Binmahfoz Ahmad, Dighriri Anas, Gray Cindy, Gray Stuart R
Department of Public Health, Umm Al-Qura University, Mecca, Makkah Province, Saudi Arabia.
University of Glasgow School of Cardiovascular and Metabolic Health, Glasgow, Scotland, UK.
BMJ Open Sport Exerc Med. 2025 Sep 2;11(3):e002363. doi: 10.1136/bmjsem-2024-002363. eCollection 2025.
The prevalence of obesity has tripled over the past 35 years. Although caloric restriction reduces body fat, lean tissue is also lost. Resistance exercise may mitigate these effects. This review assesses the effects of resistance exercise on body composition and cardiometabolic health in adults with overweight or obesity undergoing dietary weight loss.
A search was performed in PubMed, Embase, CINAHL, Scopus, Web of Science and CENTRAL. Systematic searches yielded N=6934 studies of which n=25 were relevant for inclusion after screening for eligibility. We included randomised controlled trials of adults (18-65 years) (body mass index ≥25 kg/m) comparing dietary weight-loss interventions with resistance exercise to diet-only weight-loss interventions. The Cochrane Collaboration's risk of bias and GRADE (Grades of Recommendations Assessment, Development and Evaluation) assessment tools were used. A meta-analysis was performed, including those studies that compared dietary weight-loss plus resistance exercise interventions to diet-only weight-loss interventions.
Overall, resistance exercise during diet-induced weight loss had no effect on body mass (mean difference between groups: -0.32 kg, p=0.35), with weight loss ranging from -2.5 kg to -20.9 kg in diet plus resistance exercise groups and from -0.7 kg to -20.4 kg in diet-only groups. However, resistance exercise protected against the loss of fat-free mass (between-group standardised mean difference (SMD): 0.40, p=0.0003, moderate certainty) and increased loss of fat mass (SMD: -0.36, p<0.00001, high certainty). Muscular strength was also significantly greater (SMD 2.36, p=0.00001) following the inclusion of resistance exercise (low certainty). No effects of resistance were seen in any of the other cardiometabolic markers studied.
In people living with obesity and overweight, the addition of resistance exercise to dietary restriction may enhance its beneficial effects. Current evidence, therefore, supports the implementation of resistance exercise during weight loss to attenuate the loss of fat-free mass (moderate certainty), increase loss of fat mass (high certainty) and improve muscle strength (low certainty).
CRD 42021266482.
在过去35年里，肥胖症的患病率增长了两倍。尽管热量限制可减少体脂，但瘦组织也会流失。抗阻运动可能会减轻这些影响。本综述评估了抗阻运动对正在进行饮食减肥的超重或肥胖成年人身体成分和心脏代谢健康的影响。
在PubMed、Embase、CINAHL、Scopus、Web of Science和CENTRAL数据库中进行了检索。系统检索共得到6934项研究，经筛选纳入标准后，有25项研究符合纳入条件。我们纳入了针对18至65岁成年人（体重指数≥25kg/m²）的随机对照试验，比较了饮食减肥干预联合抗阻运动与单纯饮食减肥干预效果。使用了Cochrane协作网的偏倚风险评估工具和GRADE（推荐分级评估、制定与评价）评估工具。进行了荟萃分析，纳入了那些比较饮食减肥加抗阻运动干预与单纯饮食减肥干预的研究。
总体而言，在饮食诱导的体重减轻期间，抗阻运动对体重没有影响（组间平均差异：-0.32kg，p=0.35），饮食加抗阻运动组的体重减轻范围为-2.5kg至-20.9kg，单纯饮食组为-0.7kg至-20.4kg。然而，抗阻运动可防止去脂体重的流失（组间标准化平均差异（SMD）：0.40，p=0.0003，中等确定性），并增加脂肪量的流失（SMD：-0.36，p<0.00001，高确定性）。纳入抗阻运动后，肌肉力量也显著增强（SMD 2.36，p=0.00001）（低确定性）。在所研究的任何其他心脏代谢标志物中均未观察到抗阻运动的影响。
对于肥胖和超重人群，在饮食限制的基础上增加抗阻运动可能会增强其有益效果。因此，目前的证据支持在减肥期间进行抗阻运动，以减轻去脂体重的流失（中等确定性），增加脂肪量的流失（高确定性）并改善肌肉力量（低确定性）。
PROSPERO注册号：CRD 42021266482。
