Impact of different training modalities on anthropometric outcomes in patients with obesity: A systematic review and network meta-analysis.
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ABSTRACT:
SUBMITTER: Morze J
PROVIDER: S-EPMC8244024 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe aim of this systematic review of randomized controlled trials was to compare the effects of aerobic training (AET), resistance training (RT), and combined aerobic and resistance training (CT) on anthropometric parameters, blood lipids, and cardiorespiratory fitness in overweight and obese subjects.MethodsElectronic searches for randomized controlled trials were performed in MEDLINE, EMBASE and the Cochrane Trial Register. Inclusion criteria were: Body Mass Index: ≥25 kg/m(2), 19+ years of age, supervised exercise training, and a minimum intervention period of 8 weeks. Anthropometric outcomes, blood lipids, and cardiorespiratory fitness parameters were included. Pooled effects were calculated by inverse-variance random effect pairwise meta-analyses and Bayesian random effects network meta-analyses.Findings15 trials enrolling 741 participants were included in the meta-analysis. Compared to RT, AET resulted in a significantly more pronounced reduction of body weight [mean differences (MD): -1.15 kg, p = 0.04], waist circumference [MD: -1.10 cm, p = 0.004], and fat mass [MD: -1.15 kg, p = 0.001] respectively. RT was more effective than AET in improving lean body mass [MD: 1.26 kg, p<0.00001]. When comparing CT with RT, MD in change of body weight [MD: -2.03 kg, p<0.0001], waist circumference [MD: -1.57 cm, p = 0.0002], and fat mass [MD: -1.88 kg, p<0.00001] were all in favor of CT. Results from the network meta-analyses confirmed these findings.ConclusionEvidence from both pairwise and network meta-analyses suggests that CT is the most efficacious means to reduce anthropometric outcomes and should be recommended in the prevention and treatment of overweight, and obesity whenever possible.
| S-EPMC3866267 | biostudies-literature
Project description:The relation between meal frequency and measures of obesity is inconclusive. Therefore, this systematic review and network meta-analysis (NMA) set out to compare the isocaloric effects of different meal frequencies on anthropometric outcomes and energy intake (EI). A systematic literature search was conducted in 3 electronic databases (Medline, Cochrane Library, Web of Science; search date, 11 March 2019). Randomized controlled trials (RCTs) were included with ≥2 wk intervention duration comparing any 2 of the eligible isocaloric meal frequencies (i.e., 1 to ≥8 meals/d). Random-effects NMA was performed for 4 outcomes [body weight (BW), waist circumference (WC), fat mass (FM), and EI], and surface under the cumulative ranking curve (SUCRA) was estimated using a frequentist approach (P-score: value is between 0 and 1). Twenty-two RCTs with 647 participants were included. Our results suggest that 2 meals/d probably slightly reduces BW compared with 3 meals/d [mean difference (MD): -1.02 kg; 95% CI: -1.70, -0.35 kg) or 6 meals/d (MD: -1.29 kg; 95% CI: -1.74, -0.84 kg; moderate certainty of evidence). We are uncertain whether 1 or 2 meals/d reduces BW compared with ≥8 meals/d (MD1 meal/d vs. ≥8 meals/d: -2.25 kg; 95% CI: -5.13, 0.63 kg; MD2 meals/d vs. ≥8 meals/d: -1.32 kg; 95% CI: -2.19, -0.45 kg) and whether 1 meal/d probably reduces FM compared with 3 meals/d (MD: -1.84 kg; 95% CI: -3.72, 0.05 kg; very low certainty of evidence). Two meals per day compared with 6 meals/d probably reduce WC (MD: -3.77 cm; 95% CI: -4.68, -2.86 cm; moderate certainty of evidence). One meal per day was ranked as the best frequency for reducing BW (P-score: 0.81), followed by 2 meals/d (P-score: 0.74), whereas 2 meals/d performed best for WC (P-score: 0.96). EI was not affected by meal frequency. In conclusion, our findings indicate that there is little robust evidence that reducing meal frequency is beneficial.
