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2015;10 (4): e0119017.

Effects of lifestyle interventions that include a physical activity component in class II and III obese individuals: a systematic review and meta-analysis.

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
Author Information
  1. Aurélie Baillot: Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada; Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
  2. Ahmed J Romain: Unit of Nutrition and Diabetes, Department of Endocrinology-Nutrition and Diabetes, University Hospital of Montpellier, Montpellier, France.
  3. Katherine Boisvert-Vigneault: Research Centre on Aging, Health and Social Services Centre, Institute of Geriatrics, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
  4. Mélisa Audet: Research Centre on Aging, Health and Social Services Centre, Institute of Geriatrics, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
  5. Jean Patrice Baillargeon: Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada; Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
  6. Isabelle J Dionne: Research Centre on Aging, Health and Social Services Centre, Institute of Geriatrics, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
  7. Louis Valiquette: Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Quebec, Canada.
  8. Claire Nour Abou Chakra: Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Quebec, Canada.
  9. Antoine Avignon: Unit of Nutrition and Diabetes, Department of Endocrinology-Nutrition and Diabetes, University Hospital of Montpellier, Montpellier, France; INSERM U1046, Physiology and experimental medicine of heart and muscles, University of Montpellier, Montpellier, France.
  10. Marie-France Langlois: Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada; Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
PMID: 25830342 DOI: 10.1371/journal.pone.0119017

Abstract

BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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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Grants

  1. NRF-124607/Canadian Institutes of Health Research

MeSH Term

Cardiovascular Diseases
Humans
Life Style
Motor Activity
Obesity
Quality of Life
Risk Factors
Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Review Systematic Review
Article has an altmetric score of 11

Word Cloud

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