Exercise is efficacious for reducing selected body composition variables in children and adolescents. The most favorable alterations in body composition occurred with 1) low-intensity, long-duration exercise; 2) aerobic exercise combined with high-repetition resistance training; and 3) exercise programs combined with a behavioral-modification component.
Objectives: To examine the effects of exercise training on paediatric obesity immediately after training and at a one year follow up and to provide recommendations for future research. Methods: Studies that met the following criteria were included in a meta-analysis: (a) at least six subjects per group; (b) subject groups consisting of children in the 4-17 year age range; (c) pre-test and post-test values for body composition; (d) used exercise such as walking, jogging, cycle ergometry, high repetition resistance exercise, and combinations; (e) training programmes lasting eight weeks or more; (f) full length publications; (g) apparently healthy children. Results: A total of 135 studies of exercise as a method of treatment of paediatric obesity were located. Eight, containing 236 subjects, met our criteria for inclusion. Across all designs and categories, fixed effects modelling yielded significant decreases in the dependent variable percentage body fat immediately (0 = 1.04 (0.35); 95% confidence interval (CI) 0.41 to 1.6) and one year after the exercise intervention (0 = 0.84 (0.51); 95% CI 0.22 to 0.94). Forward stepwise linear regression suggested that the percentage body fat measured at the end of exercise training, exercise duration, and programme length accounted for 53-86% of the variance for percentage body fat at one year. Conclusions: These data indicate that exercise is efficacious for reducing percentage body fat in obese children and adolescents, and that exercise intervention may encourage long term maintenance of the observed gains. P ublic health officials refer to paediatric obesity in descriptive terms such as "alarming" and "epidemic".1 Prospective research has shown that obesity during childhood substantially increases the risk of orthopaedic, metabolic, respiratory, and psychosocial disorders.2 These serious consequences have prompted researchers, clinicians, and healthcare professionals to study the impact of various treatment programmes in obese children.Although there is agreement within the scientific community that exercise is an empirically validated method of treating obesity, numerous questions remain about the long term efficacy of exercise intervention programmes in children. A large number of studies on the role of physical activity in paediatric obesity were reviewed recently, 3 but only a few provided long term follow up data on the improvements derived. In the light of the impending direction in obesity research that involves molecular and behavioural genetics-that is, the next generation of treatments-it seems prudent to synthesise what we now know about the long term effectiveness of exercise as a treatment for paediatric obesity.Meta-analysis is a quantitative approach popularised by Glass,4 in which studies are converted into individual data points and then subjected to statistical analysis. This approach allows investigators to make comparisons on a common research problem that would be difficult or impossible to perform using conventional research paradigms. Thus the twof...
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