Effect of diet combined with exercise intervention on tumor necrosis factor α in overweight or obese groups: based on the exercise dose-response relationship
Description
Background: Chronic low-grade systemic inflammation caused by obesity or overweight is associated with multiple complications and risk of disease development. Tumor necrosis factor α (TNF-α) is one of the key inflammatory factors and has a significant impact on all body functions. Objective: 1) To assess whether combined interventions are more effective than single interventions in combining diet and exercise. 2) To assess the effectiveness of exercise dose in different interventions on tumor necrosis factor (TNF-α) in patients with obesity or overweight. Methods: Four electronic databases of randomized controlled trials involving exercise or dietary interventions in patients with obesity or overweight were searched comprehensively, including data from the build-up to August 2024. Two independent researchers evaluated the quality of the literature. Pairwise, network, and dose-response meta-analyses were conducted using random effects models to examine the impact of diverse interventions on tumor necrosis factor α. Results: A total of 19 randomized controlled trials with 1479 patients with obesity or overweight were included. The network meta-analysis showed that the hypocaloric diet combined with aerobic training (HDAT) possessed the highest ranking (SMD= -1.00,95%CI -1.51 to -0.49), followed by hypocaloric diet (HD) (SMD= -0.40,95%CI -0.89 to 0.09), hypocaloric diet combined with resistance training (HDRT) (SMD= -0.48,95%CI- 1.43 to 0.48), and aerobic training combined with resistance training (ART) (SMD= -0.18,95%CI -0.92 to 0.57). In addition, in the hypocaloric diet combined with exercise, a significant improvement in TNF-α levels was observed when the total dose of exercise reached 150 metabolic equivalent of task-min/week. Conclusion: Based on the GRADE rating guidelines, moderate-quality research evidence suggests that the hypocaloric diet combined with aerobic training (HDAT) is the optimal treatment for improving tumor necrosis factor α in patients with obesity or overweight. Furthermore, the total exercise dose and tumor necrosis factor α levels demonstrated a non-linear dose-response relationship. Future studies should further explore the effects of specific aerobic exercise modalities on inflammatory factor levels in obese or overweight patients to provide a more personalized exercise prescription.