Sports Medicine and Science, KyungHee University, Global Campus, Republic of Korea.
Public Health Nurs. 2021 May;38(3):502-516. doi: 10.1111/phn.12862. Epub 2021 Feb 10.
Conflicting findings of the effects of exercise on body fat, free fat mass, insulin, insulin resistance, and physical fitness for overweight and obesity in children and adolescents. The purpose of this meta-analysis was to investigate the effects of exercise interventions in children and adolescents with overweight and obesity depending on exercise type and to build effective exercise interventions to reduce risks of metabolic disorders.
Databases were used to find eligible studies regarding the effects of exercise interventions on overweight and obesity in children and adolescents in randomized controlled trails. Effect size was calculated using the standardized mean difference statistic and heterogeneity across studies was estimated using the Q statistic.
A total of 27 studies met the inclusion criteria. Children and adolescents with overweight and obesity who participated in aerobic exercise had reduced body mass index, % body fat, fasting insulin, free fat mass, TNF-α, and IL-6, and increased physical fitness compared with control groups. Reduced free fat mass in resistance exercise was not found. Glucose, insulin resistance, blood pressure, C-reactive protein (CRP), and blood markers including total cholesterol (TC), triglyceride, LDL, and HDL did not have significant change. Average exercise interventions were aerobic exercise, 3 times/week, 60 min, and 36 weeks of exercise period.
Aerobic exercise may be beneficial to reduce body fat, fasting insulin, and inflammatory markers, and increased physical fitness for overweight and obesity in childhood and adolescence, but resistance exercise may be added, which can help avoid muscle loss in children and adolescents with overweight and obesity.
运动对超重和肥胖儿童和青少年体脂、游离脂肪量、胰岛素、胰岛素抵抗和身体适应性的影响存在争议。本荟萃分析的目的是研究超重和肥胖儿童和青少年进行不同类型运动干预的效果，并制定有效的运动干预措施来降低代谢紊乱的风险。
使用数据库搜索关于运动干预对超重和肥胖儿童和青少年影响的随机对照试验的合格研究。使用标准化均数差统计量计算效应大小，并使用 Q 统计量估计研究间的异质性。
共有 27 项研究符合纳入标准。与对照组相比，参加有氧运动的超重和肥胖儿童和青少年的体重指数、体脂百分比、空腹胰岛素、游离脂肪量、TNF-α 和 IL-6 降低，身体适应性提高。而在抗阻运动中并未发现游离脂肪量减少。血糖、胰岛素抵抗、血压、C 反应蛋白（CRP）以及包括总胆固醇（TC）、甘油三酯、LDL 和 HDL 在内的血液标志物均无显著变化。平均运动干预为每周 3 次、每次 60 分钟、持续 36 周的有氧运动。
有氧运动可能有益于减少超重和肥胖儿童和青少年的体脂、空腹胰岛素和炎症标志物，并提高身体适应性，但可增加抗阻运动，有助于避免超重和肥胖儿童和青少年的肌肉流失。
