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Table 1 General study characteristics

From: Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight/obese participants: a systematic review and network meta-analysis

Reference

Sample size

Age (years)

Duration of the active intervention (follow-up)

Study design

Dietary intervention

Dropout

Baseline BMI (kg/m2)

Female (%)

Exercise prescription

% diabetics

Anderssen et al. [40] Reseland et al. [41]

166

40

12 months

D + E vs. D vs. E

D: increased fish, fruit and vegetables and fibre, reduce intake of sugar and SFA, no heavy evening meal

D + E: 3% D: 5%

 

28.9

0%

(0 months)

 

E: supervised weekly, aerobic training (strength, flexibility, circuit training, jogging), 60%–80% of peak heart rate

 
 

0%

    

E: 9%

Andrews et al. [42]

494

60

12 months

D + E vs. D

D: aimed at enabling patients to lose 5%–10% of their initial body weight, based on UK dietary guidelines E: asked to do at least 30-min brisk walking on at least 5 days per week

D + E: 2% D: 1%

 

31.55

35%

(0 months)

   
 

100%

     

Borg et al. [43]

82

42.6

8 months

D + E vs. D

D: low-fat diet

D + E: 18% D: 1%

32.9

0%

(23 months)

E: supervised weekly in group, reached 50%–60% of MHR, included two groups: (1) walking, expended 1,000 kcal per week, and (2) walking, expended 2,000 kcal per week

n.d.

Brekke et al. [44]

49

43

12 months

D + E vs. D

D: Nordic Nutrition Recommendation in addition increase of low GI food

D + E: 17%

25.6

33%

(12 months)

E: the goal to increase physical activity through walking or other more intensive activities for at least 30 min, four to five times per week

D: 4%

100%

Christensen et al. [52]

28

63

17 months

D vs. E

D: the goal of the dietary intervention was to produce and maintain a weight loss of at least 10%

D: 14%

E: 19%

E: exercise intervention consisted of a warm-up phase (10 min), a circuit training phase (45 min) and a cool down/stretching phase four periods of 12 weeks and one period of 4 weeks (total 52 weeks). The aim was to gradually translate the intervention from facility-based exercises to home-based exercises

37.05

81.3

(0 months)

0%

Fogelholm et al. [45]

82

35

13 months

D + E vs. D

D: low-fat diet

D + E: 2% D: 3%

34

100%

(11 months)

E: supervised weekly in group, reached 50%–60% of MHR, included two groups: (1) walking, expended 1,000 kcal per week, and (2) walking, expend 2,000 kcal per week

0%

Foster-Schubert et al. [46]

351

58

12 months

D + E vs. D vs. E

D: total daily energy intake 1,200–2,000 kcal/day on baseline weight <30% fat and 10% reduction in body weight by 6 months with maintenance thereafter for 12 months

D + E: 8% D: 11%

E: 9%

E: ≥45 min of moderate-to-vigorous intensity exercise, 5 days/week (225 min/week) for 12 months; supervised; 70%–85% of MHR

28.6

100%

(0 months)

0%

Messier et al. [51]

238

68.7

18 months

D + E vs. D vs. E

D: the goal of intervention was to produce and maintain an average weight loss of 5% baseline body weight. The intervention was divided into three phases: intensive, transition and maintenance

D + E: 24%

34.3

73%

(0 months)

Nicklas et al. [47]

9%

D: 23%

E: 20%

E: exercise consisted of an aerobic phase, a resistance training phase, a second aerobic phase and a cooling down phase

Messier et al. [50]

454

66

18 months

D + E vs. D vs. E

D: diet was based on partial meal replacements, including up to two meal replacement shakes per day; for the third meal, participants followed a weekly menu plan and recipes that were 500 to 750 kcal, low in fat and high in vegetables; initial diet plan provided an energy intake deficit of 800 to 1,000 kcal/day

D + E: 11%

33.6

72%

(0 months)

D: 15%

13%

E: 11%

E: exercise was conducted for 1 h on 3 days/week for 18 months; programme consisted of aerobic walking (15 min), strength training (20 min), a second aerobic phase (15 min) and cool down (10 min)

Pan et al. [48]

397

44.4

72 months

D + E vs. D vs. E

D: caloric intake at 25–30 kcal/kg of BW, increased vegetable intake and reduced intake of sugars, using individual goals

D + E: 8%

25.6

47%

(0 months)

D: 8%

0%, 100% IGT

E: increased the amount of exercise at least 1 U/day and U/day for those less than 50 years old with no evidence of heart disease or arthritis. The rate of increase and type of exercise depending on age, past exercise pattern and existence for heart problem other than IGT

E: 8%

Pritchard et al. [39]

39

44.25

12 months

D vs. E

D: low-fat diet

D: 0%

E: aerobic exercise; minimum participation was three sessions of 30 min per week. 65%–75% of MHR was recommended to achieve maximum weight loss

