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.