| S-EPMC7490164 | biostudies-literature
Project description:Current international guidelines recommend aerobic, resistance, and combined exercises for the management of type 2 diabetes mellitus (T2DM). In our study, we conducted a network meta-analysis to assess the comparative impact of different exercise training modalities on glycemic control, cardiovascular risk factors, and weight loss in patients with T2DM.We searched five electronic databases to identify randomized controlled trials (RCTs) that compared the differences between different exercise training modalities for patients with T2DM. The risk of bias in the included RCTs was evaluated according to the Cochrane tool. Network meta-analysis was performed to calculate mean difference the ratio of the mean and absolute risk differences. Data were analyzed using R-3.4.0.A total of 37 studies with 2208 patients with T2DM were included in our study. Both supervised aerobic and supervised resistance exercises showed a significant reduction in HbA1c compared to no exercise (0.30% lower, 0.30% lower, respectively), however, there was a less reduction when compared to combined exercise (0.17% higher, 0.23% higher). Supervised aerobic also presented more significant improvement than no exercise in fasting plasma glucose (9.38 mg/dl lower), total cholesterol (20.24 mg/dl lower), triacylglycerol (19.34 mg/dl lower), and low-density lipoprotein cholesterol (11.88 mg/dl lower). Supervised resistance showed more benefit than no exercise in improving systolic blood pressure (3.90 mmHg lower]) and total cholesterol (22.08 mg/dl lower]. In addition, supervised aerobic exercise was more powerful in improving HbA1c and weight loss than unsupervised aerobic (HbA1c: 0.60% lower; weight loss: 5.02 kg lower) and unsupervised resistance (HbA1c: 0.53% lower) exercises.Compared with either supervised aerobic or supervised resistance exercise alone, combined exercise showed more pronounced improvement in HbA1c levels; however, there was a less marked improvement in some cardiovascular risk factors. In terms of weight loss, there were no significant differences among the combined, supervised aerobic, and supervised resistance exercises.Our study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number: CRD42017067518 .
| S-EPMC6060544 | biostudies-other
Project description:IntroductionHeart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training can bring multifactorial benefits to heart transplant (HTx) recipients. However, it is unclear that exercise modality should be preferred. Therefore, the aim of this systematic review and network meta-analysis is to compare the efficacy and safety of different training modalities in HTx recipients.Methods and analysisWe will perform a comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and PEDro from inception until November 2020. Two registries (ClinicalTrials.gov and REBEC) will also be searched for potential results in unpublished studies. There will be no restriction on language, date of publication, publication status or sample size. We will include randomised controlled trials enrolling adult HTx recipients with the presence of at least one exercise training group, which might be compared with another training modality and/or a non-exercise control group for a minimum of 4 weeks of intervention. The primary outcomes will be peak oxygen consumption and occurrence of adverse events. As secondary outcomes, the interaction between pulmonary ventilation, pulmonary perfusion and cardiac output, oxygen uptake efficiency slope, heart rate response, oxygen pulse, peak blood pressure and peak subjective perception of effort. In addition, we will evaluate the 6 min walking distance, health-related quality of life, endothelial function, muscle strength, body fat percentage and lean mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and we plan to use the Confidence in Network Meta-Analysis tool to assess confidence in the results. All materials (raw data, processed data, statistical code and outputs) will be shared in a public repository.Ethics and disseminationGiven the nature of this study, no ethical approval will be required. We believe that the findings of this study may show which is the most efficacious and safe physical training modality for HTx recipients. The completed systematic review and network meta-analysis will be submitted to a peer-reviewed journal.Prospero registration numberCRD42020191192.
| S-EPMC7778772 | biostudies-literature
Project description:Considerable research has tested physical activity (PA) interventions to prevent and treat overweight and obesity. This comprehensive meta-analysis synthesized the anthropometric effects of supervised exercise interventions and motivational interventions to increase PA. Eligible intervention studies included healthy participants with reported anthropometric outcomes [e.g., body mass index (BMI)]. Extensive searching located 54,642 potentially eligible studies. We included data from 535 supervised exercise and 283 motivational interventions in our syntheses, which used random-effects analyses. Exploratory moderator analyses used meta-analytic analogues of ANOVA and regression. We synthesized data from 20,494 participants in supervised exercise and 94,711 undergoing motivational interventions. The overall mean effect sizes (ES, d) for treatment versus control groups in supervised exercise interventions were 0.20 (treatment vs. control within-group comparison) and 0.22 (between-group comparison). The ES of 0.22 represents a post-intervention BMI of 26.7 kg/m(2) for treatment participants relative to 27.7 kg/m(2) for controls. The corresponding mean ES for motivational interventions was significantly smaller (d = 0.09 for between group, d = 0.10 for treatment vs. control within-group). Control group within-group comparisons revealed slightly worsening anthropometric outcomes during study participation (d = -0.03 to -0.04). Moderator analyses identified potential variables for future research. These findings document significant improvements in anthropometric effects from both supervised exercise and motivational interventions.
