Effects of physical activity and dietary supplement on fat free mass and bone mass density during weight loss – a systematic review and meta-analysis.

Anja Roth,Martin Sattelmayer,Simone Gafner,Lara Allet,Chloé Schorderet

doi:10.12688/f1000research.75539.1

Abstract

Background: After a diet- or surgery induced weight loss almost 1/3 of lost weight consists of fat free mass (FFM) if carried out without additional therapy. Exercise training and a sufficient supply of protein, calcium and vitamin D is recommended to reduce the loss of FFM. Objective: To investigate the effect of exercise training, protein, calcium, and vitamin D supplementation on the preservation of FFM during non-surgical and surgical weight loss and of the combination of all interventions together in adults with obesity. Methods: A systematic review was performed with a pairwise meta-analysis and an exploratory network meta-analysis according to the PRISMA statement. Results: Thirty studies were included in the quantitative analysis. The pairwise meta-analysis showed for Exercise Training + High Protein vs. High Protein a moderate and statistically significant effect size (SMD 0.45; 95% CI 0.04 to 0.86), for Exercise Training + High Protein vs. Exercise Training a high but statistically not significant effect size (SMD 0.91; 95% CI -0.59 to 2.41) and for Exercise Training alone vs. Control a moderate but statistically not significant effect size (SMD 0.67; 95% CI -0.25 to 1.60). In the exploratory network meta-analysis three interventions showed statistically significant effect sizes compared to Control and all of them included the treatment Exercise Training. Conclusions: Results underline the importance of exercise training and a sufficient protein intake to preserve FFM during weight loss in adults with obesity. The effect of calcium and vitamin D supplementation remains controversial and further research are needed.

Highlights

In the past three decades, the prevalence of obesity and overweight has risen substantially
Regarding the effect of diet induced weight loss on fat free mass (FFM), results of this study indicate that Exercise Training plus dietary supplementation is superior to only exercise training, to only dietary supplementation and to no additional therapy during weight loss
The present systematic review with meta-analysis and exploratory network meta-analysis investigated the effect of exercise training, protein, calcium and vitamin D supplementation alone or in all possible combinations on the preservation of FFM during weight loss in adults considered overweight or obese

Summary

Introduction

In the past three decades, the prevalence of obesity and overweight has risen substantially. Exercise training and a sufficient supply of protein, calcium and vitamin D is recommended to reduce the loss of FFM. Objective: To investigate the effect of exercise training, protein, calcium, and vitamin D supplementation on the preservation of FFM during non-surgical and surgical weight loss and of the combination of all interventions together in adults with obesity. In the exploratory network meta-analysis three interventions showed statistically significant effect sizes compared to Control and all of them included the treatment Exercise Training. Conclusions: Results underline the importance of exercise training and a sufficient protein intake to preserve FFM during weight loss in article can be found at the end of the article

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