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. 2022 Jul 18;12:12252. doi: 10.1038/s41598-022-15770-x

Table 1.

Characteristics of studies included in the review.

References Country Population randomized (N) and follow-up period Patients’ characteristics Type of intervention
Lost weight objective
Diet advice
Physical activity advice
Type of intervention
Length and duration of interventions
Type of care protocols in CG Personnel conducting intervention Weight loss in CG
Mean difference (SD) and 95% CI
Greaves39 UK

N = 108

12 months

Age: 40–74

BMI > 28; High CV risk

LWO: Not specified

DA: Caloric and fat restriction

PAA: To increase

TOI: Group-based sessions

L-DI: 120’ first month, followed by 90’ session at 1.5, 2, 4, 6 and 9 months

Standard care

Pack of written information on CV risk

Nurse and coaches

 − 2.04 (6.87)

CI (− 3.96; 0.12)

Lin40 USA

N = 124

Outcomes at 6 months

Follow up until 12 months

Age > 21

BMI > 27

LWO: Not specified

DA: Reduce fat and sugar intake. Portion control

PAA: Increase moving and exercise

TOI: Individual

L-DI: Text messages 3–4 times per day during 6 months

Standard care

Initial clinical assessment, personalized weight control plan and PA recommendations. Additional educational material at 6 and 12 months

Dietitian and physician

 − 0.2 (3.16)

CI (− 1.4; 1.0)

Weinhold33 USA

N = 78

3 months

Age: 18–65

BMI = 25.0 to 50.0 Prediabetes

LWO: 7% reduction

DA: Caloric and fat restriction

PAA: To increase at least 150’/week

TOI: Group-based

L-DI: 60’/week during 3 months

Standard care

Booklet with strategies for self-regulated weight loss

Dietitians

 − 0.4 (0,6)

CI (− 0.59; − 0.21)

Oh22 South Korea

N = 32

1 month

Age > 20

Rural women with MetS

LWO: Not specified

DA: Caloric and saturated fat restriction

PAA: Strength training, rhythmic dance, warm up, and cooldown exercises

TOI: Group-based

L-DI: 12 sessions, 3 times/week, 120’/session during 1 month

Standard care

Educational booklet

Nurses

 − 2 (10.90)

CI (− 8.59; 4.59)

Alghamdi41 Saudi Arabia

N = 70

3 months

Age > 20

BMI ≥ 30

LWO: ≥ 5% reduction

DA: Caloric and CH restriction

PAA: To increase

TOI: Individual sessions

L-DI: 8 visits (15–20’ each) during 3 months

Standard care

Printed health education materials regarding diet and PA

Nurses

 − 2.8 (4.96)

CI (− 3.96; − 1.64)

Blackford44 Australia

N = 401

6 months

Age: 50–69

Rural adults with, or at risk of MetS

LWO: Not specified

DAA: Diet intervention with motivational support

PAA: To increase

TOI: Home-based: printed and interactive online material

LDI: Self-management during 6 months

Waitlisted to receive the programme after post-test data collection Home-based

1.1 (21.95)

CI (− 2.29; 4.49)

Fernández-Ruiz35 Spain

N = 74

12 months of intervention,

and 1-year follow-up post-intervention

Age: not defined

BMI = 25.0–29.9 or BMI > 30

LWO: Not specified

DAA: Modification of unhealthy dietary habits

PAA: To increase: stretching exercises followed by moderate aerobic work

TOI: Group-based

L-DI: Monthly session (60’) for educational treatment. Four sessions (40’) of PA every week. Monthly session (6’) of cognitive behavioural therapy

Standard care Physicians, nurses, nutritionists and psychologists

 − 0.2 (12.35)

CI (− 4.18; 3.78)

Bo36 Italy

N = 335

1 year

Age: 45–64

Adults with MetS

LWO: Not specified

DA: Individually prescribed diet

PAA: To increase 150’/week

TOI: Individual and group-based

L-DI: 5 sessions of 60’: 1 individual session and 4 grouped

Standard care Family physicians and dietitian

1.63 (6,17)

CI (0.83; 2.42)

Duijzer34 Netherlands

N = 316

18 months

Age: 40–70

High risk of type 2 diabetes

LWO: < 5–10%

DA: Tailored dietary advice

PAA: To increase at least 30’/day, 5 days/week

TOI: Individual and group-based

L-DI: 5 to 8 individual consultations and one group session

Standard care

General practitioners, practice nurses, dieticians and

physiotherapists, sport coaches

 − 0.4 (3.7)

CI (− 1.06; 0.26)

Christensen29 Denmark

N = 144

12 months (results of the first 3 months)

Age: 18–40

(BMI > 25 or body fat % > 33)

Age > 40 years (Body fat % > 34)

Female health care workers

LWO: Not specified

DA: Caloric restriction

PAA: To increase

TOI: Individual and group-based

L-DI: 180’/week

Standard care

Monthly two-hour oral lecture

Sport instructors

0.68 (2.37)

CI (− 0.02; 1.38)

Kandula42 USA

N = 63

6 months

Age: not defined

Participants with at least one atherosclerotic CV risk factor, including obesity

LWO: Not specified

DAA: Fat and salt restriction

PAA: To increase 150’/week of moderate intensity

TOI: Group-based classes and individual follow-up telephone support calls

L-DI: weekly group classes (60–90’) and individual telephone support during 4 months

Standard care

Translated print education materials about atherosclerotic CV risk and healthy behaviours

Dieticians

 − 0.2 (3,13)

CI (− 1.14; 0.78)

Thiabpho30 Thailand

N = 60

4 months

Age: 30–50

(BMI)⩾27.5

With no non-communicable disease

LWO: Not specified

DAA: Caloric restriction and balanced diet

PAA: To increase a minimum of 150’/week of moderate exercise

TOI: Group-based

L-DI: During 4 months 12 sessions (90–120’), once a week for the first eight weeks and then every two weeks until the 16th week

