Effects of caloric restriction with different doses of exercise on fat loss in people living with type 2 diabetes: A secondary analysis of the DOSE-EX randomized clinical trial.

IF 9.7 1区医学 Q1 HOSPITALITY, LEISURE, SPORT & TOURISM Journal of Sport and Health Science Pub Date : 2024-10-18 DOI:10.1016/j.jshs.2024.100999

Mark P P Lyngbæk, Grit E Legaard, Nina S Nielsen, Cody Durrer, Thomas P Almdal, Morten Asp Vonsild Lund, Benedikte Liebetrau, Caroline Ewertsen, Carsten Lauridsen, Thomas P J Solomon, Kristian Karstoft, Bente K Pedersen, Mathias Ried-Larsen

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Abstract

Background: Fat loss mainly conveys the benefits of caloric restriction for people living with type 2 diabetes. The literature is equivocal regarding whether exercise facilitates fat loss during caloric restriction. This analysis aimed to assess the dose-response effects of exercise in combination with a caloric restriction on fat mass (FM) and FM percentage (FM %) in persons with diagnosed type 2 diabetes.

Methods: In this secondary analysis of a 4-armed randomized trial, 82 persons living with type 2 diabetes were randomly allocated to the control group (CON) (n = 21), diet control (DCON) (25 % caloric restriction; n = 20), diet control and exercise 3 times per wk (MED) (n = 20), or diet control and exercise 6 times per wk (HED) (n = 21) for 16 wk. The primary analysis was the change in FM% points. Secondary analyses included fat-free mass and visceral adipose tissue (VAT) volume (cm³).

Results: FM% decreased compared to CON by a mean difference of -3.5% (95% confidence interval (95%CI): -5.6% to -1.4%), -6.3% (95%CI: -8.4% to -4.1%), and -8.0% (95%CI: -10.2% to -5.8%) for DCON, MED, and HED, respectively. Compared to DCON, MED and HED decreased FM% by -2.8% (95%CI: -4.9% to -0.7%) and -4.5% (95%CI: -6.6% to -2.4%), respectively. The difference in FM% between HED and MED was -1.8% (95%CI: -3.9% to 0.4%). DCON and MED decreased fat-free mass compared to CON, whereas HED preserved fat-free mass (-0.2% (95%CI: -2.0% to 1.7%)). Compared to CON, VAT volume decreased by -666.0 cm³ (95%CI: -912.8 cm³ to -385.1 cm³), -1264.0 (95%CI: -1679.6 cm³ to -655.9 cm³), and -1786.4 cm³ (95%CI: -2264.6 cm³ to -1321.2 cm³) more for DCON, MED, and HED, respectively. HED decreased VAT volume more than DCON (-1120.4 cm³ (95%CI: -1746.6 cm³ to -639.4 cm³)) while the remaining comparisons did not reveal any differences.

Conclusion: All interventions were superior in reducing FM% compared to standard care. Adding exercise to a caloric restriction was superior in reducing FM% compared to a caloric restriction alone.

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限制热量和不同剂量的运动对 2 型糖尿病患者减脂的影响：DOSE-EX 随机临床试验的二次分析。

背景：减脂主要体现了限制热量摄入对 2 型糖尿病患者的益处。关于运动是否能在限制热量的过程中促进脂肪减少，相关文献的研究结果并不一致。本分析旨在评估运动结合热量限制对确诊的 2 型糖尿病患者的脂肪量（FM）和脂肪百分比（FM%）的剂量反应效应：在这项四臂随机试验的二次分析中，82 名 2 型糖尿病患者被随机分配到对照组（CON）（n = 21）、饮食控制组（DCON）（限制 25% 热量；n = 20）、饮食控制和每周锻炼 3 次组（MED）（n = 20）或饮食控制和每周锻炼 6 次组（HED）（n = 21），为期 16 周。主要分析指标为 FM% 分数的变化。次要分析包括去脂质量和内脏脂肪组织（VAT）体积（cm3）：DCON、MED和HED的FM%与CON相比分别下降了-3.5%（95%置信区间（95%CI）：-5.6%至-1.4%）、-6.3%（95%CI：-8.4%至-4.1%）和-8.0%（95%CI：-10.2%至-5.8%）。与DCON相比，MED和HED的FM%分别下降了-2.8%（95%CI：-4.9%至-0.7%）和-4.5%（95%CI：-6.6%至-2.4%）。HED和MED的去脂率差异为-1.8%（95%CI：-3.9%至0.4%）。与CON相比，DCON和MED减少了去脂质量，而HED保留了去脂质量（-0.2%（95%CI：-2.0%至1.7%））。与CON相比，DCON、MED和HED的VAT体积分别减少了-666.0立方厘米（95%CI：-912.8立方厘米至-385.1立方厘米）、-1264.0立方厘米（95%CI：-1679.6立方厘米至-655.9立方厘米）和-1786.4立方厘米（95%CI：-2264.6立方厘米至-1321.2立方厘米）。HED比DCON减少的VAT体积更多（-1120.4立方厘米（95%CI：-1746.6立方厘米至-639.4立方厘米）），而其余比较未显示任何差异：结论：与标准护理相比，所有干预措施在降低FM%方面都更有优势。结论：与标准护理相比，所有干预措施在降低 FM% 方面都更有优势。在限制热量摄入的基础上增加运动，在降低 FM% 方面要优于单独限制热量摄入。

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来源期刊

Journal of Sport and Health Science SPORT SCIENCES-

CiteScore

18.30

自引率

1.70%

发文量

101

审稿时长

22 weeks

期刊介绍： The Journal of Sport and Health Science (JSHS) is an international, multidisciplinary journal that aims to advance the fields of sport, exercise, physical activity, and health sciences. Published by Elsevier B.V. on behalf of Shanghai University of Sport, JSHS is dedicated to promoting original and impactful research, as well as topical reviews, editorials, opinions, and commentary papers. With a focus on physical and mental health, injury and disease prevention, traditional Chinese exercise, and human performance, JSHS offers a platform for scholars and researchers to share their findings and contribute to the advancement of these fields. Our journal is peer-reviewed, ensuring that all published works meet the highest academic standards. Supported by a carefully selected international editorial board, JSHS upholds impeccable integrity and provides an efficient publication platform. We invite submissions from scholars and researchers worldwide, and we are committed to disseminating insightful and influential research in the field of sport and health science.