Optimising weight-loss interventions in cancer patients—A systematic review and network meta-analysis

Background Excess weight has been associated with increased morbidity and a worse prognosis in adult patients with early-stage cancer. The optimal lifestyle interventions to optimize anthropometric measures amongst cancer patients and survivors remain inconsistent. Objective To conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the effects of exercise and dietary interventions alone or in combination on anthropometric measures of adult cancer patients and survivors. Methods A systematic search of Medline, Embase and the Cochrane Trials Registry was performed. Outcomes of interest included changes in weight, body mass index (BMI), and waist circumference. Screening and data collection were performed by two reviewers. Bayesian NMAs were performed. Results Overall, 98 RCTs were included; 75 were incorporated in NMAs (n = 12,199). Groups of intervention strategies included: 3 exercise interventions, 8 dietary interventions, 7 combination interventions of diet and exercise and standard care. Median intervention duration was 26 weeks. NMA suggested that diet alone (mean difference [MD] -2.25kg, 95% CrI -3.43 to -0.91kg) and combination strategies (MD -2.52kg, 95% CrI -3.54 to -1.62kg) were associated with more weight loss compared to standard care. All dietary interventions achieved a similar magnitude of weight loss (MD range from -2.03kg to -2.52kg). Both diet alone and combination strategies demonstrated greater BMI reductions versus standard care, and each of diet alone, exercise alone and combination strategies demonstrated greater reductions in waist circumference than standard care. Conclusion Diet and exercise alone or in combination are effective lifestyle interventions to improve anthropometric measures in cancer patients and survivors. All reputable diets appear to be similarly effective to achieve weight loss.

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Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis

General Hospital Psychiatry ◽

10.1016/j.genhosppsych.2017.04.003 ◽

2017 ◽

Vol 47 ◽

pp. 83-102 ◽

Cited By ~ 46

Author(s):

John A. Naslund ◽

Karen L. Whiteman ◽

Gregory J. McHugo ◽

Kelly A. Aschbrenner ◽

Lisa A. Marsch ◽

...

Keyword(s):

Systematic Review ◽

Mental Illness ◽

Weight Loss ◽

Serious Mental Illness ◽

Meta Analysis ◽

Lifestyle Interventions ◽

Obese Adults

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FTO genotype and weight loss in diet and lifestyle interventions: a systematic review and meta-analysis

American Journal of Clinical Nutrition ◽

10.3945/ajcn.115.123448 ◽

2016 ◽

Vol 103 (4) ◽

pp. 1162-1170 ◽

Cited By ~ 41

Author(s):

Lingwei Xiang ◽

Hongyu Wu ◽

An Pan ◽

Bhakti Patel ◽

Guangda Xiang ◽

...

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Meta Analysis ◽

Lifestyle Interventions ◽

Diet And Lifestyle

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Weight loss from lifestyle interventions and severity of sleep apnoea: a systematic review and meta-analysis

Sleep Medicine ◽

10.1016/j.sleep.2014.05.012 ◽

2014 ◽

Vol 15 (10) ◽

pp. 1173-1183 ◽

Cited By ~ 46

Author(s):

Lana J. Mitchell ◽

Zoe E. Davidson ◽

Maxine Bonham ◽

Denise M. O'Driscoll ◽

Garun S. Hamilton ◽

...

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Meta Analysis ◽

Sleep Apnoea ◽

Lifestyle Interventions

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The Effect of Lifestyle Intervention on Diabetes Prevention by Ethnicity: A Systematic Review of Intervention Characteristics Using the TIDieR Framework

Nutrients ◽

10.3390/nu13114118 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4118

Author(s):

Mingling Chen ◽

Gebresilasea Gendisha Ukke ◽

Lisa J. Moran ◽

Surbhi Sood ◽

Christie J. Bennett ◽

...

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Ethnic Groups ◽

Lifestyle Intervention ◽

Latin American ◽

Meta Analysis ◽

Middle Eastern ◽

Optimal Number ◽

Diabetes Incidence ◽

Lifestyle Interventions

Lifestyle intervention is effective in preventing type 2 diabetes mellitus (T2DM), but the efficacy of intervention components across different ethnic groups is less clear. This systematic review examined the effects of intervention characteristics of lifestyle interventions on diabetes incidence and weight loss by ethnicity using the Template for Intervention Description and Replication (TIDieR) framework. MEDLINE, EMBASE and other databases were searched for randomized and non-randomized controlled trials on lifestyle interventions (diet and/or physical activity) in adults at risk of T2DM. Ethnicity was categorized into European, South Asian, East and Southeast Asian, Middle Eastern, Latin American and African groups. Forty-five studies (18,789 participants) were included in the systematic review and 41 studies in meta-analysis. Meta-analysis showed a high number of intervention sessions was significantly associated with a greater reduction in diabetes incidence (P = 0.043) and weight (P = 0.015), while other intervention characteristics including intervention provider and delivery format did not alter the outcomes (all P > 0.05). Additionally, narrative synthesis showed long-term interventions (≥12 months) were associated with significant diabetes risk reduction for all ethnic groups, while short-term interventions (<12 months) were more effective in weight loss in most ethnic groups. There may be ethnic preferences for the optimal number of intervention sessions.

