臺灣博碩士論文加值系統

背景：最近的系統性文獻回顧研究了2001~2011年間使用MRI和CT評估運動對體脂肪的改善效益。
目的：本研究目的是以DEXA為檢測工具，來探討運動訓練對改變體脂肪的效果。
資料來源：Pubmed電子資料庫2015年12月之前所有人體實驗文獻。
文獻選擇：納入標準為（1）受試對象為60歲以下，無使用藥物且無罹患疾病者；（2）有具體運動處方；（3）身體組成測量使用雙能量X光吸收儀（DEXA）或核磁共振攝影（MRI）；（4）具控制組或對照組。排除條件為研究中還包含其他減少體脂肪的介入，例如飲食和藥物方面的介入。
評價與綜合方法：從最初1715篇文獻進行仔細篩選，最後納入45篇文獻（69個實驗組），1400名參與者（男性：561，女性：735，未知：104）的資料進行分析。對前測體脂與體脂肪改變的關聯性進行評估。
結果：我們發現了在運動訓練實驗後體脂肪改變不一的結果：34組減少體脂，31組無改變，4組體脂增加。無論性別，能出現有減脂結果的大多是前測體脂率較高的參與者。運動介入後，前測體脂率與體脂肪改變有中等負相關（男：r =－0.640，p =0.001；女：r =－0.504，p =0.028）。高強度間歇訓練每單位時間（10分鐘）減少體脂率顯著高於非高強度間歇訓練（HIIT：0.025±0.012％／10min.；non-HIIT：0.005±0.006％／10min.，p <0.001）。
局限性：納入的多為短期研究（3-26週）。
結論：我們發現使人體組成正常化是運動訓練的效果。特別是，運動訓練似乎對肥胖者更有效但對瘦的人並無效。

Background：Most recent systemic review reported 15 literatures from 2001 to 2011 using MRI and CT scan as indicators for effectiveness of exercise on body fat.
Objectives：The aim of this study was to investigate training efficacy of exercise on body fat change with inclusion of literature using DEXA as an evaluation tool.
Data Sources：Pubmed electronic database from inception to December 2015.
Study Selection：Inclusion criteria were (1) participants aged less than 60, who were non-medicating and non-illness (2) specific exercise recipe were given (3) body composition taken by dual-energy X-ray absorptionmetry (DEXA) or magnetic resonance imaging (MRI) (4) studies that have paralleled control group. Excluding criteria are studies that contain other fat-reducing interventions, such as diet and medication.
Appraisal and Synthesis Methods：Initially, 1715 articles were identified. After careful selection, data from 45 articles (69 trials) involving 1400 participants (561 male, 735 female, 104 unknown) were extracted for analysis. Relationship between baseline body fat and the body fat change was assessed.
Result：We found mixed results on body fat change after training trials: decrease (N=34), no change (N=30), or increase (N=4). Effective fat reduction results are mostly came from those participants with higher baseline body fat, independent of sex. A negative correlation between baseline body fat and fat change after exercise was found (male：r =－0.640, p =0.001；female：r =－0.504, p =0.028). Reducing body fat in the same unit of training time （10 minute） was significant higher in HIIT than non-HIIT (HIIT：0.025±0.012％／10min.；non-HIIT：0.005%±0.006％／10min., p <0.001).
Limitations：Most of the included trials were short term (3-26 weeks).
Conclusion：We found a normalization effect of exercise training in body composition. In particular, exercise training appears to be more effective for those who were obese but not for those lean people.

