Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM, Amsterdam, The Netherlands.
Amsterdam Movement Sciences Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands.
Diabet Med. 2023 Jul;40(7):e15096. doi: 10.1111/dme.15096. Epub 2023 Apr 26.
This systematic review and meta-analysis evaluates the additional effect of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes.
Embase, Medline, Web of Science and Cochrane Central databases were evaluated, and 11 studies were included. Random-effects meta-analysis was performed on body weight and measures of body composition and glycaemic control, to compare the effect of hypocaloric diet plus exercise with hypocaloric diet alone.
Exercise interventions consisted of walking or jogging, cycle ergometer training, football training or resistance training and duration varied from 2 to 52 weeks. Body weight and measures of body composition and glycaemic control decreased during both the combined intervention and hypocaloric diet alone. Mean difference in change of body weight (-0.77 kg [95% CI: -2.03; 0.50]), BMI (-0.34 kg/m [95% CI: -0.73; 0.05]), waist circumference (-1.42 cm [95% CI: -3.84; 1.00]), fat-free mass (-0.18 kg [95% CI: -0.52; 0.17]), fat mass (-1.61 kg [95% CI: -4.42; 1.19]), fasting glucose (+0.14 mmol/L [95% CI: -0.02; 0.30]), HbA (-1 mmol/mol [95% CI: -3; 1], -0.1% [95% CI: -0.2; 0.1]) and HOMA-IR (+0.01 [95% CI: -0.40; 0.42]) was not statistically different between the combined intervention and hypocaloric diet alone. Two studies reported VO and showed significant increases upon the addition of exercise to hypocaloric diet.
Based on limited data, we did not find additional effects of exercise to hypocaloric diet in adults with overweight or obesity and type 2 diabetes on body weight, body composition or glycaemic control, while cardio-respiratory fitness improved.
本系统评价和荟萃分析评估了在超重或肥胖且 2 型糖尿病成人中，运动对低热量饮食的额外作用，以评估其对体重、身体成分、血糖控制和心肺功能的影响。
评估了 Embase、Medline、Web of Science 和 Cochrane Central 数据库，并纳入了 11 项研究。对体重和身体成分及血糖控制的测量值进行了随机效应荟萃分析，以比较低热量饮食加运动与单纯低热量饮食的效果。
运动干预包括步行或慢跑、脚踏车测力计训练、足球训练或抗阻训练，持续时间从 2 周到 52 周不等。在联合干预和单纯低热量饮食期间，体重以及身体成分和血糖控制的测量值均降低。体重变化的平均差值（-0.77kg[95%CI：-2.03；0.50]）、BMI（-0.34kg/m[95%CI：-0.73；0.05]）、腰围（-1.42cm[95%CI：-3.84；1.00]）、去脂体重（-0.18kg[95%CI：-0.52；0.17]）、脂肪量（-1.61kg[95%CI：-4.42；1.19]）、空腹血糖（+0.14mmol/L[95%CI：-0.02；0.30]）、HbA1c（-1mmol/mol[95%CI：-3；1]，-0.1%[95%CI：-0.2；0.1]）和 HOMA-IR（+0.01[95%CI：-0.40；0.42]）在联合干预和单纯低热量饮食之间没有统计学差异。有两项研究报告了 VO2，并显示在低热量饮食中加入运动可显著增加。
基于有限的数据，我们未发现超重或肥胖且 2 型糖尿病成人在体重、身体成分或血糖控制方面，运动对低热量饮食有额外的作用，而心肺功能得到了改善。
