Table 2. Characteristics of Study Interventions and Participants, Systematic Review and Meta-Analysis of Weight Loss in Short-Term Physical Activity or Nutrition Interventions Among Adults With Overweight or Obesity, 2021–2023.
| Author, year, country | Study type and setting | Population, inclusion criteria | Sample size, intervention and control groups at trial start and end; weight change, kg | Intervention group description and focus | Control group description | Intervention duration and intensity | Study quality rating |
|---|---|---|---|---|---|---|---|
| Arterburn et al, 2019, US (34) | Online or distance learning via telephone | Participants aged 18–65 y, BMI (kg/m2) 27–42, interested in losing weight and at stable weight | Start: intervention, n = 66, control, n = 67. End: intervention, n = 63, control n = 61. Weight change: intervention, n = −5.00; control, n = −0.20 | Focus: Nutrition. Intervention group was instructed to follow a specific program, intended to provide 800–1,000 kcal/d. Support tools: Written program materials (meal plan guide, food journals, recipes, habits of health book, and workbook). Also had access to online support tools and the intervention’s nutrition support team. Suggested exercise: Participants were encouraged, but not required, to exercise. Group or individual class: Participants were assigned a coach to have one-on-one coaching via telephone. |
Control group followed a self-directed, reduced calorie diet. Participants were instructed to log food, exercise, and progress; received a one-on-one introduction session; and received other publicly available information from ChooseMyPlate.com. | Duration: 16 weeks. Intensity: 23 coaching telephone calls | Fair |
| Baetge et al, 2017, US (28) | In-person: health care setting | Women aged 18–69 y, sedentary, with overweight or obesity, no diabetes diagnosis, and not in a diet or exercise program within 3 months of starting the study | Start: intervention, n = 29, control, n = 20. End: intervention, n = 29, control, n = 20. Weight change: intervention, n = −4.26; control, n = −0.10 | Focus: Both nutrition and physical activity. Intervention group participants had an initial 1,200 kcal/d goal for the first week to 1,500 kcal/d thereafter and supervised circuit training. Educational resources: Participants were given a commercial weight management plan book. Organized activity: Required in-person exercise training sessions. Support tools: Participants were given food and exercise diaries, meal replacements, and supplements. |
Control group was wait-listed and instructed not to change their dietary intake or engage in physical activity for the 12 weeks of the study, but were randomized into 1 of the 4 diet groups once they completed their initial control group. | 12 weeks. Intensity: 4 supervised circuit-training sessions per week | Fair |
| Carnie et al, 2013, US (35) | Mixed: In-person, workplace; online, web-based application | Women employees of National Institutes of Health with BMI ≥25, no diabetes diagnosis, healthy, with no active participation in other exercise or weight loss programs | Start: intervention, n = 99; control, n = 100. End: intervention, n = 69; control, n = 70. Weight change: intervention, n = −2.7; control. n = −2.0 | Focus: Nutrition. Personalized goals: A dietitian provided participants a daily meal plan reflecting individualized calorie needs. Group and individual class: One-on-one coaching with dietitians and group nutrition education sessions. Educational resources: Access to a website that included resources to promote exercise and healthy eating. Support tools: Access to private fitness rooms, a pedometer. | Control group was provided wellness information on the internet. | 24 weeks. Weekly group nutrition education sessions for the first 3 months, monthly for the last 3 months | Lowa |
| Cleo et al, 2019, Australia (27) | Mixed: In-person: university; Online: email | Participants aged 18–75 y, able to consent, BMI ≥25, could attend all required appointments, had access to email or telephone, and free from exercise-limiting comorbidities | Start: intervention, n = 25; control, n = 25. End: intervention, n = 21; control, n = 23. Weight change: intervention, n = −3.30; control, n = −0.40 | Focus: Both nutrition and physical activity. Educational resources: Received a leaflet that listed 7 behaviors associated with negative energy balance, 2 behaviors designed to improve awareness of food intake, and 1 behavior to promote routine establishment. Support tools: A logbook was provided to participants for recording adherence to the 7 behaviors. Group/individual classes: group introduction meeting. |
Control group was wait-listed. They were contacted weekly via telephone for 12 weeks and received no weight-loss advice. They were later offered either of the interventions after this time. | 12 weeks. Single 2-h group introduction meeting | Fair |
| Collins et al, 2012, Australia (30) | Online or distance learning via a web-based application | Adults aged 18–60 y, BMI 25–40, not participating in other weight loss programs, passed a health screen, available for in-person assessments, and had internet, computer, and email access | Start: intervention, n = 106; control, n = 104. End: intervention, n = 90; control, n = 96. Weight change: intervention, n = −2.98; control, n = 0.36 | Focus: Both nutrition and physical activity. Personalized goals: Received personalized daily calorie targets and menu plans. Personalized messages: Received personalized messages based on whether participant had accessed site or recorded weight. Received personalized feedback: Personalized feedback from physical activity and nutrition diaries and summaries and visualization of weight loss achievements. Automatic messages: Received automated e-feedback. Educational resources: Access to program website. Support tools: Received a reminder schedule to use the diary. Peer mentoring: Participation in web-based community forums. | Control group was wait-listed. | 12 weeks, new content weekly | High |