原創聲明書 …………………………………………………………… ii
學位考試審定書 ……………………………………………………… iii
中文摘要 ……………………………………………………………… iv
英文摘要 ……………………………………………………………… vi
謝誌 …………………………………………………………..…..…… ix
目錄 …………………………………………………………………… x
表目錄 ………………………………………………………………… xii
圖目錄 ………………………………………………………………... xiii
第壹章 緒論 ………………………………………………………..... 1
第一節 研究背景 ………………………………………………......... 1
第二節 研究目的 ………………………………………………......... 3
第貳章 研究方法 …………………………………………………..... 4
第一節 文獻來源與搜索 ………………………………………......... 4
第二節 文獻選擇 ………………………………………………......... 5
第三節 資料提取和文獻品質評估 ……………………………......... 5
第四節 資料整合 ………………………………………………......... 6
第五節 資料分析 ………………………………………………......... 6
第參章 結果 ………………………………………………………..... 9
第一節 文獻檢索與篩選 ………………………………………......... 9
第二節 納入的研究說明 ………………………………………......... 9
第三節 方法學品質評估 ………………………………………......... 10
第四節 整合的結果 ……………………………………………......... 10
第五節 次群體分析 ……………………………………………......... 12
第肆章 討論 ………………………………………………………..... 13
第一節 體位對運動減脂影響 …………………………………......... 13
第二節 非肥胖體位運動仍可減脂 ……………………………......... 13
第三節 運動介入後卻體脂率增加 ……………………………......... 14
第四節 肥胖體位運動後無顯著減脂 …………………………......... 15
第五節 前測體脂率與改變體脂關係 …………………………......... 16
第六節 高強度間歇運動單位時間減少體脂率僅於肥胖者 ….......... 17
第七節 啟示 ……………………………………………………......... 17
第八節 侷限性 ………………………………………..………........... 18
第九節 結論 ……………………………………………………......... 18
符合道德標準宣言 ………………………...…………………………. 19
參考文獻 ………………………...……………………………………. 20
圖表說明 ………………………...……………………………………. 30

國民健康署（2013）。健康減重1100公噸。2015年12月28日，取自衛生福利部，國民健康署網址http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?id=201307180001&parentid=201108110001
全民運動組（2014）。民眾運動意識提升103年規律運動人口再成長。2015年12月28日，取自教育部體育署網址http://www.sa.gov.tw/wSite/ct?xItem=12293&ctNode=300&mp=11
全國賽會服務組（2015）。全國賽事統計。2015年12月28日，取自跑者廣場網址 http://www.taipeimarathon.org.tw/contestnew.aspx
國民健康署（2015） 。個人一天所需熱量知多少？安全有效減重的第一步。2015年12月28日，取自衛生福利部國民健康署網址http://obesity.hpa.gov.tw/TC/BodyweightTipContent.aspx?id=6&chk=642e12e6-9507-4c01-af41-da2d74c9ed79¶m=pn%3d1
Alberga, A. S., Farnesi, B.-C., Lafleche, A., Legault, L., & Komorowski, J. (2013). The effects of resistance exercise training on body composition and strength in obese prepubertal children. Physician and Sportsmedicine, 41(3), 103-109.
Alcaraz, P. E., Perez-Gomez, J., Chavarrias, M., & Blazevich, A. J. (2011). Similarity in adaptations to high-resistance circuit vs. traditional strength training in resistance-trained men. Journal of Strength & Conditioning Research, 25(9), 2519-2527.
Alvarez, V. P., Dixon, J. B., Strauss, B. J., Laurie, C. P., Chaston, T. B., & O’Brien, P. E. (2007). Single frequency bioelectrical impedance is a poor method for determining fat mass in moderately obese women. Obesity Surgery, 17(2), 211-221.
Ara, I., Pérez-Gómez, J., Vicente-Rodriguez, G., Chavarren, J., Dorado, C., & Calbet, J. A. (2006). Serum free testosterone, leptin and soluble leptin receptor changes in a 6-week strength-training programme. British Journal of Nutrition, 96(06), 1053-1059.
Arikawa, A. Y., Thomas, W., Gross, M., Smith, A., Phipps, W. R., Kurzer, M. S., & Schmitz, K. H. (2013). Aerobic training reduces systemic oxidative stress in young women with elevated levels of F 2-isoprostanes. Contemporary Clinical Trials, 34(2), 212-217.
Bigaard, J., Frederiksen, K., Tjønneland, A., Thomsen, B. L., Overvad, K., Heitmann, B. L., & Sørensen, T. I. (2004). Body fat and fat‐free mass and all‐cause mortality. Obesity Research, 12(7), 1042-1049.
Boutcher, S. H. (2010). High-intensity intermittent exercise and fat loss. Journal of Obesity, 2011, 868305-868305.

Carey, D. G. (2009). Quantifying differences in the “fat burning” zone and the aerobic zone: implications for training. Journal of Strength & Conditioning Research, 23(7), 2090-2095.
Cortez-Cooper, M. Y., DeVan, A. E., Anton, M. M., Farrar, R. P., Beckwith, K. A., Todd, J. S., et al., (2005). Effects of High Intensity Resistance Training on Arterial Stiffness and Wave Reflection in Women*. American Journal of Hypertension, 18(7), 930-934.
Cribb, P. J., & Hayes, A. (2006). Effects of supplement-timing and resistance exercise on skeletal muscle hypertrophy. Medicine & Science in Sports & Exercise, 38(11), 1918-1925.
