Efficacy of exercise for treating overweight in children and adolescents: a systematic review

Abstract

Background: Overweight prevalence among children/adolescents is increasing, while adult obesity may potentially cause a decline in life expectancy. More exercise is uniformly recommended, although treatment efficacy remains unclear. Objective: To determine the efficacy of exercise alone for treating overweight in children/adolescents. Design: A systematic review and meta-analysis of randomized trials published in English were completed following multiple database searches performed on December 10, 2004. Studies of isolated or adjunctive exercise/physical activity treatment in overweight/obese children or adolescents which reported any overweight outcome were included. Literature searches identified 645 papers which were manually searched, of which 45 were considered for inclusion, of which 13 papers which reported 14 studies were included (N ¼ 481 overweight boys and girls, aged B12 years). Two reviewers independently identified relevant papers for potential inclusion and assessed methodological quality. Principal measures of effects included the mean difference (MD) (between treatment and control groups), the weighted MD (WMD), and the standardized MD (SMD). Results: Few studies were of robust design. The pooled SMD was À0.4 (À0.7, À0.1, P ¼ 0.006) for percent body fat, and À0.2 (À0.6, 0.1, P ¼ 0.07) for central obesity outcomes, whereas the pooled WMD was À2.7 kg (À6.1 kg, 0.8 kg, P ¼ 0.07) for body weight, all of which favored exercise. Pooled effects on body weight were significant and larger for studies of higher doses, whereas nonsignificant and smaller effects were seen for studies of lower doses of exercise (155-180 min/weeks vs 120-150 min/ weeks). Conclusions: Based on the small number of short-term randomized trials currently available, an aerobic exercise prescription of 155-180 min/weeks at moderate-to-high intensity is effective for reducing body fat in overweight children/adolescents, but effects on body weight and central obesity are inconclusive. Recommendations for future study designs are discussed.

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

“…Nevertheless, comparative studies in adults have shown that the effect of PA on weight control is limited and generally lower than that obtained by diet restriction. [80][81][82][83][84][85] Moreover, it has been established that the relative effectiveness of diet or PA depends upon the degree of adiposity excess, given the maximal effect of diet in markedly obese subjects and that of PA at low degrees of fat excess. 86 In order to disentangle the concept that diet and PA have comparable effects in obesity management, we depicted in Figure 1 how their relative roles should be considered different, keeping body composition into consideration.…”

Nonalcoholic fatty liver disease: a challenge for pediatricians

“…154,155 Lots of research has shown comparable short 144,151 and longterm effects on weight reduction 140,149 in treatment of fatty liver to many other medical and surgical modalities. 148,156,157 Lifestyle interventions delineate the first step in the management of children with NAFLD. However, the longterm impact of the treatment on the disease course remains unclear.…”

Efeito do exercício físico sobre peso corporal em crianças com excesso de peso: ensaio clínico comunitário randomizado em uma favela no Brasil

“…Entretanto, intervenções como a prática de atividade física têm levado a resultados discordantes: alguns estudos randomizados têm demonstrado que a prática de incorporar exercícios físicos parece ser mais efetiva em pro-mover perda de peso a longo prazo em crianças com excesso de peso, do que aquela de apenas incorporar orientações dietéticas 15,16,17 . Entretanto, não existe um consenso em relação a esses achados 18 .…”