Abstract 14599: Selected Types of Exercise Improve BMI z-score in Overweight and Obese Children and Adolescents: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials
Introduction: The effect of selected types of exercise on BMI z-score in overweight and obese children and adolescents has not been established.
Hypothesis: Exercise (aerobic and/or strength) improves body mass index (BMI) z-score in overweight and obese children and adolescents.
Methods: Studies meeting the following criteria were included: (1) direct and indirect evidence from randomized trials that included aerobic exercise and/or strength training, (2) exercise interventions at least 4 weeks, (3) children and adolescents 2 to 18 years of age, (4) participants overweight or obese, (5) studies published in any language, (6) published and unpublished studies between January 1, 1990 and September, 2015, and (7) data available or calculable for BMI z-score. Studies were retrieved by searching six electronic databases, cross-referencing and expert review. Dual selection and abstraction occurred. The primary outcome was changes in BMI z-score. Confidence in the cumulative evidence was assessed using the GRADE instrument for network meta-analysis. Network meta-analysis was performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve was used to calculate a hierarchy of exercise treatments.
Results: Of the 6087 citations screened, 34 studies representing 2,239 participants were included. Median exercise training occurred 3 times per week, 50 minutes per session over a 12-week period. Statistically significant reductions in BMI z-score were found for aerobic exercise and combined aerobic and strength exercise, but not strength training alone (M±SD, 95% CI: aerobic, -0.10, -0.15 to -0.05; aerobic and strength, -0.11, -0.19, -0.03; strength, 0.04, -0.07 to 0.15). Combined aerobic and strength training was ranked as the best, followed by aerobic exercise and then strength training. Overall confidence in effect estimates was ranked as low for aerobic exercise and very low for combined aerobic and strength training as well as strength training.
Conclusions: Aerobic exercise and combined aerobic exercise and strength training are associated with reductions in BMI z-score. A need exists for additional, well designed randomized trials. Trial registration number: PROSPERO (CRD42015026377).
Author Disclosures: G.A. Kelley: None. K.S. Kelley: None.
- © 2016 by American Heart Association, Inc.