Meta-analysis of the effect of optimal exercise prescription on the application of the population with the intention of weight loss
彭刚 1许听 1张弘玮 1张频 1狄建忠1
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作者信息
1. 上海交通大学医学院附属第六人民医院运动医学科,上海 200233
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摘要
目的 探究有意愿减重人群的每周最佳活动剂量及其基线BMI水平对干预效果的影响.方法 应用计算机检索PubMed、Embase、Cochrane Library和Web of Science数据库(建库时间至2024年5月),搜集有关运动疗法对有意愿减重人群进行随机对照试验的文献.英文检索关键词包括"weight loss""overweight""exercise prescription"等.按照纳入与排除标准对纳入文献进行筛选,并提取相关资料与评价纳入研究的偏倚风险.采用R 4.3.3软件进行统计分析.采用贝叶斯随机效应剂量反应Meta分析模型,基于模型拟合参数确定最佳模型.该模型纳入活动剂量和基线BMI水平,并使用包含3个节点的自然样条函数进行建模.结果 本研究最终纳入6篇文献,867名研究对象.Meta分析结果显示,最佳活动剂量(以代谢当量分钟,即MET min/周)为1209 MET min/周.基线BMI较高的人群在较高或较低的干预活动剂量下,BMI变化量可能为正值(即干预后体质量增加).结论 对于有意愿减重人群,减重效果最佳的活动剂量为1209 MET min/周;基线BMI较高的人群在采用极端活动剂量策略时可能造成体质量增加.因此,在制定个体化运动处方时,应综合考虑基线BMI水平和合理的活动剂量,以实现最佳减重效果.
Abstract
Objective To investigate the effect of weekly optimal activity dose and its baseline BMI level on the intervention effect in people who are willing to reduce weight. Methods A computerized search of PubMed,Embase,Cochrane Library and Web of Science databases (built until May 2024) was used to collect literature on randomized controlled trials of exercise therapy for people who wish to lose weight. The English search terms included "weight loss","overweight" and "exercise prescription". The literature was screened according to the inclusion and exclusion criteria,and relevant information was extracted and the risk of bias of the included studies was evaluated. R 4.3.3 software was used for statistical analysis. A Bayesian random-effects dose-response Meta-analysis model was used to determine the best model based on the model fitting parameters. The model incorporated activity dose and baseline BMI levels and was modeled using a natural spline function containing 3 nodes. Results Six publications with 867 study participants were ultimately included in this study.Meta-analysis results showed that the optimal activity dose (in metabolic equivalent minutes,i.e.,MET min/week) was 1209 MET min/week. People with higher baseline BMI may have a positive amount of BMI change (i.e.,an increase in body mass after the intervention) at higher or lower intervention activity doses. Conclusion For people with a desire to lose weight,the optimal activity dose for weight loss is 1209 MET min/week;people with a higher baseline BMI may cause an increase in body mass when using extreme activity dose strategies. Therefore,baseline BMI levels and reasonable activity doses should be considered when developing individualized exercise prescriptions to achieve optimal weight loss.
关键词
减重/体质量指数/运动疗法/Meta分析
Key words
Weight loss/Body mass index/Exercise therapy/Meta-analysis
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