Evans Tamla S, Dhir Pooja, Matu Jamie, Radley Duncan, Hill Andrew J, Jones Andrew, Newson Lisa, Freeman Charlotte, Kolokotroni Katerina Z, Fozard Therese, Ells Louisa J
Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK.
Obesity Institute, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
Obes Rev. 2025 May;26(5):e13896. doi: 10.1111/obr.13896. Epub 2025 Jan 22.
There is limited evidence and clinical guidelines on the behavior change support required for low-calorie diet programs. This systematic review aimed to establish the behavior change technique(s) (BCT) implemented in weight loss interventions (≤1200 kcal/d) and how these contribute to effectiveness.
Databases were searched from inception to April 2022. Screening, data extraction, BCT coding, and quality appraisal were conducted in duplicate using the Template for Intervention Description and Replication framework, Behavior Change Technique Taxonomy, and Cochrane Risk of Bias 2 tool. Data were analyzed via narrative synthesis and random effects multi-level meta-analyses.
Thirty-two papers reporting on 27 studies were included. Twenty-four BCTs were identified across studies. Eight BCTs were significantly associated with a larger reduction in weight at the end-of-diet time-point; one BCT was statistically significant at the end of weight maintenance. Physical activity, Type 2 Diabetes, and BMI category moderated intervention effects.
This is the first meta-analysis to examine how specific BCTs contribute to the effectiveness of low-calorie diets. It is recommended that a) these findings are used to develop clinical guidelines specific to behavioral support in low-calorie diet programs, and b) program commissioners stipulate the use of these BCTs in their service specifications.
关于低热量饮食计划所需行为改变支持的证据和临床指南有限。本系统评价旨在确定在减肥干预措施（≤1200千卡/天）中实施的行为改变技术（BCT），以及这些技术如何促进有效性。
检索自数据库建立至2022年4月的文献。使用干预描述与复制模板框架、行为改变技术分类法和Cochrane偏倚风险2工具，对筛选、数据提取、BCT编码和质量评估进行了重复操作。通过叙述性综合分析和随机效应多层次荟萃分析对数据进行分析。
纳入了32篇报告27项研究的论文。各项研究共确定了24种行为改变技术。八项行为改变技术与节食结束时体重的更大幅度减轻显著相关；一项行为改变技术在体重维持期末具有统计学意义。身体活动、2型糖尿病和体重指数类别对干预效果有调节作用。
这是第一项研究特定行为改变技术如何促进低热量饮食有效性的荟萃分析。建议：a）利用这些研究结果制定针对低热量饮食计划中行为支持的临床指南，b）项目委托方在其服务规范中规定使用这些行为改变技术。