E: 0%

29.1

0%

(0 months)

0%

Racette et al. [38]

45

57.2

12 months

D vs. E

D: decrease energy intake by 16% for the initial 3 months and by 20% for the remaining 9 months; macronutrient composition was flexible

D: 4% E: 4%

37.2

63%

(0 months)

0%

E: the goal of the E intervention was to induce an energy deficit comparable to the CR intervention by increasing daily energy expenditure through exercise without changing caloric intake. Exercise physiologists and trainers worked with ex-participants individually to establish and monitor their exercise routines

Skender et al. [37]

61

45

12 months

D + E vs. D vs. E

Da: help your heart eating plan; well-balanced, low-cholesterol eating plan

D + E: 50%

35

48%

(12 months)

E: supervised weekly although group brisk walking at a level of felt “vigorous” not “strenuous”, 45 min, 4–5 times/week

D: 65%

0%

 

E: 42%

Snel et al. [36]

27

57.5

4 months

D + E vs. D

D: 4 months: 450 kcal/day (consisting of three sachets of Modifast); weight maintenance: 1,800 kcal

D + E: 0% D: 0%

37

48%

(14 months)

100%

E: 4 days training at home for 30 min at 70% of maximum aerobic capacity on a cyclo-ergometer and 1 h in hospital training under the supervision of a physiotherapist

Stefanick et al. [35]

276

56.9/47.8

12 months

D + E vs. D vs. E

D: NCEP step 2 diet

D + E: 3%

 

26.3/27

48%

(0 months)

 

E: supervised weekly, aerobic exercise =16-km jogging per week

D: 3%

 

0%

    

E: 3%

Villareal et al. [34]

80

70

12 months

D + E vs. D vs. E

D: balance diet with an energy deficit of 500 to 750 kcal. The diet contained 1 g of high-quality protein/kg of BW per day

D + E: 11%

37

61%

(0 months)

D: 15%

n.d.

E: 12%

E: three supervised exercise training sessions per week. Each session was 90 min in duration and consisted of aerobic and resistance exercise and exercise to improve flexibility and balance

Volpe et al. [33]

90

44.4

6 months

D + E vs. D vs. E

D: intensive (weekly) nutritional classes (1–3 months)

D + E: n.d.

E: supervised training on Nordic Track™ indoor skiing apparatus, 3–4 days per week, 30 min for 6 weeks

30.5/35.3

51%

(6 months)

0%

D: n.d.

E: n.d.

Wadden et al. [32]

77

42

12 months

D + E vs. E

D: conventional diet with 1,200–1,500 kcal/day

D + E: 22%

36.5

100%

(0 months)

E: supervised weekly in a group, 1 h, two times per week, included in three exercise groups: (1) aerobic, (2) strength and (3) combined training

E: 22%

0%

Wing et al. [29]

114

45.5

24 months

D + E vs. D vs. E

D: participants were asked to follow an 800–100 kcal/day diet, with 20% of calories as fat, exactly as prescribed for 1–8 weeks of the programme. Gradually more flexible with calorie goals adjusted to 1,200–1,500 kcal/day at week 16. Subject attended weekly group meetings for the first 6 months

D + E: 20% D: 5% E: 16%

E: supervised by exercise physiologists weekly in a group. Mainly brisk walking, 3 miles, five times per week, total activity gradually increased to 1,500 kcal per week

35.9

79%

(0 months)

0%

Wing et al. [30]

30

55.56

12 months

D + E vs. D

D: daily calorie goal designed to produce approximately 1 kg/week weight loss. Low-fat diet

D + E: 13%

38.2

70%

(0 months)

D: 0%

100%

E: all participants exercised twice a week as a group and once a week on their own, with each exercise session lasting approximately 1 h

Wood et al. [49]

152

39.1/40.3

12 months

D + E vs. D

Db: NCEP step 1 diet

D + E: 14%

E: aerobic exercise (brisk walking and jogging) that met 3 days a week, 60%–80% of MHR for 25–45 min per time (by the fourth month of the study)

27.9/30.7

48%

(0 months)

D: 13%

0%

Wood et al. [28]

89

44.1

12 months

D vs. E

D: individual prescription designed to reduce baseline total body fat by one third over a 9-month period

D: 4%

E: 2%

n.d

0%

(0 months)

E: supervised exercise programme and individual prescriptions based on estimates of the amount of energy necessary to decrease total body fat progressively by one third over 9 months

0%

  1. BMI body mass index, BW body weight, CR caloric restriction, D diet, E exercise, GI glycaemic index, IGT impaired glucose tolerance, MHR maximal heart rate, NCEP National Cholesterol Education Program, SFA saturated fat, UK United Kingdom; n.d. no data.
  2. aSkender et al. [37]: 50% CH, 30% F, 20% P, low cholesterol.
  3. bWood et al. [49]: 55% CH, 30% F, <10% SFA, <300 mg/day.