| S-EPMC4071135 | biostudies-literature
Project description:(1) Background: aging is associated with functional changes such as balance, which plays a critical role in older adults. Physical exercise has been established as a factor capable of modulating these age-related alterations. (2) Methods: a meta-analysis of randomized clinical trials (RCTs) was conducted. The systematic search was performed in the PubMed/MEDLINE, Web of Science, the SPORTDiscus and Cochrane Library databases. Articles were included if participants were 65 years or older, healthy and performing resistance training, aerobic training, balance training or multicomponent training. Studies were excluded if there was a combination of training with other types of intervention. The protocol of this systematic review was published in the International Prospective Register of Systematic Reviews (PROSPERO) with the code CRD42021233252 (3) Results: the search strategy found a total of 1103 studies. After removing duplicates and the inclusion and exclusion criteria, eight articles were included in the meta-analysis, with a total of 335 healthy older adults analyzed. The results showed no significant differences between the intervention groups and the control groups after the exercise programs. (4) Conclusions: interventions based on different types of exercise improved static balance in elderly population, but without statistically significant difference in comparison with the control groups.
| S-EPMC10222379 | biostudies-literature
Project description:IntroductionLung cancer is a common malignancy and a major cause of cancer-related deaths worldwide, ranking high in terms of morbidity and prevalence. Exercise is a well-established recovery aid for many chronic respiratory conditions and lung cancer. However, it is difficult to determine the superiority of different exercise training modalities using randomised controlled trials (RCTs) or pairwise meta-analyses. Our Bayesian network meta-analysis (NMA) aimed to compare the impact of different perioperative exercise training modalities on lung function, exercise capacity, adverse events, health-related quality of life and mortality in patients undergoing lung cancer surgery, including preoperative and postoperative patients.Methods and analysisWe will perform a comprehensive literature search using PubMed, EMBASE, Cochrane Library and Web of Science, from inception to May 2022, to identify studies that potentially provide data regarding exercise training modalities for patients with lung cancer. We will assess the risk of bias according to the Cochrane risk-of-bias tool and certainty of evidence for the main outcomes using the Grading of Recommendations Assessment, Development and Evaluation framework. Pairwise meta-analyses will be conducted using a random effects model and Stata software, and the NMA will be analysed using R software.Ethics and disseminationEthical approval and patient consent were not required because this study was a meta-analysis of published RCTs. The results of this study are submitted to a peer-reviewed journal for publication.Prospero registration numberCRD42021278923.
| S-EPMC9528628 | biostudies-literature
Project description:A colonoscopy is considered to be the standard diagnostic test used to detect early colorectal lesions. Detection rates are expected to improve with optimised visualisation. A systematic review and network meta-analysis was conducted to evaluate detection efficiency in several colonoscopic modalities. Relevant articles were identified in searches of the PubMed, EMBASE and Cochrane Library databases. The modalities, comprising of standard-definition white light (SDWL), high-definition white light (HDWL), narrow-band imaging (NBI), autofluorescence imaging (AFI), PENTAX image enhanced technology (i-SCAN), Fuji Intelligent Color Enhancement (FICE), dye-based chromoendoscopy and novel image enhanced systems, including blue laser imaging (BLI) and linked color imaging (LCI), were compared to identify the most efficient modalities that could be used to detect colorectal lesions. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated. As a result, 40 studies fulfilled the inclusion criteria. Overall, in the network meta-analyses, NBI (OR, 1.29; 95% CI, 1.04-1.58), FICE (OR, 1.39; 95% CI, 1.11-1.77), chromoendoscopy (OR, 1.53; 95% CI, 1.22-1.93) and AFI (OR, 1.81; 95% CI, 1.07-2.87) were significantly better compared with SDWL at identifying adenoma in patients, and chromoendoscopy also proved significantly superior to HDWL (OR, 1.30; 95% CI, 1.06-1.60). In pairwise analyses, it was demonstrated that chromoendoscopy was significantly superior to HDWL at detecting the number of polyps (MD, -1.11; 95% CI, -1.46, -0.76) and flat lesions (MD, -0.30; 95% CI, -0.49, -0.10) per subject. Additionally, FICE detected a significantly greater number of subjects with polyps (OR, 0.78; 95% CI, 0.64-0.96) and NBI was significantly better at detecting the number of subjects with flat lesions (OR, 0.77; 95% CI, 0.60-0.99) compared with HDWL. Based on the meta-analysis, NBI, FICE and AFI were significantly better compared with SDWL at detecting patients with adenoma. Additionally, chromoendoscopy was significantly better than SDWL and HDWL at detecting the number of colorectal adenoma, however additional studies are needed to confirm these findings.
