1
|
Xie Y, Gu Y, Li Z, He B, Zhang L. Effects of Different Exercises Combined with Different Dietary Interventions on Body Composition: A Systematic Review and Network Meta-Analysis. Nutrients 2024; 16:3007. [PMID: 39275322 PMCID: PMC11397086 DOI: 10.3390/nu16173007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 08/28/2024] [Accepted: 09/03/2024] [Indexed: 09/16/2024] Open
Abstract
BACKGROUND Exercise and dietary interventions are essential for maintaining weight and reducing fat accumulation. With the growing popularity of various dietary strategies, evidence suggests that combining exercise with dietary interventions offers greater benefits than either approach alone. Consequently, this combined strategy has become a preferred method for many individuals aiming to maintain health. Calorie restriction, 5/2 intermittent fasting, time-restricted feeding, and the ketogenic diet are among the most popular dietary interventions today. Aerobic exercise, resistance training, and mixed exercise are the most widely practiced forms of physical activity. Exploring the best combinations of these approaches to determine which yields the most effective results is both meaningful and valuable. Despite this trend, a comparative analysis of the effects of different exercise and diet combinations is lacking. This study uses network meta-analysis to evaluate the impact of various combined interventions on body composition and to compare their efficacy. METHODS We systematically reviewed literature from database inception through May 2024, searching PubMed, Web of Science, Embase, and the Cochrane Library. The study was registered in PROSPERO under the title: "Effects of Exercise Combined with Different Dietary Interventions on Body Composition: A Systematic Review and Network Meta-Analysis" (identifier: CRD42024542184). Studies were meticulously selected based on specific inclusion and exclusion criteria (The included studies must be randomized controlled trials involving healthy adults aged 18 to 65 years. Articles were rigorously screened according to the specified inclusion and exclusion criteria.), and their risk of bias was assessed using the Cochrane risk of bias tool. Data were aggregated and analyzed using network meta-analysis, with intervention efficacy ranked by Surface Under the Cumulative Ranking (SUCRA) curves. RESULTS The network meta-analysis included 78 randomized controlled trials with 5219 participants, comparing the effects of four combined interventions: exercise with calorie restriction (CR+EX), exercise with time-restricted eating (TRF+EX), exercise with 5/2 intermittent fasting (5/2F+EX), and exercise with a ketogenic diet (KD+EX) on body composition. Intervention efficacy ranking was as follows: (1) Weight Reduction: CR+EX > KD+EX > TRF+EX > 5/2F+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 2.94 (-3.64, 9.52); 2.37 (-0.40, 5.15); 1.80 (-1.75, 5.34)). (2) BMI: CR+EX > KD+EX > 5/2F+EX > TRF+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 1.95 (-0.49, 4.39); 2.20 (1.08, 3.32); 1.23 (-0.26, 2.71)). (3) Body Fat Percentage: CR+EX > 5/2F+EX > TRF+EX > KD+EX (Relative to CR+EX, the effect sizes of 5/2F+EX, TRF+EX and KD+EX are 2.66 (-1.56, 6.89); 2.84 (0.56, 5.13); 3.14 (0.52, 5.75).). (4) Lean Body Mass in Male: CR+EX > TRF+EX > KD+EX (Relative to CR+EX, the effect sizes of TRF+EX and KD+EX are -1.60 (-6.98, 3.78); -2.76 (-7.93, 2.40)). (5) Lean Body Mass in Female: TRF+EX > CR+EX > 5/2F+EX > KD+EX (Relative to TRF+EX, the effect sizes of CR+EX, 5/2F+EX and KD+EX are -0.52 (-2.58, 1.55); -1.83 (-4.71, 1.04); -2.46 (-5.69,0.76).). CONCLUSION Calorie restriction combined with exercise emerged as the most effective strategy for reducing weight and fat percentage while maintaining lean body mass. For women, combining exercise with time-restricted eating proved optimal for preserving muscle mass. While combining exercise with a ketogenic diet effectively reduces weight, it is comparatively less effective at decreasing fat percentage and preserving lean body mass. Hence, the ketogenic diet combined with exercise is considered suboptimal.
