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Effects of Lifestyle Interventions That Include a Physical Activity Component in Class II and III Obese Individuals: A Systematic Review and Meta-Analysis

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Title
Effects of Lifestyle Interventions That Include a Physical Activity Component in Class II and III Obese Individuals: A Systematic Review and Meta-Analysis
Published in
PLOS ONE, April 2015
DOI 10.1371/journal.pone.0119017
Pubmed ID
Authors

Aurélie Baillot, Ahmed J. Romain, Katherine Boisvert-Vigneault, Mélisa Audet, Jean Patrice Baillargeon, Isabelle J. Dionne, Louis Valiquette, Claire Nour Abou Chakra, Antoine Avignon, Marie-France Langlois

Abstract

In class II and III obese individuals, lifestyle intervention is the first step to achieve weight loss and treat obesity-related comorbidities before considering bariatric surgery. A systematic review, meta-analysis, and meta-regression were performed to assess the impact of lifestyle interventions incorporating a physical activity (PA) component on health outcomes of class II and III obese individuals. An electronic search was conducted in 4 databases (Medline, Scopus, CINAHL and Sportdiscus). Two independent investigators selected original studies assessing the impact of lifestyle interventions with PA components on anthropometric parameters, cardiometabolic risk factors (fat mass, blood pressure, lipid and glucose metabolism), behaviour modification (PA and nutritional changes), and quality of life in adults with body mass index (BMI) ≥ 35 kg/m2. Estimates were pooled using a random-effect model (DerSimonian and Laird method). Heterogeneity between studies was assessed by the Cochran's chi-square test and quantified through an estimation of the I². Of the 3,170 identified articles, 56 met our eligibility criteria, with a large majority of uncontrolled studies (80%). The meta-analysis based on uncontrolled studies showed significant heterogeneity among all included studies. The pooled mean difference in weight loss was 8.9 kg (95% CI, 10.2-7.7; p < 0.01) and 2.8 kg/m² in BMI loss (95% CI, 3.4-2.2; p < 0.01). Long-term interventions produced superior weight loss (11.3 kg) compared to short-term (7.2 kg) and intermediate-term (8.0 kg) interventions. A significant global effect of lifestyle intervention on fat mass, waist circumference, blood pressure, total cholesterol, LDL-C, triglycerides and fasting insulin was found (p<0.01), without significant effect on HDL-C and fasting blood glucose. Lifestyle interventions incorporating a PA component can improve weight and various cardiometabolic risk factors in class II and III obese individuals. However, further high quality trials are needed to confirm this evidence, especially beyond weight loss.

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Geographical breakdown

Country Count As %
United Kingdom 2 <1%
Malaysia 1 <1%
Spain 1 <1%
South Africa 1 <1%
Unknown 273 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 45 16%
Student > Bachelor 36 13%
Student > Ph. D. Student 28 10%
Researcher 20 7%
Student > Doctoral Student 20 7%
Other 67 24%
Unknown 62 22%
Readers by discipline Count As %
Medicine and Dentistry 80 29%
Nursing and Health Professions 40 14%
Sports and Recreations 22 8%
Psychology 18 6%
Agricultural and Biological Sciences 12 4%
Other 32 12%
Unknown 74 27%