MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE22 3DT, UK.
Department of Endocrinology and Diabetes, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK.
Nutrients. 2024 Sep 30;16(19):3328. doi: 10.3390/nu16193328.
Severe caloric restriction interventions (such as very-low-calorie diets) are effective for inducing significant weight loss and remission of type 2 diabetes (T2DM). However, suggestions of associated significant muscle mass (MM) loss create apprehension regarding their widespread use. We conducted a systematic review and meta-analysis to provide a quantitative assessment of their effect on measures of MM in individuals with, or without, T2DM.
EMBASE, Medline, Pubmed, CINAHL, CENTRAL and Google Scholar were systematically searched for studies involving caloric restriction interventions up to 900 kilocalories per day reporting any measure of MM, in addition to fat mass (FM) or body weight (BW).
Forty-nine studies were eligible for inclusion, involving 4785 participants. Individuals with T2DM experienced significant reductions in MM (WMD -2.88 kg, 95% CI: -3.54, -2.22; < 0.0001), although this was significantly less than the reduction in FM (WMD -7.62 kg, 95% CI: -10.87, -4.37; < 0.0001). A similar pattern was observed across studies involving individuals without T2DM. MM constituted approximately 25.5% of overall weight loss in individuals with T2DM, and 27.5% in individuals without T2DM. Subgroup analysis paradoxically revealed greater BW and FM reductions with less restrictive interventions.
Our review suggests that caloric restriction interventions up to 900 kilocalories per day are associated with a significant reduction in MM, albeit in the context of a significantly greater reduction in FM. Furthermore, MM constituted approximately a quarter of the total weight loss. Finally, our data support the use of less restrictive interventions, which appear to be more beneficial for BW and FM loss.
严格的热量限制干预（如极低热量饮食）对于诱导显著的体重减轻和 2 型糖尿病（T2DM）缓解是有效的。然而，有关大量肌肉质量（MM）损失的建议引起了对其广泛应用的担忧。我们进行了系统回顾和荟萃分析，以定量评估它们对 T2DM 患者或非 T2DM 患者 MM 测量值的影响。
系统检索了 EMBASE、Medline、Pubmed、CINAHL、CENTRAL 和 Google Scholar 中的研究，这些研究涉及热量限制干预，每天热量限制在 900 卡路里以内，除了脂肪量（FM）或体重（BW）外，还报告了任何 MM 测量值。
有 49 项研究符合纳入标准，涉及 4785 名参与者。T2DM 患者的 MM 明显减少（WMD-2.88kg，95%CI：-3.54，-2.22；<0.0001），尽管这明显小于 FM 的减少（WMD-7.62kg，95%CI：-10.87，-4.37；<0.0001）。在不患有 T2DM 的参与者中也观察到了类似的模式。在患有 T2DM 的患者中，MM 占总体重减轻的 25.5%，在不患有 T2DM 的患者中占 27.5%。亚组分析显示，限制较少的干预措施与更大的 BW 和 FM 减少有关。
我们的综述表明，每天热量限制在 900 卡路里以内与 MM 的显著减少有关，尽管在 FM 显著减少的情况下。此外，MM 约占总体重减轻的四分之一。最后，我们的数据支持使用限制较少的干预措施，这似乎对 BW 和 FM 减轻更有益。
