Resistance exercise improves body composition in overweight and obese people: an umbrella review

doi:10.12307/2023.848

Abstract

Abstract: BACKGROUND: Resistance exercise increases muscle mass and improves muscle strength, but there is a lack of conclusive evidence on its effects on body composition. Controversial results from randomized controlled trials and multiple Meta-analyses pose a problem for clinical decisions on exercise interventions.
OBJECTIVE: Based on the methodological paradigm of umbrella review, to explore the efficacy and safety of resistance exercise in improving the body composition of overweight and obese people.
METHODS: We searched PubMed, Cochrane Library, Web of Science, and CNKI for systematic reviews on the effect of resistance exercise in overweight and obese people published from database inception to August 31, 2022. Chinese search terms included “anti-resistance, resistance, self-weight, Meta, Meta-analysis, body composition, body fat percentage, fat mass, lean body mass, body mass.” English search terms included “resistance training, strength training, weight-lifting strengthening program, body composition, body fat distribution, Meta-analysis, data pooling, overviews, clinical trial, clinical trial overviews.” PRISMA was used to evaluate the methodological quality of the included studies, and a GRADE evaluation system was used to grade the quality of evidence.
RESULTS AND CONCLUSION: A total of 14 Meta-analyses were included, and GRADE evidence quality evaluation showed that 2 outcome indicators were intermediate, 12 were low, and 14 were extremely low. Compared with the control group, 23 of the 32 outcome measures showed significant improvement. The intervention effect of resistance exercise on body fat percentage has reached a consensus, but the intervention effects on lean body mass, body mass index and visceral fat still need further confirmation. Resistance exercise is an effective and safe method to improve the body composition of overweight and obese people. The overall quality of the research and the evidence quality of the outcome indicators included in the systematic evaluation are generally low. In the future, the initial state, exercise goal and willingness of the subjects should be fully combined on the basis of clarifying the sample characteristics and refining the scheme design. Through multiple, scientific and personalized exercise prescription designs of water, air and elastic resistance, the safety and compliance of resistance exercise can be improved, providing clear evidence-based support and decision-making basis for resistance exercise intervention.

Key words: resistance training, body fat percentage, body composition, overweight and obese people, umbrella review, overview of systematic reviews

CLC Number:

Dai Xinyu, Yan Jihong, Hua Lingjun, Zheng Xiaohong. Resistance exercise improves body composition in overweight and obese people: an umbrella review[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(2): 267-271.

Figures/Tables 4

2.5 主要结局指标 2.5.1 体脂率纳入文献主要通过双能X射线吸收测定法(dual energy X-ray absorptiometry，DEXA)、水下称重测量法(hydro densitometry weighing，HDW)、空气置换体积描记法(air displacement plethysmography，ADP)、生物电阻测量法(bioelectrical Impedance，BIA)等进行体脂率的测量。结果显示，9篇文献一致肯定抗阻运动对体脂率的显著影响，其中5篇Meta分析结果为大效应量，LOPEZ等[15]的研究表明，单纯抗阻训练对体脂率的降低有一定效果，而使用抗阻运动联合热量限制将产生更显著的影响；4篇为中、小效应量，其中纳入11在剔除单次训练强度≤50% 最大重复次数(maximum repetition，MR)的研究后，效应量得到了增加。 2.5.2 瘦体质量 6篇文献通过DEXA、ADP及BIA评价抗阻运动对瘦体质量的影响。3篇显示与控制组相比，抗阻运动显著提高了实验组的瘦体质量，1篇研究亚组分析显示[15]，相比于成年人和老年人，青少年瘦体质量的增加更为显著；其他3篇显示抗阻运动对瘦体质量并无显著影响。说明抗阻运动对瘦体质量的影响存在争议。 2.5.3 内脏脂肪纳入研究主要通过磁共振成像(magnetic resonance imaging，MRI)、计算机断层扫描(computerized tomography，CT)测量内脏脂肪的体积与质量。3篇文献评价抗阻运动对内脏脂肪的影响，2篇显示与其他常规活动或空白对照相比，抗阻运动对内脏脂肪的减少有着一定作用。其中1篇显示，抗阻运动与有氧运动效果间的差异不存在统计学意义，二者均能有效减少内脏脂肪[21]。但这与另外一篇Meta分析不一致，该研究表明抗阻运动并不能减少内脏脂肪的质量，而通过长期150 min/周的中等强度有氧运动干预可以对被试的内脏脂肪产生积极影响。 2.6 次要结局指标纳入文献中，6篇文献报告了抗阻运动对BMI的影响[13，15，18-19，22，25]；5篇采用步速(gait speed，GS)、椅上站立测试(chair-stand test，CST)、6分钟步行(6 minutes walk test，6MWT)、简易机体功能评估量表(short physical performance battery，SPPB)等运动测试或量表来验证抗阻运动对生活质量的积极影响[14，16-17，19，23]；2篇文献发现抗阻运动并不能改善胰岛素敏感性[13，25]；3篇文献证实抗阻运动可以有效降低腰围[13，18，25]。不良反应方面，绝大多数研究并未报道抗阻运动的不良反应事件，认为有监督下的抗阻运动具备较高安全性。目前研究认为抗阻运动是改善超重、肥胖人群体脂率、提升生活质量的安全、无不良反应的手段。"

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