Effects of exercise in the treatment of overweight and obese children and adolescents: a systematic review of meta-analyses.
OBJECTIVE
Conduct a systematic review of previous meta-analyses addressing the effects of exercise in the treatment of overweight and obese children and adolescents.


METHODS
Previous meta-analyses of randomized controlled exercise trials that assessed adiposity in overweight and obese children and adolescents were included by searching nine electronic databases and cross-referencing from retrieved studies. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) Instrument. The alpha level for statistical significance was set at P ≤ 0.05.


RESULTS
Of the 308 studies reviewed, two aggregate data meta-analyses representing 14 and 17 studies and 481 and 701 boys and girls met all eligibility criteria. Methodological quality was 64% and 73%. For both studies, statistically significant reductions in percent body fat were observed (P = 0.006 and P < 0.00001). The number-needed-to treat (NNT) was 4 and 3 with an estimated 24.5 and 31.5 million overweight and obese children in the world potentially benefitting, 2.8 and 3.6 million in the US. No other measures of adiposity (BMI-related measures, body weight, and central obesity) were statistically significant.


CONCLUSIONS
Exercise is efficacious for reducing percent body fat in overweight and obese children and adolescents. Insufficient evidence exists to suggest that exercise reduces other measures of adiposity.
Meta-Analytic Research Group, Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV 26506-9190, USA.
George A
GA
Kelley
Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, P.O. Box 9190, Morgantown, WV 26506-9190, USA.
Kristi S
KS
Kelley
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D050177:Overweight / Q000628:therapy*; D063766:Pediatric Obesity / Q000097:blood / Q000517:prevention & control* / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015431:Weight Loss