| Crane et al, 2015, US (32) | Mixed. In-person: not specified; Online: web-based applications | Men aged 18–65 y, BMI 25–40, with regular internet access, and able to exercise safely | Start: intervention, n = 53; control, n = 54. End: intervention, n = 48; control, n = 49. Weight change: intervention, n = −5.10; control, n = −0.50 | Focus: Both nutrition and physical activity. Intervention group participated in a program and encouraged to implement modest calorie restriction via 100-calorie reductions and established physical activity progression. Personalized messages: Automated, tailored feedback was provided based on meeting or not meeting physical activity goal, days of daily weighing, weight loss, and changes made to eating. Personalized goals: Encouraged participants to personalize the exercise types with gradual progression and plans and mastering one dietary change at a time. Educational resources: Participants self-tailored the order of specific diet strategies to focus on each week and received a brief online lesson on how to implement the strategy. Automatic messages: A reminder to complete the contact was sent mid-week. Individual/group sessions: Two face-to-face sessions. |
Control group was wait-listed. | 22 weeks. Two 1-h face-to-face group sessions followed by interactive online intervention contacts weekly for 10 wks and monthly online contact for 3 mo. Encouraged gradual physical activity progression to 225 min/wk. | Fair |
| Hardcastle et al, 2013, UK (33) | In-person: health care setting | Participants aged 18-65 y, BMI ≥28, and ≥1 CVD risk factors | Start: intervention, n = 203; control, n = 131. End: intervention, n = 125; control, n = 93. Weight change: intervention, n = −0.62; control, n = 0.13 | Focus: Both nutrition and physical activity. Intervention group received face-to-face consultation with a physical activity specialist or registered dietician, and goal setting. Personal goals: Recommendation to be physically active for 30 minutes, at least 5 times a week. Educational resources: Participants received exercise and nutrition information. Group/individual sessions: Five face-to-face motivational interviewing sessions delivered by a physical activity specialist and registered dietician. | Control group received a leaflet with lifestyle guidelines, the physiological and psychological benefits of increased physical activity, and a food and physical activity quiz with advice depending on scores. | 26 wk. Up to 5 face-to-face motivational interviewing sessions conducted over 6 mo; each session was approximately 20–30 min. Recommendation for 150 min physical activity per week. | Lowa |
| Hepdurgun et al, 2020, Turkey (24) | Online or distance learning: web-based application | Participants aged 18–65 y, BMI 25–40, and internet access | Start: intervention, n = 51; control, n = 50. End: intervention, n = 40; control, n = 36. Weight change: intervention, n = −2.28; control, n = −0.74 | Focus: Both nutrition and physical activity. Intervention group received access to the internet-based program, weekly lesson videos, and food diaries; were given feedback on their performance and sent reminder emails if inactive. Personalized messages: Participants were given feedback on their performance of watching videos and filling their food diary through the in-program message system. Educational resources: 69 videos prepared related to nutrition with information on various topics such as healthy eating, and 145 videos of exercises that can be done at home. Support tools: Food diary to follow up on the daily calorie intake and change in body weight. Automatic messages: Reminder messages were sent if participants had not logged in for a week. | Control group received an initial visit, weekly informative emails about healthy eating, physical exercise, and weight loss. | 8 weeks | Lowa |
| Jane et al, 2018, Australia (36) | Online or distance learning: web-based application | Participants aged 21-65 y with BMI 25-40 | Start: intervention, n = 46; control, n = 45. End: intervention, n = 19; control, n = 17. Weight change: intervention, n = −4.60; control, n = 0.20 | Focus: Both nutrition and physical activity. Intervention group received instructions to follow a specific diet and peer support through a Facebook group. Educational resources: Participants received example breakfast, lunch, and dinner recipes. Suggest exercise: Recommends individuals aim for a step count of 10,000 steps per day. Peer mentoring: peer support from other group members (the Facebook group). | Control group was instructed to follow the Australian government’s dietary guidelines and the National Physical Activity Guidelines for Adults as standard care. | 24 weeks. Clinical appointments for a duration of approximately 15 min at baseline, and weeks 6, 12, 18 and 24. Suggested step count of 10,000 steps per day. | Lowa |
