Kim Kyoung-Kon, Kang Jee-Hyun, Kim Eun Mi
Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea.
Department of Family Medicine, Konyang University College of Medicine, Daejeon, Korea.
J Obes Metab Syndr. 2022 Sep 30;31(3):230-244. doi: 10.7570/jomes22050.
Despite the considerable number of trials and meta-analyses of studies on intermittent energy restriction (IER), it is not preferred to continuous energy restriction (CER) by the majority of obesity specialists. In this meta-analysis, we compare the effects of IER and CER on obesity using evidence from randomized controlled trials (RCTs).
A systematic electronic literature search was conducted to find RCTs published between January 1, 2011, and December 31, 2021 that directly compared IER and CER for an active weight loss period of at least 12 weeks and reported obesity indices or metabolic markers in adults with overweight or obesity. Finally, 16 RCTs from 25 articles with 1,438 participants were included.
The attrition rates were 26.6% and 24.1% in the IER and CER groups, respectively, with no significant differences in changes in body weight, waist circumference, or body fat composition. CER changed blood glucose levels more than IER, but there was no significant difference in glycated hemoglobin levels. Systolic blood pressure was significantly lower in the CER group than the IER group, but diastolic blood pressure did not differ significantly between the groups. Changes in blood lipids did not differ significantly between the interventions. No differences between IER and CER were observed in the sensitivity analyses.
IER can be an alternative to CER because it induces comparable weight reduction and metabolic improvement. However, the effect of IER was not superior to that of CER, and its attrition rate was not lower than that of CER.
尽管关于间歇性能量限制(IER)的研究有大量试验和荟萃分析,但大多数肥胖专家并不认为它比持续能量限制(CER)更优。在这项荟萃分析中,我们使用随机对照试验(RCT)的证据比较IER和CER对肥胖的影响。
进行了系统的电子文献检索,以查找2011年1月1日至2021年12月31日期间发表的RCT,这些试验直接比较了IER和CER在至少12周的积极减重期的效果,并报告了超重或肥胖成年人的肥胖指数或代谢指标。最后,纳入了来自25篇文章的16项RCT,共1438名参与者。
IER组和CER组的失访率分别为26.6%和24.1%,体重、腰围或体脂成分变化无显著差异。CER比IER更能改变血糖水平,但糖化血红蛋白水平无显著差异。CER组的收缩压显著低于IER组,但两组间舒张压无显著差异。干预措施之间血脂变化无显著差异。敏感性分析未观察到IER和CER之间的差异。
IER可以作为CER的替代方案,因为它能带来相当的体重减轻和代谢改善。然而,IER的效果并不优于CER,其失访率也不低于CER。