-effect relationship between the exposure to night shifts and weight gain as well as of obesity.
Topics: Health Personnel; Humans; Life Style; Obesity; Overweight; Prevalence; Weight Gain
PubMed: 30151553
DOI: 10.7417/T.2018.2077 -
Obesity Reviews : An Official Journal... Sep 2019Overweight and obesity are increasing worldwide. In general practice, different approaches exist to treat people with weight problems. To provide the foundation for the...
Overweight and obesity are increasing worldwide. In general practice, different approaches exist to treat people with weight problems. To provide the foundation for the development of a structured clinical pathway for overweight and obesity management in primary care, we performed a systematic overview of international evidence-based guidelines. We searched in PubMed and major guideline databases for all guidelines published in World Health Organization (WHO) "Stratum A" nations that dealt with adults with overweight or obesity. Nineteen guidelines including 711 relevant recommendations were identified. Most of them concluded that a multidisciplinary team should treat overweight and obesity as a chronic disease. Body mass index (BMI) should be used as a routine measure for diagnosis, and weight-related complications should be taken into account. A multifactorial, comprehensive lifestyle programme that includes reduced calorie intake, increased physical activity, and measures to support behavioural change for at least 6 to 12 months is recommended. After weight reduction, long-term measures for weight maintenance are necessary. Bariatric surgery can be offered to people with a BMI greater than or equal to 35 kg/m when all non-surgical interventions have failed. In conclusion, there was considerable agreement in international, evidence-based guidelines on how multidisciplinary management of overweight and obesity in primary care should be performed.
Topics: Evidence-Based Practice; Humans; Obesity; Obesity Management; Overweight; Practice Guidelines as Topic; Primary Health Care; Weight Loss
PubMed: 31286668
DOI: 10.1111/obr.12889 -
International Journal of Public Health 2022Adolescence is considered a vital time to address healthy attitudes and values towards an effective transition to adulthood. The aim of this review was to analyse... (Review)
Review
Adolescence is considered a vital time to address healthy attitudes and values towards an effective transition to adulthood. The aim of this review was to analyse self-concept, self-perception, physical exercise, and lifestyle in the late adolescent population. Systematic review of studies assessing the results by the Rosenberg Self-Esteem Scale, the General Health Questionnaire, the Activity Questionnaire for Adolescents, and the Health Behaviour in School-aged Children questionnaires in late adolescents. The PRISMA recommendations were followed. The CASPe quality-check system was applied, excluding articles with a score <8. 1589 studies were found, and 69 articles were selected. Adolescents with high self-concept and self-perception tend to be emotionally stable, sociable, and responsible. No significant differences were found regarding self-concept and self-perception between different countries, but there were differences between men and women. Physical activity and healthy diet improve self-concept and perception of body image. Self-concept and self-perception are associated with responsibility, stability, and mental strength. Most healthy behaviours during adolescence are followed during adulthood. Socio-cultural level of Health Science students is a differential factor for overweight and obesity.
Topics: Adolescent; Adult; Body Image; Child; Exercise; Female; Humans; Life Style; Male; Overweight; Self Concept; Surveys and Questionnaires
PubMed: 36250150
DOI: 10.3389/ijph.2022.1604954 -
Obesity Reviews : An Official Journal... May 2022To systematically review and analyze the effects of resistance-based exercise programs on body composition, regional adiposity, and body weight in individuals with... (Meta-Analysis)
Meta-Analysis Review
Resistance training effectiveness on body composition and body weight outcomes in individuals with overweight and obesity across the lifespan: A systematic review and meta-analysis.
To systematically review and analyze the effects of resistance-based exercise programs on body composition, regional adiposity, and body weight in individuals with overweight/obesity across the lifespan. Using PRISMA guidelines, randomized controlled trials were searched in nine electronic databases up to December 2020. Meta-analyses were performed using random-effects model. One-hundred sixteen articles describing 114 trials (n = 4184 participants) were included. Interventions involving resistance training and caloric restriction were the most effective for reducing body fat percentage (ES = -3.8%, 95% CI: -4.7 to -2.9%, p < 0.001) and whole-body fat mass (ES = -5.3 kg, 95% CI: -7.2 to -3.5 kg, p < 0.001) compared with groups without intervention. Significant results were also observed following combined resistance and aerobic exercise (ES = -2.3% and -1.4 kg, p < 0.001) and resistance training alone (ES = -1.6% and -1.0 kg, p < 0.001) compared with no training controls. Resistance training alone was the most effective for increasing lean mass compared with no training controls (ES = 0.8 kg, 95% CI: 0.6 to 1.0 kg, p < 0.001), whereas lean mass was maintained following interventions involving resistance training and caloric restriction (ES = ~ - 0.3 kg, p = 0.550-0.727). Results were consistently observed across age and sex groups (p = 0.001-0.011). Reductions in regional adiposity and body weight measures were also observed following combined resistance and aerobic exercise and programs including caloric restriction (p < 0.001). In conclusion, this study provides evidence that resistance-based exercise programs are effective and should be considered within any multicomponent therapy program when caloric restriction is utilized in individuals with overweight or obesity.
Topics: Body Composition; Body Mass Index; Body Weight; Humans; Longevity; Obesity; Overweight; Resistance Training
PubMed: 35191588
DOI: 10.1111/obr.13428