| Mayer et al, 2019, US (26) | In-person: community-based setting | Residents of East Harlem who speak Spanish- or English, BMI ≥25, and no diabetes diagnosis | Start: intervention, n = 210; control, n = 192. End: intervention, n = 156, control, n = 147. Weight change: intervention, n = −1.20; control, n = −0.50 | Focus: Both nutrition and physical activity. Support tools: Participants made “action plans” and provided peer support by exercising together and brainstorming ideas to address challenges they identified. Peer mentoring: Peer-led workshops at community sites. Individual/group sessions: Group peer-led workshops. | Control group was wait-listed. They received written materials in English and Spanish about diabetes prevention and a copy of their test results, and were invited to take part in the peer education workshops at no cost after a 1-year waiting period. | 24 weeks; eight 90-min peer-led workshops | Lowa |
| Morgan et al, 2012, Australia (31) | Online or distance learning in web-based application | Male employees of Tomago Aluminium aged 18-65 y, BMI 25-40 | Start: intervention, n = 65; control, n = 45. End: (data missing) Weight change: intervention, n = −4.00; control, n = −0.30 | Focus: Both nutrition and physical activity. Intervention group received a face-to-face information session, access to a study website to report weight and daily eating and exercise diaries, weight-loss education resources, a pedometer, and financial incentives. Educational resources: Overview of basic education for weight loss. Support tools: A study website, resources consisting of a weight loss handbook, a website user guide, and a pedometer. Incentives: A $50 gift voucher per crew member to be spent at a local sporting equipment store for the crew with the highest mean percentage weight loss after 1 month and at the conclusion of the program. Group/individual class: Face-to-face intervention session. | Control group was wait-listed for 14 weeks. | 12 weeks. One face-to-face information session (75 min) | High |
| Morgan et al, 2013, Australia (29) | Online or distance learning in web-based application | Men with BMI 25-40, from the Hunter Region of New South Wales, Australia, with access to a mobile phone and a computer with email and internet | Start: intervention, n = 53 control, n = 52. End: intervention, n = 43 control, n = 45 Weight change: intervention, −4.40 control, n = −0.50 |
Focus: Both nutrition and physical activity. Intervention group received a website user guide, an online food and exercise diary, and feedback emails about their food and exercise diary entries. Personalized messages: Received 7 feedback emails about their food and exercise diary entries. Personalized goals: Advised to achieve a negative energy balance of 2000 kilojoules (kJ) per day. Men were asked to set 3 SMART goals each month (one each for weight, physical activity, and eating). Support tools: Pedometer, tape measure for waist circumference, a kilojoule counter book, online food and exercise diary. Educational resources: A weight loss DVD, a weight loss handbook and support guide, and a website user guide. | Control group was wait-listed. They received no program until after the 6-month assessments. | 12 weeks. Participants to weigh-in -- record their weight on the website at least once a week | High |
| Padwal et al, 2017, Canada (25) | In-person: community-based setting | Adults with BMI ≥35 | Start: intervention, n = 215; control, n = 211. End: intervention, n = 215; control, n = 211. Weight change: intervention, n = −3.70; control, n = −2.90 | Focus: Both nutrition and physical activity. Intervention groups received group education sessions for healthful eating, increasing physical activity, goal setting, and self-monitoring. Group/individual sessions: 13 group sessions. | Control group received printed educational materials. After a week, they were contacted to be encouraged to read the printed materials, register for in-person sessions, or access the web modules. | 12 weeks. 13 group sessions | Lowa |
| Yardley et al, 2014, UK (37) | Online or distance learning in web-based application and telephone | Adults aged ≥18 y and BMI ≥30 | Start: intervention, n = 47; control, n = 43. End: intervention, n = 37 control, n = 29. Weight change: intervention, n = −4.23; control, n = −1.99 | Focus: Both nutrition and physical activity. The web-based intervention was designed to provide support for self-management of weight, based on patient choice of either a low-calorie or a low- carbohydrate eating plan and encouragement of physical activity. Personalized messages: Users received advice based on progress (eg, positive feedback if successful, advice on overcoming barriers if unsuccessful). Educational resources: Recommended links to other relevant high-quality websites. Support tools: A web-based goal-setting tool required patients to choose their first weekly goal from preset choices likely to promote significant weight loss; could set motivational automated messages and track weight and calories. Group/individual sessions: one-on-one contact in face-to-face with nurse. | Control group received access to interventions and support as determined by the primary care staff and was offered access to the website at the end of the study. | 26 weeks. Scheduled support at 2 weeks and then monthly for the 6 months of the study (a total of 7 contacts) | Lowa |
Abbreviations: I, intervention; C, comparator; BMI, body mass index; CVD, cardiovascular disease; NIH, National Institutes of Health; UK, United Kingdom.
a
Study was determined to be low quality because of high participant attrition (>20%).