Effects of Blood Flow Restriction Training on Cardiometabolic Health and Body Composition in Adults with Overweight and Obesity: a Meta-analysis

Overview

Journal Front Physiol

Date 2025 Feb 3

PMID 39896196

Authors

Hao Kong

Yilin Zhang

Mingyue Yin

Kai Xu

Qingguo Sun

Yun Xie

Olivier Girard

Affiliations

Soon will be listed here.

Abstract

Objective: This meta-analysis aims to evaluate the effects of blood flow restriction (BFR) training on cardiometabolic health and body composition in adults with overweight and obesity.

Method: Following PRISMA guidelines, a systematic search of PubMed (MEDLINE), EMBASE, Web of Science, Cochrane, and Scopus databases was conducted on 15 March 2024. Pooled effects for each outcome were summarized using Hedge's () through meta-analysis-based random effects models, and subgroup analyses were used to explore moderators.

Results: A total of 11 studies with 242 participants (Age:32.6 ± 3.6, BMI:27.2 ± 3.5) were included. Regarding cardiometabolic health, BFR training significantly reduced systolic blood pressure ( = [0.08, 1.16], = 0.02), while no significant differences were observed in maximal oxygen uptake ( [-0.21, 1.17], = 0.17) or diastolic blood pressure ( [-0.22, 0.84], = 0.25). Regarding body composition, BFR training significantly reduced body fat percentage ( = [0.01, 0.58]; = 0.04), while no significant differences ( > 0.05) were observed in body weight ( [-0.14, 0.42]), body mass index ( [-0.21, 0.38]), waist circumference ( [-0.28, 0.53]), or waist-to-hip ratio ( [-0.19, 1.15]). Subgroup analysis revealed no significant difference in improving systolic blood pressure ( [-0.10, 1.24] vs. = [-0.18, 1.59]) and body fat percentage ( [-0.20, 0.61] vs. [-0.05, 0.95]) between BFR resistance training and BFR aerobic training. In all selected studies, the overall risk of bias was categorized as "some concern". The certainty of evidence for the BFR outcomes was low.

Conclusion: BFR training shows promise in improving cardiometabolic health and body composition, indicating that it may serve as a beneficial, individualized exercise prescription for improving cardiovascular disease risk and fat loss in adults with excess body weight and obesity.

Systematic Review Registration: https://archive.org/details/osf-registrations-uv6jx-v1.

References

Chen Y, Ma C, Wang J, Gu Y, Gao Y . Effects of 40% of Maximum Oxygen Uptake Intensity Cycling Combined with Blood Flow Restriction Training on Body Composition and Serum Biomarkers of Chinese College Students with Obesity. Int J Environ Res Public Health. 2022; 19(1). PMC: 8750492. DOI: 10.3390/ijerph19010168. View

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

Nuttall F . Body Mass Index: Obesity, BMI, and Health: A Critical Review. Nutr Today. 2016; 50(3):117-128. PMC: 4890841. DOI: 10.1097/NT.0000000000000092. View

Spitz R, Chatakondi R, Bell Z, Wong V, Dankel S, Abe T . The impact of cuff width and biological sex on cuff preference and the perceived discomfort to blood-flow-restricted arm exercise. Physiol Meas. 2019; 40(5):055001. DOI: 10.1088/1361-6579/ab1787. View

Willis L, Slentz C, Bateman L, Shields A, Piner L, Bales C . Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults. J Appl Physiol (1985). 2012; 113(12):1831-7. PMC: 3544497. DOI: 10.1152/japplphysiol.01370.2011. View

Kim K, Kim K, Kim C, Kang S, Kim H, Yoon S . Effects of Exercise on the Body Composition and Lipid Profile of Individuals with Obesity: A Systematic Review and Meta-Analysis. J Obes Metab Syndr. 2020; 28(4):278-294. PMC: 6939705. DOI: 10.7570/jomes.2019.28.4.278. View

Haslam D, James W . Obesity. Lancet. 2005; 366(9492):1197-209. DOI: 10.1016/S0140-6736(05)67483-1. View

Oppert J, Ciangura C, Bellicha A . Physical activity and exercise for weight loss and maintenance in people living with obesity. Rev Endocr Metab Disord. 2023; 24(5):937-949. DOI: 10.1007/s11154-023-09805-5. View

Kim J, Yoon J . Does Obesity Affect the Severity of Exercise-Induced Muscle Injury?. J Obes Metab Syndr. 2021; 30(2):132-140. PMC: 8277587. DOI: 10.7570/jomes20100. View

10.

Hughes L, Paton B, Rosenblatt B, Gissane C, Patterson S . Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis. Br J Sports Med. 2017; 51(13):1003-1011. DOI: 10.1136/bjsports-2016-097071. View

11.

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

12.

Wenger H, Bell G . The interactions of intensity, frequency and duration of exercise training in altering cardiorespiratory fitness. Sports Med. 1986; 3(5):346-56. DOI: 10.2165/00007256-198603050-00004. View

13.

Wu T, Gao X, Chen M, van Dam R . Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis. Obes Rev. 2009; 10(3):313-23. DOI: 10.1111/j.1467-789X.2008.00547.x. View

14.

Su Y, Wang F, Wang M, He S, Yang X, Luan Z . Effects of blood flow restriction training on muscle fitness and cardiovascular risk of obese college students. Front Physiol. 2024; 14:1252052. PMC: 10791898. DOI: 10.3389/fphys.2023.1252052. View

15.

Li S, Guo R, Yu T, Li S, Han T, Yu W . Effect of High-Intensity Interval Training Combined with Blood Flow Restriction at Different Phases on Abdominal Visceral Fat among Obese Adults: A Randomized Controlled Trial. Int J Environ Res Public Health. 2022; 19(19). PMC: 9565218. DOI: 10.3390/ijerph191911936. View

16.

Spranger M, Krishnan A, Levy P, OLeary D, Smith S . Blood flow restriction training and the exercise pressor reflex: a call for concern. Am J Physiol Heart Circ Physiol. 2015; 309(9):H1440-52. PMC: 7002872. DOI: 10.1152/ajpheart.00208.2015. View

17.

Al-Mhanna S, Batrakoulis A, Ghazali W, Mohamed M, Aldayel A, Alhussain M . Effects of combined aerobic and resistance training on glycemic control, blood pressure, inflammation, cardiorespiratory fitness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis. PeerJ. 2024; 12:e17525. PMC: 11182026. DOI: 10.7717/peerj.17525. View

18.

Afshin A, Forouzanfar M, Reitsma M, Sur P, Estep K, Lee A . Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017; 377(1):13-27. PMC: 5477817. DOI: 10.1056/NEJMoa1614362. View

19.

Garber C, Blissmer B, Deschenes M, Franklin B, LaMonte M, Lee I . American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011; 43(7):1334-59. DOI: 10.1249/MSS.0b013e318213fefb. View

20.

Patterson S, Hughes L, Warmington S, Burr J, Scott B, Owens J . Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol. 2019; 10:533. PMC: 6530612. DOI: 10.3389/fphys.2019.00533. View