Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Obes Rev. 2021 Oct;22(10):e13280. doi: 10.1111/obr.13280. Epub 2021 May 24.
Weight gain prevention is a global public health priority to address escalating adiposity in adults. This review evaluates the efficacy of weight gain prevention trials targeting adults aged 18-50 years and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Trials of any duration from inception to May 2020 that evaluated a weight gain prevention intervention (using either prescriptive diet, prescriptive physical activity, prescriptive diet, and/or physical activity or non-prescriptive lifestyle) and included weight or body mass index (weight [kg]/height [m ]) were eligible. Twenty-nine trials across 34 publications (participants n = 37,407) were included. Intervention resulted in less weight gain compared with controls (-1.15 kg [95% CI -1.50, -0.80 kg] p < 0.001). Subgroup analysis demonstrated greater effectiveness with prescriptive (-1.60 kg [95% CI -2.00, -1.19] p < 0.001) compared with non-prescriptive (-0.81 kg [95% CI 1.10, -0.53] p < 0.001) intervention types. Interventions had greatest impact in healthy weight (18.5-24.9 kg/m ) (-0.82 kg [95% CI -1.5, -0.50] p < 0.001) or overweight (25.0-29.9 kg/m ) (-1.48 kg [95% CI -1.85, -1.12] p < 0.001) compared with obese populations (≥30.0 kg/m ) (-0.56 kg [95% CI -1.40, 0.27] p = 0.19). These findings demonstrate that lifestyle intervention prevents cumulative weight gain in non-obese adults, with future research required to inform cost-effectiveness and implementation feasibility.
体重增加预防是解决成年人肥胖问题的全球公共卫生重点。本综述评估了针对 18-50 岁成年人的体重增加预防试验的疗效，并遵循系统评价和荟萃分析的首选报告项目（PRISMA）协议。从开始到 2020 年 5 月的任何持续时间的试验，评估了体重增加预防干预措施（使用规定饮食、规定体力活动、规定饮食和/或体力活动或非规定生活方式），并包括体重或体重指数（体重[kg]/身高[m]）是合格的。共有 34 篇文献中的 29 项试验（参与者 n=37407）入选。与对照组相比，干预组体重增加较少（-1.15kg[95%CI-1.50，-0.80kg]，p<0.001）。亚组分析表明，规定干预措施（-1.60kg[95%CI-2.00，-1.19]，p<0.001）比非规定干预措施（-0.81kg[95%CI1.10，-0.53]，p<0.001）更有效。在健康体重（18.5-24.9kg/m）（-0.82kg[95%CI-1.5，-0.50]，p<0.001）或超重（25.0-29.9kg/m）（-1.48kg[95%CI-1.85，-1.12]，p<0.001）人群中，干预措施的影响最大，而在肥胖人群（≥30.0kg/m）中（-0.56kg[95%CI-1.40，0.27]，p=0.19），影响较小。这些发现表明，生活方式干预可预防非肥胖成年人的体重累积增加，需要进一步研究以确定成本效益和实施可行性。
