The Centre for Lifestyle Medicine and Behaviour (CLIMB), School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Obes Rev. 2022 Feb;23(2):e13357. doi: 10.1111/obr.13357. Epub 2021 Sep 28.
Traditional weight management interventions typically involve people making large changes to their energy intake and/or expenditure and can be effective in the short term, but weight regain is common. An alternative strategy is a small change approach, which asks people to make small(er) changes to their diet and/or physical activity behaviors (e.g., 100-kcal reduction or increases of 1000 steps/day). This approach may lead to sustained weight management because such energy-deficit goals are easier for people to integrate into their lives and then maintain. This systematic review and meta-analysis of randomized and quasi-randomized controlled trials assessed the effectiveness of a small change approach for weight management; 21 trials were included. In weight gain prevention trials with adults, the mean difference in weight change between groups was -0.7 kg (95% CI -1.0 to -0.4, 95% PI -1.1 to -0.3) at program-end and -0.9 kg (95% CI -1.5 to -0.3, 95% PI -3.1 to 1.3) at last follow-up, favoring small change interventions. A small change approach was not effective for weight loss. Only 2/21 trials had a low risk of bias. Initial evidence supports the effectiveness of a small change approach for weight gain prevention but not weight loss. Further high-quality trials with longer follow-up are required.
传统的体重管理干预措施通常涉及人们对能量摄入和/或消耗进行大幅度改变，短期内可能有效，但体重容易反弹。另一种策略是小变化方法，要求人们对饮食和/或体育活动行为进行小幅度改变（例如，减少 100 卡路里或每天增加 1000 步）。这种方法可能会导致体重管理的持续效果，因为人们更容易将这些能量不足的目标融入日常生活并维持下去。本系统评价和荟萃分析对随机和准随机对照试验进行了评估，以评估小变化方法在体重管理方面的有效性；共纳入 21 项试验。在针对成年人的体重增加预防试验中，组间体重变化的平均差异在项目结束时为-0.7kg（95%置信区间-1.0 至-0.4，95%置信区间-1.1 至-0.3），在最后一次随访时为-0.9kg（95%置信区间-1.5 至-0.3，95%置信区间-3.1 至 1.3），小变化干预措施更有利。小变化方法对减肥无效。21 项试验中仅有 2 项试验的偏倚风险较低。初步证据支持小变化方法在预防体重增加方面的有效性，但对减肥无效。需要进一步进行高质量、随访时间更长的试验。