Collapse
Affiliation(s)
- Yongchao Xie
- Centre for Sport Nutrition and Health, Centre for Nutritional Ecology, School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China
| | - Yu Gu
- Henan Sports Medicine and Rehabilitation Center, Henan Sport University, Zhengzhou 450044, China
| | - Zhen Li
- Centre for Sport Nutrition and Health, Centre for Nutritional Ecology, School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China
| | - Bingchen He
- Department of Physical Education, South China University of Technology, Guangzhou 510641, China
| | - Lei Zhang
- Centre for Sport Nutrition and Health, Centre for Nutritional Ecology, School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China
| |
Collapse
|
2
|
Liu T, Liu Y, Yan T, Zhang B, Zhou L, Zhu W, Wang G, Kang J, Peng W, Shi L. Intermittent fasting, exercise, and dietary modification induce unique transcriptomic signatures of multiple tissues governing metabolic homeostasis during weight loss and rebound weight gain. J Nutr Biochem 2024; 130:109649. [PMID: 38642842 DOI: 10.1016/j.jnutbio.2024.109649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 04/22/2024]
Abstract
Obesity and its related metabolic diseases bring great challenges to public health. In-depth understanding on the efficacy of weight-loss interventions is critical for long-term weight control. Our study demonstrated the comparable efficacy of exercise (EX), intermittent fasting (IF), or the change of daily diet from an unhealthy to a normal chow (DR) for weight reduction, but largely divergently affected metabolic status and transcriptome of subcutaneous fat, scapular brown fat, skeletal muscles and liver in high-fat-high-fructose diet (HFHF) induced obese mice. EX and IF reduced systematic inflammation, improved glucose and lipid metabolism in liver and muscle, and amino acid metabolism and thermogenesis in adipose tissues. EX exhibited broad regulatory effects on TCA cycle, carbon metabolism, thermogenesis, propanoate-, fatty acid and amino acid metabolism across multiple tissues. IF prominently affected genes involved in mitophagy and autophagy in adipose tissues and core genes involved in butanoate metabolism in liver. DR, however, failed to improve metabolic homeostasis and biological dysfunctions in obese mice. Notably, by exploring potential inter-organ communication, we identified an obesity-resistant-like gene profile that were strongly correlated with HFHF induced metabolic derangements and could predict the degree of weight regain induced by the follow-up HFHF diet. Among them, 12 genes (e.g., Gdf15, Tfrc, Cdv3, Map2k4, and Nqo1) were causally associated with human metabolic traits, i.e., BMI, body fat mass, HbA1C, fasting glucose, and cholesterol. Our findings provide critical groundwork for improved understanding of the impacts of weight-loss interventions on host metabolism. The identified genes predicting weight regain may be considered regulatory targets for improving long-term weight control.
Collapse
Affiliation(s)
- Tianqi Liu
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi'an, China
| | - Yuan Liu
- School of Physical Education, Shaanxi Normal University, Xi'an, China
| | - Tao Yan
- School of Food Science and Engineering, South China University of Technology, Guangzhou, Guangdong, China
| | - Baobao Zhang
- School of Physical Education, Shaanxi Normal University, Xi'an, China
| | - Lanqi Zhou
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi'an, China
| | - Wanyu Zhu
- School of Physical Education, Shaanxi Normal University, Xi'an, China
| | - Guoze Wang
- School of Public Health, Guizhou Medical University, Guiyang, Guizhou, China
| | - Jie Kang
- School of Physical Education, Shaanxi Normal University, Xi'an, China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, Qinghai, China.
| | - Lin Shi
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi'an, China.
| |
Collapse
|
3
|
Jagim AR, Moschelli JS, Woodroffe LM, Horswill CA, Bloomfield SA, Oppliger RA. Contemporary Issue: Health and Safety of Female Wrestlers. Curr Sports Med Rep 2024; 23:262-269. [PMID: 38941548 DOI: 10.1249/jsr.0000000000001183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
ABSTRACT Female wrestling has grown exponentially over the past decade. Within the United States, 46 states now recognize female high school wrestling, and 153 colleges have programs. It is on track to become an NCAA championship-level sport in 2026. A primary health and safety risk among this cohort pertains to rapid weight loss strategies. These can lead to intentional caloric restriction and decreased body fatness, with the perceived goal of attaining a competitive advantage. Low energy availability and low body fatness are associated with a number of health concerns including menstrual dysfunction and loss of bone mineral density in girls and women. The current recommendation of 12% as a minimum for percentage body fat is very likely too low, opening the door for health perturbations among this population. The minimum threshold might more appropriately fall within the range of 18% to 20%. Body fat assessment methods, primarily skinfold measures that are used to guide weight class selection, have not been adequately validated among this population and therefore should be an area of research focus, while also exploring alternative assessment techniques. Further, we recommend that weight cycling, restrictive energy intake, and intentional dehydration be avoided. Research should assess the effects of frequent weight cycling (to "make weight") and prolonged periods of low body fat on the reproductive and bone health of these athletes. Finally, research and clinical evaluations on female wrestlers are limited, and we offer a list of research priorities for future investigation into this contemporary issue.
Collapse
Affiliation(s)
- Andrew R Jagim
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI
| | - Jill S Moschelli
- Sports Medicine and Orthopedics, Michigan State University, East Lansing, MI
| | | | - Craig A Horswill
- Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL
| | - Susan A Bloomfield
- Kinesiology and Sport Management, Texas A&M University - College Station, TX
| | | |
Collapse
|
4
|
Dickerson B, Maury J, Jenkins V, Nottingham K, Xing D, Gonzalez DE, Leonard M, Kendra J, Ko J, Yoo C, Johnson S, Pradelles R, Purpura M, Jäger R, Sowinski R, Rasmussen CJ, Kreider RB. Effects of Supplementation with Microalgae Extract from Phaeodactylum tricornutum (Mi136) to Support Benefits from a Weight Management Intervention in Overweight Women. Nutrients 2024; 16:990. [PMID: 38613023 PMCID: PMC11013338 DOI: 10.3390/nu16070990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Microalgae like Phaeodactylum tricornutum (PT) contain the carotenoid, fucoxanthin, which has been purported to promote fat loss, lower blood lipids, and improve glucose management. This study examined whether dietary supplementation with microalgae extracts from PT containing 4.4 mg/d of fucoxanthin affects changes in body composition or health markers in overweight women during an exercise and diet intervention. MATERIALS AND METHODS A total of 37 females (28.6 ± 7.9 years, 80.2 ± 14.9 kg, 29.6 ± 3.8 kg/m², 41.4 ± 4.2% fat) fasted for 12 h, donated a fasting blood sample, completed health and mood state inventories, and undertook body composition, health, and exercise assessments. In a counterbalanced, randomized, and double-blind manner, participants ingested a placebo (PL), or microalgae extract of Phaeodactylum tricornutum standardized to 4.4 mg of fucoxanthin (FX) for 12 weeks while participating in a supervised exercise program that included resistance-training and walking (3 days/week) with encouragement to accumulate 10,000 steps/day on remaining days of the week. The diet intervention involved reducing energy intake by about -300 kcal/d (i.e., ≈1400-1600 kcals/d, 55% carbohydrate, 30% fat, 15% protein) to promote a -500 kcal/d energy deficit with exercise. Follow-up testing was performed at 6 and 12 weeks. A general linear model (GLM) with repeated measures statistical analysis was used to analyze group responses and changes from baseline with 95% confidence intervals. RESULTS Dietary supplementation with microalgae extract from PT containing fucoxanthin for 12 weeks did not promote additional weight loss or fat loss in overweight but otherwise healthy females initiating an exercise and diet intervention designed to promote modest weight loss. However, fucoxanthin supplementation preserved bone mass, increased bone density, and saw greater improvements in walking steps/day, resting heart rate, aerobic capacity, blood lipid profiles, adherence to diet goals, functional activity tolerance, and measures of quality of life. Consequently, there appears to be some benefit to supplementing microalgae extract from PT containing fucoxanthin during a diet and exercise program. Registered clinical trial #NCT04761406.
