Efficacy of Exercise Intervention for Weight Loss in Overweight and Obese Adolescents: Meta-Analysis and Implications
- PMID: 27139723
- DOI: 10.1007/s40279-016-0537-6
Efficacy of Exercise Intervention for Weight Loss in Overweight and Obese Adolescents: Meta-Analysis and Implications
Abstract
Background: The global rise in obesity prevalence among children and adolescents has been linked to modifiable lifestyle factors, including lack of physical activity. However, no known meta-analysis has been conducted on the effects of exercise intervention on body composition and cardiometabolic risk factors in overweight and obese adolescents.
Objectives: The aim of this study was to (1) estimate whether exercise intervention meaningfully improves body composition and cardiometabolic risk factors in overweight and obese adolescents; and (2) discuss the implications of the findings in terms of primary healthcare provision and public health policy, using New Zealand as an exemplar context.
Data sources: Electronic databases (PubMed, Web of Science, SPORTDiscus, Google Scholar) from inception to May 2015. The reference lists of eligible articles and relevant reviews were also checked.
Study selection: Inclusion criteria were (1) randomized controlled trial; (2) structured exercise intervention, alone or combined with any other kind of intervention; (3) control group received no structured exercise or behavioural modification designed to increase physical activity; (4) participants overweight or obese (body mass index [BMI] ≥85th percentile); and (5) participants aged between 10 and 19 years.
Appraisal and synthesis methods: Initially, 1667 articles were identified. After evaluation of study characteristics, quality and validity, data from 13 articles (15 trials) involving 556 participants (176 male, 193 female, 187 unknown) were extracted for meta-analysis. Meta-analyses were completed on five body composition parameters and ten cardiometabolic parameters. Effect sizes (ESs) were calculated as mean differences, as well as standardized mean differences in order to determine effect magnitude.
Results: Exercise intervention reduced BMI (mean 2.0 kg/m2, 95 % CI 1.5-2.5; ES moderate), body weight (mean 3.7 kg, 95 % CI 1.7-5.8; ES small), body fat percentage (3.1 %, 95 % CI 2.2-4.1; ES small), waist circumference (3.0 cm, 95 % CI 1.3-4.8; ES small), but the increase (improvement) in lean mass was trivial (mean 1.6 kg, 95 % CI 0.5-2.6). The response to an oral glucose tolerance test following exercise intervention was for a decrease in the area under the curve for insulin (mean 162 μU/μl, 95 % CI 93-231; ES large) and blood glucose (mean 39 mg/dl, 95 % CI 9.4-69; ES moderate). Improvements in the homeostatic model assessment were also noted (mean 1.0, 95 % CI 0.7-1.4; ES moderate) and systolic blood pressure (mean 7.1 mmHg, 95 % CI 3.5-10.7; ES moderate). The effects of exercise on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting insulin and fasting blood glucose were inconclusive.
Limitations: Most of the included trials were short term (6-36 weeks) and 13 had methodological limitations. Additionally, the meta-analyses for some of the secondary outcomes had a small number of participants or substantial statistical heterogeneity.
Conclusions: The current evidence suggests that exercise intervention in overweight and obese adolescents improves body composition, particularly by lowering body fat. The limited available evidence further indicates that exercise intervention may improve some cardiometabolic risk factors.
Similar articles
-
Exercise Dose and Weight Loss in Adolescents with Overweight-Obesity: A Meta-Regression.Sports Med. 2019 Jan;49(1):83-94. doi: 10.1007/s40279-018-01040-2. Sports Med. 2019. PMID: 30560421
-
Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for the U.S. Preventive Services Task Force [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Jul. Report No.: 15-05222-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Jul. Report No.: 15-05222-EF-1. PMID: 29364620 Free Books & Documents. Review.
-
Lifestyle intervention for improving school achievement in overweight or obese children and adolescents.Cochrane Database Syst Rev. 2014 Mar 14;(3):CD009728. doi: 10.1002/14651858.CD009728.pub2. Cochrane Database Syst Rev. 2014. Update in: Cochrane Database Syst Rev. 2018 Jan 29;1:CD009728. doi: 10.1002/14651858.CD009728.pub3. PMID: 24627300 Updated. Review.
-
The effectiveness of web-based programs on the reduction of childhood obesity in school-aged children: A systematic review.JBI Libr Syst Rev. 2012;10(42 Suppl):1-14. doi: 10.11124/jbisrir-2012-248. JBI Libr Syst Rev. 2012. PMID: 27820152
-
Effectiveness of martial arts exercise on anthropometric and body composition parameters of overweight and obese subjects: a systematic review and meta-analysis.BMC Public Health. 2020 Aug 17;20(1):1246. doi: 10.1186/s12889-020-09340-x. BMC Public Health. 2020. PMID: 32807119 Free PMC article.
Cited by
-
Molecular insights of exercise therapy in disease prevention and treatment.Signal Transduct Target Ther. 2024 May 29;9(1):138. doi: 10.1038/s41392-024-01841-0. Signal Transduct Target Ther. 2024. PMID: 38806473 Free PMC article. Review.
-
Effect of exercise training on heath, quality of life, exercise capacity in juvenile idiopathic arthritis: a meta-analysis of randomized controlled trials.Pediatr Rheumatol Online J. 2024 Mar 4;22(1):33. doi: 10.1186/s12969-024-00967-3. Pediatr Rheumatol Online J. 2024. PMID: 38438855 Free PMC article. Review.
-
Immunomodulatory effects of exercise in cancer prevention and adjuvant therapy: a narrative review.Front Physiol. 2024 Jan 4;14:1292580. doi: 10.3389/fphys.2023.1292580. eCollection 2023. Front Physiol. 2024. PMID: 38239881 Free PMC article. Review.
-
Association of Sugar-Sweetened Beverage Consumption and Moderate-to-Vigorous Physical Activity with Childhood and Adolescent Overweight/Obesity: Findings from a Surveillance Project in Jiangsu Province of China.Nutrients. 2023 Sep 27;15(19):4164. doi: 10.3390/nu15194164. Nutrients. 2023. PMID: 37836448 Free PMC article.
-
The positive impact of lifestyle intervention on selected mio- and chemokines levels in prepubertal children with obesity.Pediatr Endocrinol Diabetes Metab. 2023;29(2):83-90. doi: 10.5114/pedm.2023.127273. Pediatr Endocrinol Diabetes Metab. 2023. PMID: 37728459 Free PMC article.
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical