Abstract：
OBJECTIVE: Weight loss in individuals with obesity and overweight leads to metabolic and health benefits but also poses the risk of muscle mass reduction. This systematic review and meta-analysis of randomized controlled trials aims to determine the initial protein amount necessary for achieving weight loss while maintaining muscle mass, strength, and physical function in adults with overweight and obesity.
METHODS: Relevant literature databases, including Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica (Embase), the Cumulative Index to Nursing and Allied Health Literature (CINHAL), and Web of Science, were electronically searched up to 15 March 2023. We examined the effect of additional protein intake on muscle mass, strength, and physical function in adults with overweight or obesity targeting weight loss. The risk of bias was assessed using the Cochrane RoB 2.0 tool. Results were synthesized using standardized mean differences (SMD) and 95% confidence intervals (CI) via a random-effects model.
RESULTS: Forty-seven studies (n = 3218) were included. In the muscle mass analysis, twenty-eight trials with 1989 participants were encompassed. Results indicated that increased protein intake significantly prevents muscle mass decline in adults with overweight or obesity aiming for weight loss (SMD 0.75; 95% CI 0.41 to 1.10; p < 0.001). Enhanced protein intake did not significantly prevent decreases in muscle strength and physical function. An intake exceeding 1.3 g/kg/day is anticipated to increase muscle mass, while an intake below 1.0 g/kg/day is associated with a higher risk of muscle mass decline. The risk of bias in studies regarding muscle mass ranged from low to high.
CONCLUSIONS: Adults with overweight or obesity and aim for weight loss can more effectively retain muscle mass through higher protein intake, as opposed to no protein intake enhancement.
METHODS: Relevant literature databases, including Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica (Embase), the Cumulative Index to Nursing and Allied Health Literature (CINHAL), and Web of Science, were electronically searched up to 15 March 2023. We examined the effect of additional protein intake on muscle mass, strength, and physical function in adults with overweight or obesity targeting weight loss. The risk of bias was assessed using the Cochrane RoB 2.0 tool. Results were synthesized using standardized mean differences (SMD) and 95% confidence intervals (CI) via a random-effects model.
RESULTS: Forty-seven studies (n = 3218) were included. In the muscle mass analysis, twenty-eight trials with 1989 participants were encompassed. Results indicated that increased protein intake significantly prevents muscle mass decline in adults with overweight or obesity aiming for weight loss (SMD 0.75; 95% CI 0.41 to 1.10; p < 0.001). Enhanced protein intake did not significantly prevent decreases in muscle strength and physical function. An intake exceeding 1.3 g/kg/day is anticipated to increase muscle mass, while an intake below 1.0 g/kg/day is associated with a higher risk of muscle mass decline. The risk of bias in studies regarding muscle mass ranged from low to high.
CONCLUSIONS: Adults with overweight or obesity and aim for weight loss can more effectively retain muscle mass through higher protein intake, as opposed to no protein intake enhancement.
摘要：
目的：肥胖和超重个体的体重减轻会带来代谢和健康益处，但也会带来肌肉质量减少的风险。这项对随机对照试验的系统评价和荟萃分析旨在确定在保持肌肉质量的同时实现体重减轻所需的初始蛋白质量。力量,超重和肥胖成年人的身体机能。
方法：相关文献数据库，包括在线医学文献分析和检索系统(Medline)，医学节选（Embase），护理和相关健康文献累积指数(CINHAL)，和WebofScience,在2023年3月15日之前进行了电子搜索。我们检查了额外蛋白质摄入对肌肉质量的影响，力量,以及超重或肥胖的成年人的身体功能。使用CochraneRoB2.0工具评估偏倚风险。通过随机效应模型使用标准化平均差异（SMD）和95％置信区间（CI）合成结果。
结果：纳入47项研究（n=3218）。在肌肉质量分析中，纳入了有1989名参与者的28项试验.结果表明，增加蛋白质摄入量可显著防止超重或肥胖成年人的肌肉质量下降，目的是减轻体重(SMD0.75;95%CI0.41至1.10;p<0.001)。增加蛋白质摄入并不能明显防止肌肉力量和身体功能的下降。摄入量超过1.3克/千克/天预计会增加肌肉质量，而摄入量低于1.0g/kg/天与肌肉质量下降的风险更高。研究中关于肌肉质量的偏倚风险从低到高不等。
结论：超重或肥胖并以减肥为目标的成年人可以通过更高的蛋白质摄入量更有效地保持肌肉质量，与不增加蛋白质摄入量相反。
方法：相关文献数据库，包括在线医学文献分析和检索系统(Medline)，医学节选（Embase），护理和相关健康文献累积指数(CINHAL)，和WebofScience,在2023年3月15日之前进行了电子搜索。我们检查了额外蛋白质摄入对肌肉质量的影响，力量,以及超重或肥胖的成年人的身体功能。使用CochraneRoB2.0工具评估偏倚风险。通过随机效应模型使用标准化平均差异（SMD）和95％置信区间（CI）合成结果。
结果：纳入47项研究（n=3218）。在肌肉质量分析中，纳入了有1989名参与者的28项试验.结果表明，增加蛋白质摄入量可显著防止超重或肥胖成年人的肌肉质量下降，目的是减轻体重(SMD0.75;95%CI0.41至1.10;p<0.001)。增加蛋白质摄入并不能明显防止肌肉力量和身体功能的下降。摄入量超过1.3克/千克/天预计会增加肌肉质量，而摄入量低于1.0g/kg/天与肌肉质量下降的风险更高。研究中关于肌肉质量的偏倚风险从低到高不等。
结论：超重或肥胖并以减肥为目标的成年人可以通过更高的蛋白质摄入量更有效地保持肌肉质量，与不增加蛋白质摄入量相反。
