Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
Obes Rev. 2016 Aug;17(8):664-90. doi: 10.1111/obr.12406. Epub 2016 May 23.
Exercise training ('exercise') and hypocaloric diet ('diet') are frequently prescribed for weight loss in obesity. Whilst body weight changes are commonly used to evaluate lifestyle interventions, visceral adiposity (VAT) is a more relevant and stronger predictor for morbidity and mortality. A meta-analysis was performed to assess the effects of exercise or diet on VAT (quantified by radiographic imaging). Relevant databases were searched through May 2014. One hundred seventeen studies (n = 4,815) were included. We found that both exercise and diet cause VAT loss (P < 0.0001). When comparing diet versus training, diet caused a larger weight loss (P = 0.04). In contrast, a trend was observed towards a larger VAT decrease in exercise (P = 0.08). Changes in weight and VAT showed a strong correlation after diet (R(2) = 0.737, P < 0.001), and a modest correlation after exercise (R(2) = 0.451, P < 0.001). In the absence of weight loss, exercise is related to 6.1% decrease in VAT, whilst diet showed virtually no change (1.1%). In conclusion, both exercise and diet reduce VAT. Despite a larger effect of diet on total body weight loss, exercise tends to have superior effects in reducing VAT. Finally, total body weight loss does not necessarily reflect changes in VAT and may represent a poor marker when evaluating benefits of lifestyle-interventions.
运动训练（“运动”）和低热量饮食（“饮食”）常被用于肥胖患者的减肥治疗。尽管体重变化常用于评估生活方式干预的效果，但内脏脂肪（VAT）是发病率和死亡率的更相关和更强的预测因子。本 meta 分析旨在评估运动或饮食对 VAT（通过影像学方法定量）的影响。通过检索相关数据库，截至 2014 年 5 月，共纳入 117 项研究（n=4815）。结果显示，运动和饮食均可导致 VAT 减少（P<0.0001）。与运动相比，饮食引起的体重下降更明显（P=0.04）。相比之下，运动引起的 VAT 下降趋势更明显（P=0.08）。饮食后体重和 VAT 的变化呈强相关（R(2)=0.737，P<0.001），运动后呈中度相关（R(2)=0.451，P<0.001）。在没有体重减轻的情况下，运动与 VAT 减少 6.1%相关，而饮食几乎没有变化（1.1%）。结论：运动和饮食均可减少 VAT。尽管饮食对总体体重减轻的影响更大，但运动在减少 VAT 方面的效果更好。最后，总体重减轻不一定反映 VAT 的变化，当评估生活方式干预的益处时，体重可能不是一个很好的标志物。
