Zhang Hui, Du Jinchao, Zhang Mingchen, Li Tingting, Zhang Pingping, Wang Xiaowen, Sun Zhongguang
School of Rehabilitation Medicine, Shandong Second Medical University, Weifang 261053, China.
Nutr Rev. 2025 Apr 1;83(4):636-647. doi: 10.1093/nutrit/nuae114.
All types of caloric restriction are preventive against cardiovascular risk factors, but the best restriction method and most affected factors have not been identified.
The objective of this study was to explore the effects of different caloric restriction methods on various cardiovascular risk factors by horizontally comparing program advantages and disadvantages via network meta-analysis.
The PubMed, Web of Science, Cochrane Library, and Embase literature databases were searched (October 2013 to October 2023).
Eligible randomized controlled trials involving participants who underwent caloric restriction and systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and high-density lipoprotein (HDL) cholesterol level measurements were included.
Thirty-six of 13 208 records (0.27%) were included. Two researchers reviewed the articles, extracted data, and assessed article quality.
Alternate-day fasting (ADF) reduced SBP (4.88 mmHg; CI, 2.06-7.15) and DBP (5.10 mmHg; CI, 2.44-7.76). Time-restricted eating reduced SBP (2.46 mmHg; CI, 0.16-4.76) but not DBP. Continuous energy restriction (CER) significantly reduced BMI (1.11 kg/m2; CI = 0.16, 2.06) and waist circumference (3.28 cm; CI, 0.62-5.94).
This meta-analysis confirmed the preventive effect of CER and ADF on various cardiovascular risk factors. Additionally, CER is more likely to reduce obesity, and ADF is more likely to reduce blood pressure (BP). Based on this meta-analysis, CER is recommended to control obesity only for people who are obese and do not have elevated BP or other abnormal indicators. Additionally, ADF for early control or prevention is recommended for patients who have abnormal BP or other cardiovascular risk factors.
PROSPERO registration no. CRD42023455889.
所有类型的热量限制都可预防心血管危险因素，但最佳的限制方法和最受影响的因素尚未确定。
本研究的目的是通过网络荟萃分析横向比较不同热量限制方法的优缺点，探讨其对各种心血管危险因素的影响。
检索了PubMed、Web of Science、Cochrane图书馆和Embase文献数据库（2013年10月至2023年10月）。
纳入符合条件的随机对照试验，试验对象为接受热量限制并测量收缩压（SBP）、舒张压（DBP）、体重指数（BMI）和高密度脂蛋白（HDL）胆固醇水平的参与者。
13208条记录中的36条（0.27%）被纳入。两名研究人员对文章进行了审查、提取数据并评估文章质量。
隔日禁食（ADF）可降低收缩压（4.88 mmHg；可信区间，2.06 - 7.15）和舒张压（5.10 mmHg；可信区间，2.44 - 7.76）。限时进食可降低收缩压（2.46 mmHg；可信区间，0.16 - 4.76），但不能降低舒张压。持续能量限制（CER）可显著降低体重指数（1.11 kg/m²；可信区间 = 0.16，2.06）和腰围（3.28 cm；可信区间，0.62 - 5.94）。
这项荟萃分析证实了CER和ADF对各种心血管危险因素的预防作用。此外，CER更有可能减轻肥胖，而ADF更有可能降低血压（BP）。基于这项荟萃分析，仅建议肥胖且血压未升高或无其他异常指标的人群采用CER来控制肥胖。此外，对于血压异常或有其他心血管危险因素的患者，建议采用ADF进行早期控制或预防。
PROSPERO注册号CRD42023455889。