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Effectiveness and Characterization of Severely Energy-Restricted Diets in People with Class III Obesity: Systematic Review and Meta-Analysis

Behavioral Sciences ◽

10.3390/bs9120144 ◽

2019 ◽

Vol 9 (12) ◽

pp. 144 ◽

Cited By ~ 3

Author(s):

Gabrielle Maston ◽

Alice A. Gibson ◽

H. Reza Kahlaee ◽

Janet Franklin ◽

Elisa Manson ◽

...

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Prediction Interval ◽

Meta Analysis ◽

Average Weight ◽

Class Iii ◽

Dietary Interventions ◽

Initial Body Weight ◽

Class Iii Obesity

Severely energy-restricted diets are used in obesity management, but their efficacy in people with class III obesity (body mass index ≥40 kg/m2) is uncertain. The aims of this systematic review and meta-analysis were to determine the effectiveness and characteristics of severely energy-restricted diets in people with class III obesity. As there was a lack of publications reporting long-term dietary interventions and randomised controlled trial designs, our original publication inclusion criteria were broadened to include uncontrolled study designs and a higher upper limit of energy intake. Eligible publications reported studies including adults with class III obesity and that assessed a diet with daily energy intake ≤5000 kJ for ≥4 weeks. Among 572 unique publications from 4 databases, 11 were eligible and 10 were suitable for meta-analysis. Our original intention was to classify comparison arms into short-term (<6 months) and long-term (>1 year) interventions. Due to the lack of long-term data found, comparison arms were classified according to the commonalities in dietary intervention length among the included publications, namely dietary interventions of 4 weeks’ duration and those of ≥6 weeks’ duration. After a 4-week severely energy-restricted diet intervention, the pooled average weight loss was 9.81 (95% confidence interval 10.80, 8.83) kg, with a 95% prediction interval of 6.38 to 13.25 kg, representing a loss of approximately 4.1 to 8.6% of initial body weight. Diets ≥6 weeks’ duration produced 25.78 (29.42, 22.15) kg pooled average weight loss, with a 95% prediction interval of 13.77 to 37.80 kg, representing approximately 10.2 to 28.0% weight loss. Daily dietary prescriptions ranged from 330 to 5000 kJ (mean ± standard deviation 2260 ± 1400 kJ), and had wide variations in macronutrient composition. The diets were administered mostly via liquid meal replacement products. While the included publications had a moderate risk of bias score, which may inflate reported weight loss outcomes, the published data to date suggest that severely energy-restricted diets, delivered via diets of varying composition, effectively produce clinically relevant weight loss (≥10% of initial body weight) when used for 6 weeks or more in people with class III obesity.

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Physical function after dietary weight loss in overweight and obese adults with osteoarthritis: a systematic review and meta-analysis

Public Health Nutrition ◽

10.1017/s1368980020002529 ◽

2020 ◽

pp. 1-16

Author(s):

Emily J Webb ◽

Peter G Osmotherly ◽

Surinder K Baines

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Physical Function ◽

Quality Criteria ◽

Self Report ◽

Excess Body Weight ◽

Lifestyle Interventions ◽

Dietary Interventions ◽

Dietary Weight Loss ◽

Meal Replacements

Abstract Objective: Osteoarthritis (OA) is associated with functional limitations that can impair mobility and reduce quality of life in affected individuals. Excess body weight in OA can exacerbate impaired physical function, highlighting the importance of weight management in this population. The aim of this systematic review was to compare the effects of different dietary interventions for weight loss on physical function in overweight and obese individuals with OA. Design: A comprehensive search of five databases was conducted to identify relevant articles for inclusion. Studies were included that examined the effect of dietary weight loss interventions, with or without exercise, on physical function in adults with OA who were overweight or obese. Quality and risk of bias were assessed using the Quality Criteria Checklist for primary research. Primary and secondary outcomes were extracted, including change in weight and physical function which included performance-based and self-report measures. Results: Nineteen relevant studies were included, which incorporated lifestyle interventions (n 8), diet in combination with meal replacements (DMR; n 5) and very low-energy diets (VLED; n 6) using meal replacements only. Pooled data for eight RCT indicated a mean difference in Western Ontario and McMaster Universities Arthritis Index (WOMAC) physical function of 12·4 and 12·5 % following DMR or VLED interventions, respectively; however, no statistically significant change was detected for lifestyle interventions. Conclusions: Our findings suggest that partial use of meal replacements is as effective as their sole use in the more restrictive VLED. Both dietary interventions are more effective than lifestyle programmes to induce significant weight loss and improvements in physical function.

