热量限制期间运动方式的比较：关于身体成分的系统评价和网状meta分析

Comparing exercise modalities during caloric restriction: a systematic review and network meta-analysis on body composition.

作者信息

Xie Yongchao, Gu Yu, Li Zhen, Zhang Lei, Hei Yang

机构信息

Centre for Sport Nutrition and Health, Centre for Nutritional Ecology, School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, China.

Henan Sports Medicine and Rehabilitation Center, Henan Sport University, Zhengzhou, China.

出版信息

Front Nutr. 2025 May 29;12:1579024. doi: 10.3389/fnut.2025.1579024. eCollection 2025.

DOI:10.3389/fnut.2025.1579024

PMID:40510496

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12158682/

Abstract

BACKGROUND

In recent years, caloric restriction (CR), intermittent fasting (IF), and the ketogenic diet (KD) have gained popularity as primary dietary interventions for improving body composition. While these approaches offer benefits, both IF and KD have been associated with various adverse effects. Although CR is generally devoid of significant side effects, it may lead to reductions in lean body mass. To mitigate this, CR combined with exercise (CR + EX) has become a preferred strategy for maintaining overall health. However, under CR conditions, the effects of exercise may differ from those observed with a normal diet. Most existing studies compare CR + EX with CR alone, exercise alone, or a control (CON) group. Although prior studies have examined caloric restriction with exercise, direct comparisons between specific exercise modalities in a caloric deficit remain unclear, necessitating a network meta-analysis approach. This study summarizes the literature on CR combined with exercise to identify which exercise regimen, when paired with CR, yields the most favorable outcomes. The findings will provide valuable recommendations for individuals seeking to maintain or improve body composition through CR + EX.

METHODS

A systematic review was conducted in accordance with the PRISMA guidelines, covering literature from the inception of databases up to September 2024. Searches were performed in PubMed, Web of Science, Embase, and the Cochrane Library. This study was registered in PROSPERO under the identifier: CRD42024588241. Only randomized controlled trials (RCTs) involving healthy populations were included. Articles were rigorously screened according to the PICOS strategy (methods) eligibility criteria, and the risk of bias was assessed using the Cochrane Risk of Bias Tool. A network meta-analysis was performed, and the intervention effects were ranked using the Surface Under the Cumulative Ranking (SUCRA) curve.

RESULTS

The network meta-analysis included 62 RCTs, encompassing 4,429 participants. The ranking of intervention effects is as follows: Weight reduction: high-intensity aerobic exercise (HA) > moderate-intensity aerobic exercise (MA) > low-intensity aerobic exercise (LA) > moderate-intensity mixed exercise (MM) > high-intensity mixed exercise (HM) > CR > low-intensity resistance exercise (LR) > moderate-intensity resistance exercise (MR) > high-intensity resistance exercise (HR) > Control group (CON), Compared to CON, the effect sizes for the other groups were as follows: HA: 7.94 (6.34, 9.55), MA: 7.78 (5.97, 9.58), LA: 7.10 (5.10, 9.10), MM: 6.65 (3.49, 9.81), HM: 7.47 (3.19, 11.75), CR: 7.10 (5.10, 9.10), LR: 5.45 (0.17, 10.72), MR: 5.62 (3.17, 8.06), HR: 6.00 (3.24, 8.76); BMI reduction: LA > MM > HA > MA > HR > CR > HM > MR > CON; Fat mass reduction: LA > HA > HM > MA > MR > LR > HR > CR > MM > CON, Compared to CON, the effect sizes for the other groups were as follows: LA: 2.70 (1.76, 3.65), MM: 3.35 (1.94, 4.75), HA: 2.90 (2.11, 3.70), MA: 2.96 (2.09, 3.84), HR: 2.56 (1.43, 3.69), CR: 2.47 (1.79, 3.15), HM: 1.73 (-0.34, 3.81), MR: 2.26 (1.08, 3.45); Body fat percentage reduction: HA > MM > LR > HR > MR > HM > MA > LA > CR > CON, Compared to CON, the effect sizes for the other groups were as follows: HA: 4.80 (3.50, 6.10), MM: 5.87 (3.22, 8.52), LR: 6.24 (1.05, 11.42), HR: 4.40 (1.93, 6.87), MR: 4.18 (2.21, 6.15), HM: 4.40 (0.80, 7.99), MA: 4.17 (2.70, 5.64), LA: 3.40 (1.44, 5.35), CR: 3.23 (2.08, 4.39); Lean body mass preservation: CON > MM > MR > LR > HR > MA > LA > HM > HA > CR, Compared to CON, the effect sizes of the other groups were as follows: MM: 0.14 (-2.91, 3.19), MR: 0.03 (-2.24, 2.29), LR: 0.36 (-4.15, 4.87), HR: -0.17 (-2.36, 2.02), MA: -0.40 (-2.22, 1.43), LA: -0.58 (-2.75, 1.59), HM: -0.81 (-4.27, 2.65), HA: -0.67 (-2.33, 0.98), CR: -1.66 (-3.12, -0.19). In summary, LR + CR, MA + CR and MR + CR are at an advantageous level in improving various indicators.

