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Journal of Obesity
Volume 2014, Article ID 358919, 18 pages
http://dx.doi.org/10.1155/2014/358919
Review Article

Avoiding Weight Gain in Cardiometabolic Disease: A Systematic Review

1Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
2Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA
3Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
4Division of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
5Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
6Division of Acute Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
7Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
8Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
9Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA 92093, USA

Received 22 November 2013; Revised 3 June 2014; Accepted 16 October 2014; Published 28 December 2014

Academic Editor: Aimin Xu

Copyright © 2014 Nisa M. Maruthur et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects. Even without weight loss, weight maintenance may be beneficial. We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify comparative studies of lifestyle interventions (self-management, diet, exercise, or their combination) without a weight loss focus in adults with or at risk for diabetes and cardiovascular disease. Weight, BMI, and waist circumference at ≥12 months were the primary outcomes. Of 24,870 citations, we included 12 trials (self-management, ; diet, ; exercise, ; combination, ) studying 4,206 participants. Self-management plus physical activity ± diet versus minimal/no intervention avoided meaningful weight (−0.65 to −1.3 kg) and BMI (−0.4 to −0.7 kg/m2) increases. Self-management and/or physical activity prevented meaningful waist circumference increases versus control (−2 to −4 cm). In patients with cardiometabolic disease, self-management plus exercise may prevent weight and BMI increases and self-management and/or exercise may prevent waist circumference increases versus minimal/no intervention. Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes.