The Effect of Diet or Exercise on Visceral Adipose Tissue in Overweight Youth.
Excess visceral adipose tissue (VAT) in children with obesity is associated with the development of cardiovascular and metabolic disease. This meta-analysis investigated if lifestyle interventions can reduce VAT in overweight and obese youth.



Pubmed, Cochrane, and PEDro were searched for clinical trials that objectively assessed VAT and included study arms with supervised diet, exercise, or a combination of both. If there was a no-therapy control group, the data of the control group and the intervention groups were used to meta-analyze the data. In all other cases, the preintervention and the postintervention data were used to meta-analyze. Effect sizes were calculated as standardized mean differences or changes of VAT and expressed as Hedges' g.



The overall weighted mean effect size on VAT of all included interventions was -0.69 (95% confidence interval [CI] = -0.90 to -0.48) (P < 0.001). Subgroup analysis showed that the overall weighted mean effect size of diet-only interventions on VAT was 0.23 (95% CI = -0.22 to 0.68) (P = 0.311). Interventions that combined diet and exercise showed a pooled effect size on VAT of -0.55 (95% CI = -0.75 to -0.39) (P < 0.001). The pooled effect size of exercise-only interventions on VAT was -0.85 (95% CI = -1.20 to -0.57) (P < 0.001).



Supervised exercise-only or combined diet and exercise interventions can reduce VAT in overweight and obese children and adolescents. The strongest effect was found in exercise-only groups. However, high-quality randomized controlled trials describing the effect of supervised dietary interventions on VAT in children are lacking.
1Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BELGIUM; 2Lunex International University of Health, Exercise and Sports, Differdange, LUXEMBOURG; 3Faculty of Medicine and Life Sciences, Biomed/Reval-Rehabilitation Research Center, Hasselt University, Diepenbeek, BELGIUM; 4Faculty of Sport and Rehabilitation Sciences, Vrije Universiteit Brussel, Brussels, BELGIUM; 5Faculty of Health, Bern University of Applied Sciences, Bern, SWITZERLAND.
Dirk
D
Vissers
Wendy
W
Hens
Dominique
D
Hansen
Jan
J
Taeymans
D000293:Adolescent; D002648:Child; D004038:Diet, Reducing; D015444:Exercise; D006801:Humans; D050152:Intra-Abdominal Fat / Q000502:physiology*; D050177:Overweight / Q000628:therapy*; D063766:Pediatric Obesity / Q000628:therapy*