Croymans, D., Krell, S., Oh, C., Katiraie, M., Lam, C., Harris, R., & Roberts, C. (2014). Effects of resistance training on central blood pressure in obese young men. Journal of Human Hypertension, 28(3), 157-164.
Donges, C. E., Duffield, R., & Drinkwater, E. J. (2010). Effects of resistance or aerobic exercise training on interleukin-6, C-reactive protein, and body composition. Medicine and Science in Sports and Exercise, 42(2), 304-313.
Earnest, C., Lupo, M., Thibodaux, J., Hollier, C., Butitta, B., Lejeune, E., et al., (2013). Interval training in men at risk for insulin resistance. International Journal of Sports Medicine, 34(04), 355-363.
Eiholzer, U., Meinhardt, U., Petrò, R., Witassek, F., Gutzwiller, F., & Gasser, T. (2010). High-intensity training increases spontaneous physical activity in children: a randomized controlled study. Journal of Pediatrics, 156(2), 242-246.
Fisher, G., Brown, A. W., Brown, M. M. B., Alcorn, A., Noles, C., Winwood, L., et al., (2015). High Intensity Interval-vs Moderate Intensity-Training for Improving Cardiometabolic Health in Overweight or Obese Males: A Randomized Controlled Trial. PloS One, 10(10), e0138853.
Foster‐Schubert, K. E., Alfano, C. M., Duggan, C. R., Xiao, L., Campbell, K. L., Kong, A., et al., (2012). Effect of diet and exercise, alone or combined, on weight and body composition in overweight‐to‐obese postmenopausal women. Obesity, 20(8), 1628-1638.
Franklin, N. C., Robinson, A. T., Bian, J.-T., Ali, M. M., Norkeviciute, E., McGinty, P., et al., (2015). Circuit Resistance Training Attenuates Acute Exertion-Induced Reductions in Arterial Function but Not Inflammation in Obese Women. Metabolic Syndrome and Related Disorders, 13(5), 227-234.
Guadalupe-Grau, A., Perez-Gomez, J., Olmedillas, H., Chavarren, J., Dorado, C., Santana, A., et al., (2009). Strength training combined with plyometric jumps in adults: sex differences in fat-bone axis adaptations. Journal of Applied Physiology, 106(4), 1100-1111.
Heydari, M., Freund, J., & Boutcher, S. H. (2012). The effect of high-intensity intermittent exercise on body composition of overweight young males. Journal of Obesity, 2012.
Jakicic, J. M., Clark, K., Coleman, E, Donnelly, J. E., Foreyt, J., Melanson, E., et al., (2001). American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Medicine and Science in Sports and Exercise, 33(12), 2145-2156.
Kerksick, C. M., Wismann-Bunn, J., Fogt, D., Thomas, A. R., Taylor, L., Campbell, B. I., et al., (2010). Changes in weight loss, body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women. Nutr J, 9(59), 1e19.
Kirk, E. P., Washburn, R. A., Bailey, B. W., LeCheminant, J. D., & Donnelly, J. E. (2007). Six months of supervised high-intensity low-volume resistance training improves strength independent of changes in muscle mass in young overweight men. Journal of Strength & Conditioning Research, 21(1), 151-156.
LeCheminant, J., Hinman, T., Pratt, K., Earl, N., Bailey, B., Thackeray, R., et al., (2014). Effect of resistance training on body composition, self‐efficacy, depression, and activity in postpartum women. Scandinavian Journal of Medicine & Science in Sports, 24(2), 414-421.
Lee, S., Kuk, J. L., Davidson, L. E., Hudson, R., Kilpatrick, K., Graham, T. E., et al., (2005). Exercise without weight loss is an effective strategy for obesity reduction in obese individuals with and without Type 2 diabetes. Journal of Applied Physiology, 99(3), 1220-1225.
Lee, S., Bacha, F., Hannon, T., Kuk, J. L., Boesch, C., & Arslanian, S. (2012). Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys a randomized, controlled trial. Diabetes, 61(11), 2787-2795.
Lee, S., Deldin, A. R., White, D., Kim, Y., Libman, I., Rivera-Vega, M., et al., (2013). Aerobic exercise but not resistance exercise reduces intrahepatic lipid content and visceral fat and improves insulin sensitivity in obese adolescent girls: a randomized controlled trial. American Journal of Physiology-Endocrinology and Metabolism, 305(10), E1222-E1229.
Lee, S., & Kuk, J. L. (2013). Changes in fat and skeletal muscle with exercise training in obese adolescents: Comparison of whole‐body MRI and dual energy X‐ray absorptiometry. Obesity, 21(10), 2063-2071.
