title: Exercise and Vascular Function in Child Obesity: A Meta-Analysis.
abstract: BACKGROUND
  Conduit artery flow-mediated dilation (FMD) is a noninvasive index of preclinical atherosclerosis in humans. Exercise interventions can improve FMD in both healthy and clinical populations.
  
  
  OBJECTIVE
  This systematic review and meta-analysis aimed to summarize the effect of exercise training on FMD in overweight and obese children and adolescents as well as investigate the role of cardiorespiratory fitness (peak oxygen consumption [Vo2peak]) on effects observed.
  
  
  METHODS
  PubMed, Medline, Embase, and Cinahl databases were searched from the earliest available date to February 2015.
  
  
  METHODS
  Studies of children and/or adolescents who were overweight or obese were included.
  
  
  METHODS
  Standardized data extraction forms were used for patient and intervention characteristics, control/comparator groups, and key outcomes. Procedural quality of the studies was assessed using a modified version of the Physiotherapy Evidence Base Database scale.
  
  
  RESULTS
  A meta-analysis involving 219 participants compared the mean difference of pre- versus postintervention vascular function (FMD) and Vo2peak between an exercise training intervention and a control condition. There was a significantly greater improvement in FMD (mean difference 1.54%, P < .05) and Vo2peak (mean difference 3.64 mL/kg/min, P < .05) after exercise training compared with controls.
  
  
  CONCLUSIONS
  Given the diversity of exercise prescriptions, participant characteristics, and FMD measurement protocols, varying FMD effect size was noted between trials.
  
  
  CONCLUSIONS
  Exercise training improves vascular function in overweight and obese children, as indicated by enhanced FMD. Further research is required to establish the optimum exercise program for maintenance of healthy vascular function in this at-risk pediatric population.
authors.affiliation: School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia;
authors.forename: Katrin A
authors.initials: KA
authors.lastname: Dias
authors.affiliation: School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Merseyside, United Kingdom.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Green
authors.affiliation: Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; and.
authors.forename: Charlotte B
authors.initials: CB
authors.lastname: Ingul
authors.affiliation: School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia;
authors.forename: Toby G
authors.initials: TG
authors.lastname: Pavey
authors.affiliation: School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia; jcoombes@uq.edu.au.
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Coombes
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity / Q000502:physiology*; D002648:Child; D005081:Exercise Therapy / Q000379:methods* / Q000639:trends; D006801:Humans; D010101:Oxygen Consumption / Q000502:physiology; D063766:Pediatric Obesity / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014664:Vasodilation / Q000502:physiology*