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. 2015 Apr 17;14:31.
doi: 10.1186/s40200-015-0154-1. eCollection 2015.

Diet, Exercise or Diet With Exercise: Comparing the Effectiveness of Treatment Options for Weight-Loss and Changes in Fitness for Adults (18-65 Years Old) Who Are Overfat, or Obese; Systematic Review and Meta-Analysis

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Diet, Exercise or Diet With Exercise: Comparing the Effectiveness of Treatment Options for Weight-Loss and Changes in Fitness for Adults (18-65 Years Old) Who Are Overfat, or Obese; Systematic Review and Meta-Analysis

James E Clark. J Diabetes Metab Disord. .
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Abstract

There are number of means of methods to alter body composition, and metabolic issues, available for the adult who is overfat. The following is a systematic review and meta-analysis focused on comparing changes from treatment program for adults who are overfat based on analysis of aggregated effect size (ES) of inducing changes. So as to determine the relative effectiveness of such protocols and intervention plans of choice. This tiered meta-analysis of 66-population based studies, and 162-studywise groups, a clear pattern of ES being established across and within treatments. First, hypocaloric balance is necessary for changing body composition, but the effectiveness for establishing imbalance does not equate with the effectiveness for body compositional changes, or any biomarkers associated with metabolic issues. With analysis showing that there is a necessity to include exercise in combination with diet effectively elicit changes in body composition and biomarkers of metabolic issues. More importantly, the combination, resistance training (RT) was more effective than endurance training (ET) or combination of RT and ET, particularly when progressive training volume of 2-to-3 sets for 6-to-10 reps at an intensity of ≥75% 1RM, utilizing whole body and free-weight exercises, at altering body compositional measures (ES of 0.47, 0.30, and 0.40 for loss of BM, FM, and retention of FFM respectively) and reducing total cholesterol (ES = 0.85), triglycerides (ES = 0.86) and low-density lipoproteins (ES = 0.60). Additionally RT was more effective at reducing fasting insulin levels (ES = 3.5) than ET or ET and RT. Even though generally lower ES than RT, the inclusion of ET was more effective when performed at high intensity (e.g. ≥70% VO2max or HRmax for 30-minutes 3-4x's/wk), or in an interval training style than when utilizing the relatively common prescribed method of low-to-moderate (e.g., 50-70% VO2max or HRmax for at least equal time) steady state method, ES of 0.35, 0.39, and 0.13 for BM, FM, and FFM respectively. Thus indicating that focus of treatment should be on producing a large metabolic stress (as induced by RT or high levels of ET) rather than an energetic imbalance for adults who are overfat.

Keywords: Comparison; Exercise; Obesity; Weight loss.

Figures

Figure 1
Figure 1
Description summarizing the steps for inclusion/exclusion and method leading to classification and analysis of studies involved within the meta-analysis.
Figure 2
Figure 2
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of ET, or versus diet with combination of RT) methods for changes in either Body Mass (BM), Fat Mass (Fat), and Fat-Free Mass (FFM). Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.
Figure 3
Figure 3
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of either ET, RT, or combination of ET and RT) methods for changes in energetic imbalance as assumed established within the intervention protocol. Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.
Figure 4
Figure 4
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Figure 5
Figure 5
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination ET) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Figure 6
Figure 6
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of RT) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Figure 7
Figure 7
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of ET, or versus diet with combination of RT) methods for response related to changes in Insulin. Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.
Figure 8
Figure 8
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Figure 9
Figure 9
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of ET) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Figure 10
Figure 10
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of RT) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.

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