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Comparing effectiveness of fat burners and thermogenic supplements to diet and exercise for weight loss and cardiometabolic health: Systematic review and meta-analysis

Nutrition and Health ◽

10.1177/0260106020982362 ◽

2021 ◽

pp. 026010602098236

Author(s):

James E Clark ◽

Sarah Welch

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Confidence Interval ◽

Dietary Supplements ◽

Body Mass ◽

Effect Size ◽

Meta Analysis ◽

Cardiometabolic Health ◽

Chi Square ◽

Diet And Exercise

Background: Those who are overfat face an onslaught of advice for losing weight, including using dietary supplements that purport to have fat burning capabilities to achieve a reduced body mass, fat mass and improvement in cardiometabolic health in combination with exercise or diet and exercise regimens. Aim: To examine long-term effectiveness of supplements for both weight loss and improvements in cardiometabolic health for these individuals. Methods: A PRISMA methods of systematic review was conducted from August 2018 through January 2019 using Medline, PubChem, PubMed, EBOSCO CINHAL and SPORTDiscus, and Google Scholar yielding 23,441 returns of which 21 studies (duration greater than 8 weeks with participant populations of BMI greater than 24.9) were included for meta-analysis. Meta-analysis examined pooled effect size and 95% confidence interval for: body mass, fat mass, fat-free mass, total cholesterol, high-density lipoproteins, low-density lipoproteins, resting metabolic rate. Intra-study effect sizes were compared with previously reported results for diet or diet and exercise in a 2x2 chi-square analysis for the number of studies that induced effects greater than or less than the effect size. Results: There is a general trend to show effectiveness (effect size greater than 0.00) for obtaining beneficial changes from use of thermogenic dietary supplements, yet the 95% confidence interval for effect size crossed 0.00 (indicating no benefit). Chi-square comparison to exercise, or combination of diet and exercise, indicates that responses induced from weight-loss supplements were less effective than what is obtained from utilizing exercise, or diet and exercise, without additional weight-loss supplements. Conclusion: There appears to be limited benefit that may be derived from the inclusion of thermogenic dietary supplements to reduce body mass and improve cardiometabolic health for individuals who are overfat.

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Effects of Diet after Early Breast Cancer Treatment: A Systematic Review and Meta-Analysis of Clinical Trials

Breast Care ◽

10.1159/000514469 ◽

2021 ◽

pp. 1-9

Author(s):

Henrique de Araújo Vianna Träsel ◽

Frederico Soares Falcetta ◽

Fernando Kude de Almeida ◽

Mariana Rangel Ribeiro Falcetta ◽

Rodrigo Antonini Ribeiro ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Clinical Trials ◽

Cancer Patients ◽

Early Breast Cancer ◽

Meta Analysis ◽

Secondary Outcome ◽

Breast Cancer Patients ◽

Dietary Interventions ◽

Specific Diet

Purpose: Randomized clinical trials (RCT) are inconclusive regarding the role of dietary interventions in anthropometric measurements and survival in breast cancer patients. Our aim was to conduct a systematic review and meta-analysis to assess the effects of diet on these outcomes in women treated for early-stage breast cancer. Methods: Embase, MEDLINE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched for RCT comparing dietary interventions (individualized dietary counseling, prescription of a specific diet, or others) with usual care in women that were treated for early breast cancer. Primary outcomes were overall survival (OS) and disease-free survival (DFS); secondary outcome was a change in body mass index (BMI). Results: We found 12 RCT eligible for analysis, 7 of which were included in the quantitative analysis. Two studies reported OS and DFS and 6 reported BMI data. The hazard ratio (HR) for OS and DFS was 0.91 (95% confidence interval [CI] 0.77–1.07, p = 0.25) and 0.92 (95% CI 0.79–1.08, p = 0.31) for the intervention and control groups, respectively. Intervention was associated with BMI reduction in subjects who received a specific diet instead of counseling or other types of intervention (–0.67; 95% CI –1.14 to –0.21). Conclusions: Despite increasing survival among breast cancer patients due to better oncological treatments, there is still a lack of prospective data regarding the effects of dietary interventions in this population. We found positive association between prescription of specific diets in terms of anthropometric measures; there were no differences in OS or DFS.

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Group programmes for weight loss may be more effective than one-to-one sessions

BMJ ◽

10.1136/bmj.n2771 ◽

2021 ◽

pp. n2771

Author(s):

Helen Saul ◽

Deniz Gursul

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Weight Management ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Group Versus ◽

Controlled Trials ◽

Lifestyle Interventions ◽

One To One ◽

Randomised Controlled

The study Abbott S, Smith E, Tighe B, Lycett D. Group versus one-to-one multi-component lifestyle interventions for weight management: a systematic review and meta-analysis of randomised controlled trials. J Hum Nutr Diet 2021;34:485-93. To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/group-weight-loss-programmes-more-effective-than-one-to-one-sessions/

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