Collapse
Affiliation(s)
- Broderick Dickerson
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Jonathan Maury
- Research & Development Department, Microphyt, 34670 Baillargues, France; (J.M.); (R.P.)
| | - Victoria Jenkins
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Kay Nottingham
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Dante Xing
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Drew E. Gonzalez
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Megan Leonard
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Jacob Kendra
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Joungbo Ko
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Choongsung Yoo
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Sarah Johnson
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Rémi Pradelles
- Research & Development Department, Microphyt, 34670 Baillargues, France; (J.M.); (R.P.)
| | - Martin Purpura
- Increnovo LLC, Whitefish Bay, WI 53217, USA; (M.P.); (R.J.)
| | - Ralf Jäger
- Increnovo LLC, Whitefish Bay, WI 53217, USA; (M.P.); (R.J.)
| | - Ryan Sowinski
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Christopher J. Rasmussen
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| | - Richard B. Kreider
- Exercise & Sport Nutrition Laboratory, Department of Kinesiology and Sports Management, Texas A&M University, College Station, TX 77843, USA; (B.D.); (V.J.); (K.N.); (D.X.); (D.E.G.); (M.L.); (J.K.); (J.K.); (C.Y.); (S.J.); (R.S.); (C.J.R.)
| |
Collapse
|
5
|
Chen R, Armamento-Villareal R. Obesity and Skeletal Fragility. J Clin Endocrinol Metab 2024; 109:e466-e477. [PMID: 37440585 PMCID: PMC10795939 DOI: 10.1210/clinem/dgad415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/15/2023]
Abstract
Skeletal fracture has recently emerged as a complication of obesity. Given the normal or better than normal bone mineral density (BMD), the skeletal fragility of these patients appears to be a problem of bone quality rather than quantity. Type 2 diabetes mellitus (T2DM), the incidence of which increases with increasing body mass index, is also associated with an increased risk for fractures despite a normal or high BMD. With the additional bone pathology from diabetes itself, patients with both obesity and T2DM could have a worse skeletal profile. Clinically, however, there are no available methods for identifying those who are at higher risk for fractures or preventing fractures in this subgroup of patients. Weight loss, which is the cornerstone in the management of obesity (with or without T2DM), is also associated with an increased risk of bone loss. This review of the literature will focus on the skeletal manifestations associated with obesity, its interrelationship with the bone defects associated with T2DM, and the available approach to the bone health of patients suffering from obesity.
Collapse
Affiliation(s)
- Rui Chen
- Division of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| |
Collapse
|
6
|
Li W, Chen W. Weight cycling based on altered immune microenvironment as a result of metaflammation. Nutr Metab (Lond) 2023; 20:13. [PMID: 36814270 PMCID: PMC9945679 DOI: 10.1186/s12986-023-00731-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
As a result of the obesity epidemic, more people are concerned about losing weight; however, weight regain is common, leading to repeated weight loss and weight cycling. The health benefits of early weight loss are nullified by weight regain after weight cycling, which has much more severe metabolic consequences. Weight cycling alters body composition, resulting in faster fat recovery and slower muscle reconstruction. This evident fat accumulation, muscle loss, and ectopic fat deposition destroy the intestinal barrier, increase the permeability of the small intestinal epithelium, and cause the lipotoxicity of lipid metabolites and toxins to leak into extraintestinal tissues and circulation. It causes oxidative stress and hypoxia in local tissues and immune cell infiltration in various tissues, all contributing to the adaptation to this metabolic change. Immune cells transmit inflammatory responses in adipose and skeletal muscle tissue by secreting cytokines and adipokines, which mediate immune cell pathways and cause metaflammation and inefficient metabolic degradation. In this review, we focus on the regulatory function of the immunological microenvironment in the final metabolic outcome, with a particular emphasis on the cellular and molecular processes of local and systemic metaflammation induced by weight cycling-induced changes in body composition. Metaflammation in adipose and muscle tissues that is difficult to relieve may cause weight cycling. As this chronic low-grade inflammation spreads throughout the body, metabolic complications associated with weight cycling are triggered. Inhibiting the onset and progression of metabolic inflammation and enhancing the immune microenvironment of adipose and muscle tissues may be the first step in addressing weight cycling.
Collapse
Affiliation(s)
- Wanyang Li
- grid.413106.10000 0000 9889 6335Department of Clinical Nutrition, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730 China
| | - Wei Chen
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
| |
Collapse
|