CONCLUSION

Combining moderate-and low-intensity resistance or aerobic exercise with caloric restriction optimizes fat loss while preserving lean body mass, making it a superior strategy for body composition improvement.

SYSTEMATIC REVIEW REGISTRATION

This study was registered in PROSPERO under the identifier: CRD42024588241.

摘要

背景

近年来，热量限制（CR）、间歇性禁食（IF）和生酮饮食（KD）作为改善身体成分的主要饮食干预方法广受欢迎。虽然这些方法有诸多益处，但IF和KD都与各种不良反应有关。尽管CR通常没有明显的副作用，但它可能会导致瘦体重下降。为了缓解这一问题，将CR与运动相结合（CR + EX）已成为维持整体健康的首选策略。然而，在CR条件下，运动的效果可能与正常饮食时观察到的效果有所不同。大多数现有研究将CR + EX与单独的CR、单独的运动或对照组（CON）进行比较。尽管先前的研究已经探讨了热量限制与运动的关系，但在热量不足的情况下，特定运动方式之间的直接比较仍不明确，因此需要采用网络荟萃分析方法。本研究总结了关于CR与运动相结合的文献，以确定哪种运动方案与CR相结合能产生最有利的结果。这些发现将为那些寻求通过CR + EX维持或改善身体成分的人提供有价值的建议。

方法

根据PRISMA指南进行了系统综述，涵盖了从数据库建立到2024年9月的文献。在PubMed、Web of Science、Embase和Cochrane图书馆进行了检索。本研究已在PROSPERO注册，标识符为：CRD42024588241。仅纳入了涉及健康人群的随机对照试验（RCT）。根据PICOS策略（方法）的纳入标准对文章进行了严格筛选，并使用Cochrane偏倚风险工具评估了偏倚风险。进行了网络荟萃分析，并使用累积排名曲线下面积（SUCRA）对干预效果进行了排名。

结果

网络荟萃分析纳入了62项RCT，共涉及了4429名参与者。干预效果排名如下：体重减轻：高强度有氧运动（HA）＞中等强度有氧运动（MA）＞低强度有氧运动（LA）＞中等强度混合运动（MM）＞高强度混合运动（HM）＞CR＞低强度抗阻运动（LR）＞中等强度抗阻运动（MR）＞高强度抗阻运动（HR）＞对照组（CON），与CON相比，其他组的效应量如下：HA：7.94（6.34，9.55），MA：7.78（5.97，9.58），LA：7.10（5.10，9.10），MM：6.65（3.49，9.81），HM：7.47（3.19，11.75），CR：7.10（5.10，9.10），LR：5.45（0.17，10.72），MR：5.62（3.17，8.06），HR：6.00（3.24，8.76）；BMI降低：LA＞MM＞HA＞MA＞HR＞CR＞HM＞MR＞CON；脂肪量减少：LA＞HA＞HM＞MA＞MR＞LR＞HR＞CR＞MM＞CON，与CON相比，其他组的效应量如下：LA：2.70（1.76，3.65），MM：3.35（1.94，4.75），HA：2.90（2.11，3.70），MA：2.96（2.09，3.84），HR：2.56（1.43，3.69），CR：2.47（1.79，3.15），HM：1.73（-0.34，3.81），MR：2.26（1.08，3.45）；体脂百分比降低：HA＞MM＞LR＞HR＞MR＞HM＞MA＞LA＞CR＞CON，与CON相比，其他组的效应量如下：HA：4.80（3.50，6.10），MM：5.87（3.22，8.52），LR：6.24（1.05，11.42），HR：4.40（1.93，6.87），MR：4.18（2.21，6.15），HM：4.40（0.80，7.99），MA：4.17（2.70，5.64），LA：3.40（1.44，5.35），CR：3.23（2.08，4.39）；瘦体重保留：CON＞MM＞MR＞LR＞HR＞MA＞LA＞HM＞HA＞CR，与CON相比，其他组的效应量如下：MM：0.14（-2.91，3.19），MR：0.03（-2.24，2.29），LR：0.36（-4.15，4.87），HR：-0.17（-2.36，2.02），MA：-0.40（-2.22，1.43），LA：-0.58（-2.75，1.59），HM：-0.81（-4.27，2.65），HA：-0.67（-2.33，0.98），CR：-1.66（-3.12，-0.19）。总之，LR + CR、MA + CR和MR + CR在改善各项指标方面处于优势水平。