Lovelady, C. A., Bopp, M. J., Colleran, H. L., MacKie, H. K., & Wideman, L. (2009). Effect of exercise training on loss of bone mineral density during lactation. Medicine and Science in Sports and Exercise, 41(10), 1902-1907.
Lowry, D. W., & Tomiyama, A. J. (2015). Air displacement plethysmography versus dual-energy x-ray absorptiometry in underweight, normal-weight, and overweight/obese individuals. PloS One, 10(1), e0115086.
Malin, S. K., Hinnerichs, K. R., Echtenkamp, B. G., Evetovich, T. K., & Engebretsen, B. J. (2013). Effect of adiposity on insulin action after acute and chronic resistance exercise in non-diabetic women. European Journal of Applied Physiology, 113(12), 2933-2941.
Meinhardt, U., Witassek, F., Petrò, R., Fritz, C., & Eiholzer, U. (2013). Strength training and physical activity in boys: a randomized trial. Pediatrics, 132(6), 1105-1111.
Melanson, E. L., Sharp, T. A., Seagle, H. M., Donahoo, W. T., Grunwald, G. K., Peters, J. C., et al., (2002). Resistance and aerobic exercise have similar effects on 24-h nutrient oxidation. Medicine and Science in Sports and Exercise, 34(11), 1793-1800.
Michell, V., Samaria, C., Júnior, R. N., Danyela, V., & Dantas, E. (2014). Effects of a concurrent physical exercise program on aerobic power and body composition in adults. Journal of Sports Medicine and Physical Fitness, 54(4), 441-446.
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The, P. G. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Medicine, 6(7), e1000097. doi: 10.1371/journal.pmed.1000097
Monninkhof, E. M., Velthuis, M. J., Peeters, P. H., Twisk, J. W., & Schuit, A. J. (2009). Effect of exercise on postmenopausal sex hormone levels and role of body fat: a randomized controlled trial. Journal of Clinical Oncology, 27(27), 4492-4499.
Mosti, M. P., Carlsen, T., Aas, E., Hoff, J., Stunes, A. K., & Syversen, U. (2014). Maximal strength training improves bone mineral density and neuromuscular performance in young adult women. Journal of Strength & Conditioning Research, 28(10), 2935-2945.
Neils, C. M., Udermann, B. E., Brice, G. A., Winchester, J. B., & McGuigan, M. R. (2005). Influence of contraction velocity in untrained individuals over the initial early phase of resistance training. Journal of Strength & Conditioning Research, 19(4), 883-887.
Nybo, L., Sundstrup, E., Jakobsen, M. D., Mohr, M., Hornstrup, T., Simonsen, L., et al., (2010). High-intensity training versus traditional exercise interventions for promoting health. Med Sci Sports Exerc, 42(10), 1951-1958.
Perez-Gomez, J., Olmedillas, H., Delgado-Guerra, S., Royo, I. A., Vicente-Rodriguez, G., Ortiz, R. A., et al., (2008). Effects of weight lifting training combined with plyometric exercises on physical fitness, body composition, and knee extension velocity during kicking in football. Applied Physiology, Nutrition, and Metabolism, 33(3), 501-510.
Perez-Gomez, J., Vicente-Rodríguez, G., Ara Royo, I., Martínez-Redondo, D., Puzo Foncillas, J., Moreno, L. A., et al., (2013). Effect of endurance and resistance training on regional fat mass and lipid profile. Nutr. Hosp, 28(2), 340-346.
Poehlman, E. T., Dvorak, R. V., DeNino, W. F., Brochu, M., & Ades, P. A. (2000). Effects of Resistance Training and Endurance Training on Insulin Sensitivity in Nonobese, Young Women: A Controlled Randomized Trial 1. Journal of Clinical Endocrinology & Metabolism, 85(7), 2463-2468.
Poehlman, E. T., Denino, W. F., Beckett, T., Kinaman, K. A., Dionne, I. J., Dvorak, R., & Ades, P. A. (2002). Effects of endurance and resistance training on total daily energy expenditure in young women: a controlled randomized trial. Journal of Clinical Endocrinology & Metabolism, 87(3), 1004-1009.
Roberts, C. K., Croymans, D. M., Aziz, N., Butch, A. W., & Lee, C. C. (2013). Resistance training increases SHBG in overweight/obese, young men. Metabolism, 62(5), 725-733.
