Background: A major therapeutic goal in weight management should be total body fat reduction whereas as preserving lean body mass and bone mass density. It is uncertain if an exercise program reduces the adverse effects of calorie restriction-induced weight loss in adults.

Objective: The aim of the present study was to evaluate the differences in bone mass between adults who enrolled in a calorie restriction or an exercise-calorie restriction induced weight loss program.

Data sources: Both PubMed and Scopus libraries were searched up to February 2020.

Methods: Systematic reviews and a meta-analysis were carried out of randomized clinical trials (published to February 2020) on differences in bone mineral density and content (BMD and BMC) of adults who lost weight by calorie restriction alone (CR) or exercise-calorie restriction (CR-E). The study quality was calculated using the Cochrane scoring system. Retrieved data were pooled when weight mean differences (WMDs) were computed between two groups for BMD and BMC at various sites of the body.

Results: Thirteen studies, with a total of 852 participants were included. Available evidence found significantly higher BMD at the hip (WMD: 0.03 g/cm², 95%CI: 0.01 to 0.04, p < 0.001) and femoral neck WMD: 0.03 g/cm², 95%CI: 0.01 to 0.05, p < 0.001) and total body BMC (WMD: 0.13 kg/cm², 95%CI: −0.10 to 0.36, p < 0.001) in the CR-E compared to the CR weight loss group. In contrast, all changes in total body BMD (WMD: 0.00 g/cm², 95%CI: −0.01 to 0.02, p = 0.57) and lumbar spine BMD (WMD: 0.00 g/cm², 95%CI: −0.01 to 0.01, p = 0.89) were not statistically significant.

Limitations: Little evidence was available for different sexes separately. Most individuals were postmenopausal females and no subgroup analysis could be conducted based on menopausal status.

Conclusion: This study suggests that physical training can preserve and even significantly increase the bone mass of the hip and femoral neck during weight reduction. Of note, various exercise modalities affected BMD at different sites. Similar results were not found for lumbar spine and total body BMD.

背景：体重控制的主要治疗目标应该是减少体内总脂肪，同时保持瘦体重和骨密度。尚不确定运动计划是否可以减少卡路里限制引起的成年人体重减轻的不利影响。

目的：本研究的目的是评估参加卡路里限制或运动量限制诱导减肥计划的成年人之间骨量的差异。

数据来源：截至2020年2月，已搜索PubMed和Scopus图书馆。

方法：对仅通过卡路里限制（CR）或通过运动减肥的成年人减肥的骨矿物质密度和含量（BMD和BMC）的差异进行了随机临床试验（于2020年2月发布）进行系统评价和荟萃分析。卡路里限制（CR-E）。使用Cochrane评分系统计算研究质量。当计算两组在身体各个部位的BMD和BMC的体重均数差（WMD）时，将收集的数据汇总起来。

结果：共纳入13项研究，共有852名参与者。可用的证据发现显著更高的BMD在髋关节（WMD：0.03克/厘米²，95％CI：0.01〜0.04，P <0.001）和股骨颈WMD：0.03克/厘米²，95％CI：0.01〜0.05，P <0.001）和全身BMC（WMD：0.21公斤/厘米²，95％CI：-0.10至0.36，p <0.001）在CR-E相比，CR体重减轻组。相反，在全身BMD的所有变化（WMD：0.00克/厘米²，95％CI：-0.01至0.02，P = 0.57）和腰椎BMD（WMD：0.00克/厘米²，95％CI：-0.01到0.01，p = 0.89）无统计学意义。

局限性：很少有证据表明不同性别分别存在。大多数人是绝经后的女性，不能根据绝经状态进行亚组分析。

结论：这项研究表明，体育锻炼可以在减轻体重的同时保持甚至显着增加髋部和股骨颈的骨量。值得注意的是，各种锻炼方式影响了不同部位的BMD。腰椎和全身骨密度没有发现相似的结果。