Evidence of the influence of physical activity on the metabolic syndrome and/or on insulin resistance in pediatric populations: a systematic review

Abstract

This study is aimed at updating the relationships between physical activity (PA) and the metabolic syndrome (MetS) and/or insulin resistance (IR) in youth. Cross-sectional, prospective cohort and intervention studies, which examined the effect of PA on MetS, its components and IR in children and adolescents (<18 yrs), were searched by applying a combination of criteria in the PubMed database. The electronic search of studies published from 2000-2010 yielded >150 references. Of these, 37 studies were included. Twenty-six studies (70%) were cross-sectional observation studies, and two studies (8%) were prospective cohort studies. The remaining eight studies (22%) were interventions, of which three (<10% of all included studies) were randomized controlled trials. Commonly, higher PA levels were consistently associated with an improved metabolic profile and a reduced risk for MetS and/or IR in these populations. The impact of PA on MetS and/or IR appeared to be either independent of other factors, or alternatively or simultaneously mediated by the physical fitness and adiposity of youth. However, more-robustly designed interventions (i.e., some mega-randomized controlled trials based on lifestyle interventions) and additional cohort studies are required to make definitive inference about the magnitude and role of PA as a single genuine preventive and treatment strategy for the metabolic and cardiovascular risk of youth in the current obesogenic context.

Early detection of comorbidity in psoriasis: recommendations of the National Conference on Healthcare in Psoriasis

“…The increased adipose tissue produces hormones and cytokines in nonphysiological quantities, which promote insulin resistance or development of the metabolic syndrome [32] (Table 6 and annex). Typical clinical and paraclinical signs are visceral fat increase, arterial hypertension, dyslipidemia, and increased plasma glucose levels.…”

Predictors of Metabolically Healthy Obesity in Children

“…Our data demonstrate that being moderately-tovigorously active may have a clinically meaningful impact on the cardiometabolic health status of children with obesity. This finding is particularly important given how difficult it is for children with obesity to lose and maintain weight loss over time (29) and that regular PA (30,31), and more intense PA in particular (32), may have a positive effect on the cardiometabolic health of boys and girls. From a practical standpoint, those individuals classified as having higher cardiometabolic health risk could be prioritized for care sooner or identified to receive more aggressive therapies than their lower-risk peers; for instance, MHO children may benefit from interventions that help them to maintain their current weight, whereas their MUO peers may benefit from more intensive health services to promote weight loss.…”

Exercise and Insulin Resistance in Youth: A Meta-Analysis

“…14 Previous reviews have established that aerobic and resistance training can be used to improve the regulation of glucose, as well as provide a synergistic effect when combined in a structured exercise program across all ages. [15][16][17] Although previous original research and subsequent reviews provide the basis for including physical activity and exercise training in the treatment program for the prevention of T2DM, meta-analytic reviews of exercise and fasting insulin have been limited to adults 18,19 or children and adolescents with type 1 diabetes. 20 The current study expands on the body of literature by providing a quantitative estimate of the effect size (ES) of exercise training on fasting insulin and IR for use in future research and program design with children and adolescents.…”