Romijn, J., Coyle, E., Sidossis, L., Gastaldelli, A., Horowitz, J., Endert, E., et al.,. (1993). Regulation of endogenous fat and carbohydrate metabolism in relation to exercise intensity and duration. American Journal of Physiology-Endocrinology and Metabolism, 265(3), E380-E391.
SCHROEDER, E. T., Hawkins, S. A., & JAQUE, S. V. (2004). Musculoskeletal adaptations to 16 weeks of eccentric progressive resistance training in young women. Journal of Strength & Conditioning Research, 18(2), 227-235.
Shaibi, G. Q., Cruz, M. L., Ball, G. D., Weigensberg, M. J., Salem, G. J., Crespo, N. C, et al, (2006). Effects of resistance training on insulin sensitivity in overweight Latino adolescent males. Medicine and Science in Sports and Exercise, 38(7), 1208.
Sijie, T., Hainai, Y., Fengying, Y., & Jianxiong, W. (2012). High intensity interval exercise training in overweight young women. Journal of Sports Medicine and Physical Fitness, 52(3), 255-262.
Spence, A. L., Carter, H. H., Murray, C. P., Oxborough, D., Naylor, L. H., George, K. P., et al., (2012). MRI-derived right ventricular adaptations to endurance versus resistance training. Medicine and Science in Sports and Exercise.
Stoutenberg, M. (2008). Aerobic Training Does Not Alter CRP Concentrations in Apparently Healthy, Untrained Men. Journal of Sports Medicine and Physical Fitness, 52(1), 53-62.
Suzuki, M., Doi, T., Lee, S. J., Okamura, K., Shimizu, S., Okano, G., et al., (1999). Effect of Meal Timing after Resistance Exercise on Hindlimb Muscle Mass and Fat Accumulation in Trained Rats. Journal of Nutritional Science and Vitaminology, 45(4), 401-409. doi: 10.3177/jnsv.45.401
Tanimoto, M., Sanada, K., Yamamoto, K., Kawano, H., Gando, Y., Tabata, I., et al., (2008). Effects of whole-body low-intensity resistance training with slow movement and tonic force generation on muscular size and strength in young men. Journal of Strength & Conditioning Research, 22(6), 1926-1938.
Trapp, E., Chisholm, D., Freund, J., & Boutcher, S. (2008). The effects of high-intensity intermittent exercise training on fat loss and fasting insulin levels of young women. International Journal of Obesity, 32(4), 684-691.
Trilk, J. L., Singhal, A., Bigelman, K. A., & Cureton, K. J. (2011). Effect of sprint interval training on circulatory function during exercise in sedentary, overweight/obese women. European Journal of Applied Physiology, 111(8), 1591-1597.
Tsekouras, Y. E., Magkos, F., Kellas, Y., Basioukas, K. N., Kavouras, S. A., & Sidossis, L. S. (2008). High-intensity interval aerobic training reduces hepatic very low-density lipoprotein-triglyceride secretion rate in men. American Journal of Physiology-Endocrinology and Metabolism, 295(4), E851-E858.
Van Aggel-Leijssen, D. P., Saris, W. H., Wagenmakers, A. J., Senden, J. M., & Van Baak, M. A. (2002). Effect of exercise training at different intensities on fat metabolism of obese men. Journal of Applied Physiology, 92(3), 1300-1309.
van Loon, L. J., Greenhaff, P. L., Constantin‐Teodosiu, D., Saris, W. H., & Wagenmakers, A. J. (2001). The effects of increasing exercise intensity on muscle fuel utilisation in humans. Journal of Physiology, 536(1), 295-304.
Vissers, D., Hens, W., Taeymans, J., Baeyens, J. P., Poortmans, J., & Van Gaal, L. (2013). The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis. PloS One, 8(2), e56415.
Washburn, R., Kirk, E., Smith, B., Honas, J., Lecheminant, J., Bailey, B., et al., (2012). One set resistance training: effect on body composition in overweight young adults. Journal of Sports Medicine and Physical Fitness, 52(3), 273-279.
Wong, P. C., Chia, M., Tsou, I. Y., Wansaicheong, G. K., Tan, B., Wang, J. C., et al., (2008). Effects of a 12-week exercise training programme on aerobic fitness, body composition, blood lipids and C-reactive protein in adolescents with obesity. Ann Acad Med Singapore, 37, 286-93.
Woodrow, G. (2007). Body composition analysis techniques in adult and pediatric patients: how reliable are they? How useful are they clinically? Peritoneal Dialysis International, 27(Supplement 2), S245-S249.