Standard care Nurses

 − 0.7(1.4)

CI (− 1.20; − 0.20)

Cai38 China

N = 480

24 months

Age: ≥ 60

BMI ≥ 28

LWO: Not specified

DA: Caloric, fat and sugar restriction

PA: To increase

TOI: Group-based and individual based interventions

L-DI: Group-based sessions (120’/week the first 12 months; 120’ monthly the following months

Standard care

2-h education sessions every 2 months

Dietitians

 − 0.03 (2.51)

CI (− 0.37; 0.31)

Nanri28 Japan

N = 107

6 months

Age: not defined

Men diagnosed with MetS

LWO: Not specified

DA: Dietary change behaviours

PAA: To increase

TOI: Individual

L-DI: Session at baseline and at 3 months

Standard care

Leaflet at the baseline

Nurses

 − 0.3 (7.81)

CI (− 2.4; 1.8)

Maruyama31 Japan

N = 111

4 months

Age: 30–59

Male office workers with MetS risk factors

LWO: Not specified

DA:

PAA: To increase

TOI: Individual and group-based

L-DI: Individualized assessment and collaborative goal setting (20’ and 10’ respectively) plus 2 individual counselling sessions and monthly website advice during the 4-month period

Standard care Registered dietitian and physical trainer

 − 0.80 (2.2)

CI (− 1.50; − 0.10)

Share23 Australia

N = 43

3 months

Age: 18–30

Women with abdominal obesity [waist circumference (WC) ≥ 80 cm], and who were physically inactive

LWO: Not specified

DA: Dietary change behaviours without caloric restriction

PAA: To increase 2 session/week

TOI: Group-based

L-DI: Weekly nutrition education and group cognitive behavioural therapy (60’)

Waitlisted to receive the programme after post-test data collection Qualified exercise scientist, dietitian and counsellor

 − 3.60 (18.67)

CI (− 13.20;6)

Moss21 UK

N = 60

Intervention 12 weeks (3 months) and follow-up until week 26. (6,5 months)

Age: 18–85

Obese patients (BMI > 30) with at least moderate OSAHS

LWO: Not specified

DA: Advice based on the principles of the eat well plate

PAA: To increase: supervised exercise sessions

TOI: Group-based

L-DI: 3 sessions/week, then 2/week during weeks 5 to 8 and then to 1/week during weeks 9 to 12

Standard care

Basic written lifestyle advice, and a weight loss leaflet

Exercise physiologist

0.2 (21)

CI (− 8.11; 8.51)

Puhkala32 Finland

N = 113

12 months of counseling + 12 months of follow up

Age: 30–62

Male truck or bus driver, waist circumference ≥ 100 cm, absence of diabetes and little PA

LWO: < 10% reduction

DA: Advice based on the principles of the eat well plate

PAA: To increase 30’of moderate-intensity walking

TOI: Individual

L-DI: during 12 months: 6 individual sessions of 60’ and 7 telephone contacts of 30’

Standard care

Advice and telephone contacts

Nutritionists and physiotherapist

 − 2.5 (5.9)

CI (-4.02; − 0.98)

Anderson37 UK

N = 560

12 months

Age: 50–70

Women with excess body weight

BMI > 25

LWO: < 7% reduction

DA: Personalised diet advice

PAA: To increase

TOI: Individual

L-DI: During 12 months 2 individual sessions (60’ and 45’) in the first 3 months and then 9 (15’) support calls over the following 9 months

Standard care Nurses

 − 1.2 (5.0)

CI (− 1.8; − 0.6)

Röhling45 Germany

N = 30

1 year

Age > 18

BMI ≥ 25

LWO: Not specified

DA: Low-carbohydrate nutrition and meal replacement therapy

PAA: To increase

TOI: Group-based

L-DI: During 3 months intervention: 7 theoretical sessions and two practical modules of 90’ each, and: 4 telephone calls (20–30’each) monthly

Waitlisted to receive the programme after post-test data collection Nutritionists, exercise scientists, biologists, physicians and psychologists

 − 1.4 (4.18)

CI (− 3.3; 0.6)

Jordi Salas Salvadó43 Spain

N = 626

12 months

Age: 55–75

Patients without

CVD, overweight/obese (BMI > 27

and < 40) and with MetS

LWO: < 5–10% reduction

DA: Mediterranean diet

PAA: To increase

TOI: Individual and group-based

L-DI: During 12 months: group sessions and telephone calls once per month

Standard care

Advice about Mediterranean diet monthly without specific advice for increasing PA. Group sessions and telephone calls every 6 months

Doctors, dietitians and nurses

 − 0.7 (4.07)

CI (− 1.1; − 0.3)

Pablos46 Spain

N = 97

8 months

Age: 20–70

Adults with BMI > 25, no regular PA living in a low median household income census tract

LWO: Not specified

DA: Personalized diet advice

PAA: To increase

TOI: Individual and group-based

L-DI: 8-month intervention: 3 sessions/week of PA (140–180’) and 1 session/week of nutrition or psychological support (60’)

Waitlisted to receive the programme after post-test data collection Doctors, nutritionists, nurses, psychologists and trainers

 − 0.13 (21.48)

CI (− 8.46; 8.20)

BMI Body mass index; CG Control group; CVD Cardiovascular disease; MetS Metabolic syndrome; PA Physical activity; OSAHS Obstructive sleep apnoea hypopnoea syndrome; SD Standard deviation; LWO Lost weight objective; DA Diet advice; PAA Physical activity advice; TOI Type of intervention; L-DI Length and duration of interventions.