| S-EPMC6566047 | biostudies-literature
Project description:BackgroundRecently, the effect of exercise on sleep quality has been paid increasing attention by researchers. A number of systematic reviews and direct meta-analyses have explored the effectiveness of exercise on sleep quality. However, which type of exercise is optimal for sleep quality is still not clear. Therefore, this study aims to adopt network meta-analysis to evaluate the effect of different exercise modalities on sleep quality and find the most effective one for improving sleep quality.MethodsThe databases searched included PubMed, Web of Science, EMBASE, CENTRAL, PsycINFO, and SPORTDiscus. Studies published in English and from the dates of database inception to October 8, 2019, were included. Besides, we also checked the reference lists of systematic reviews published in recent years. Two independent researchers screened all studies, included the studies that met eligible criteria and will then extract data. The risk of bias will be assessed by the 2 researchers according to the modified Cochrane Risk of Bias Tool. During these processes, any disagreement will be discussed to reach a consensus. STATA 14.0 software will be used for direct meta-analysis and network meta-analysis.ResultsHigh-quality synthesis of current evidences will be provided from Pittsburgh sleep quality index. And the effectiveness of different exercise modalities for sleep quality will also be shown.ConclusionThis study will provide the evidence of the most effective exercise for better sleep quality.RegistrationThis study was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (registration number: INPLASY202050096).
| S-EPMC7373514 | biostudies-literature
Project description:Background: Eating or skipping breakfast for weight interests scientific and lay communities. Our objective was to systematically review and meta-analyze causal effects of eating versus skipping breakfast on obesity-related anthropometric outcomes in humans. Methods: Six databases were searched for obesity- and breakfast-related terms (final search: 02 JAN 2020). Studies needed to isolate eating versus skipping breakfast in randomized controlled trials. Mean differences were synthesized using inverse variance random effects meta-analysis for each outcome. Positive estimates indicate higher outcomes in breakfast conditions (e.g., weight gain). Leave-one-out sensitivity analysis, secondary baseline habit-by-breakfast assignment analysis, and study duration cumulative analysis were performed. Risk of bias was assessed using Cochrane risk of bias tool. Results: Ten articles (12 comparisons; 6d-12wk) were included. Conditions included recommendations to eat versus skip breakfast, or provision of some or all meals. 95% confidence intervals of all main analyses included the null value of no difference for each outcome: body weight (0.17 kg [-0.40,0.73], k=12, n=487, I 2=74.5), BMI (0.07 kg/m 2 [-0.10,0.23, k=8, n=396, I 2=54.1), body fat percentage (-0.27% [-1.01,0.47], k=6, n=179, I 2=52.4), fat mass (0.24 kg [-0.21,0.69], k=6, n=205, I 2=0.0), lean mass (0.18 kg [-0.08,0.44], k=6, n=205, I 2=6.7), waist circumference (0.18 cm [-1.77,2.13], k=4, n=102, I 2=78.7), waist:hip ratio (0.00 [-0.01,0.01], k=4, n=102, I 2=8.0), sagittal abdominal diameter (0.19 cm [-2.35,2.73], k=2, n=56, I 2=0.0), and fat mass index (0.00 kg/m 2 [-0.22,0.23], k=2, n=56, I 2=0.0). Subgroup analysis showed only one statistically significant result. The interaction effect for BMI (-0.36[-0.65,-0.07]) indicates assignment to conditions consistent with baseline habits had lower BMI. Leave-one-out analysis did not indicate substantial influence of any one study. Conclusions: There was no discernible effect of eating or skipping breakfast on obesity-related anthropometric measures when pooling studies with substantial design heterogeneity and sometimes statistical heterogeneity. Registration: PROSPERO CRD42016033290.
| S-EPMC8924556 | biostudies-literature