title: Systematic review of physical activity and exercise interventions on body mass indices, subsequent physical activity and psychological symptoms in overweight and obese adolescents.
abstract: OBJECTIVE
  To examine the effects of physical activity and exercise interventions on body mass index, subsequent physical activity and psychological symptoms for overweight and obese adolescents (12-18 years).
  
  
  BACKGROUND
  Overweight and obesity have increased among adolescents globally and physical activity has decreased. Healthcare systems face challenges promoting physical activity and in treating obesity. Promotion of physical activity must be effective and school nurses should be equipped with the information and resources required to implement counselling for overweight and obese adolescents.
  
  
  METHODS
  A systematic review of randomized controlled trials was conducted according to procedures by the Centre for Reviews and Dissemination and the Joanna Briggs Institute.
  
  
  METHODS
  Research studies published between 1950-2013 were identified from the following databases. CINAHL, MEDLINE (Ovid) and PsycINFO.
  
  
  METHODS
  Selected studies were reviewed for quality and a risk-of-bias assessment was conducted for the included studies. A narrative synthesis was used to report results, while a fixed-effect meta-analysis was used to analyse the interventions effects on physical activity and body mass index.
  
  
  RESULTS
  Fourteen published studies were included to this review. Supervised exercise interventions most affected adolescents' body mass index. The interventions effect on adolescents' physical activity was small and heterogeneous. Two interventions positively affected psychological symptoms.
  
  
  CONCLUSIONS
  Interventions were complex, with more than one component and the aspect that effectively promotes physical activity in obese adolescents was not clear. However, it seems that exercise interventions affect the body mass index of overweight or obese adolescents. Interventions that include a component for promoting physical activity with or without supervised exercise can affect subsequent physical activity and body mass index.
authors.affiliation: Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Ruotsalainen
authors.affiliation: Institute of Health Sciences, University of Oulu, Finland.|Northern Ostrobothnia Hospital District, Oulu, Finland.
authors.forename: Helvi
authors.initials: H
authors.lastname: Kyngäs
authors.affiliation: LIKES-Research Center for Sport and Health Sciences, Jyväskylä, Finland.
authors.forename: Tuija
authors.initials: T
authors.lastname: Tammelin
authors.affiliation: Institute of Health Sciences, University of Oulu, Finland.
authors.forename: Maria
authors.initials: M
authors.lastname: Kääriäinen
mesh_terms: D000293:Adolescent; D001828:Body Image; D015992:Body Mass Index; D002648:Child; D015444:Exercise / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology* / Q000628:therapy; D009765:Obesity / Q000523:psychology / Q000628:therapy; D050177:Overweight / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: adolescent health; exercise; intervention; obesity; overweight; physical activity; systematic review and meta-analysis