scholarly journals Exercise and BMI in Overweight and Obese Children and Adolescents: A Systematic Review and Trial Sequential Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
George A. Kelley ◽  
Kristi S. Kelley ◽  
Russell R. Pate
Keyword(s):  
Children And Adolescents ◽  
Exercise Intervention ◽  
Average Length ◽  
Meta Analysis ◽  
Exercise Program ◽  
Number Needed To Treat ◽  
Obese Children ◽  
Random Effects Models ◽  
Type 1 Error ◽  
Intervention Trials

Objective. Determine the effects of exercise on body mass index (BMI in kg·m−2) among overweight and obese children and adolescents.Methods. Trial sequential meta-analysis of randomized controlled exercise intervention trials ≥ 4 weeks and published up to November 11, 2014.Results. Of the 5,436 citations screened, 20 studies representing 971 boys and girls were included. Average length, frequency, and duration of training were 13 weeks, 3 times per week, for 46 minutes per session. Overall, random-effects models showed that exercise decreased BMI by 3.6% (mean: −1.08; 95% CI: −0.52 to −1.64;Q=231.4;p<0.001;I2=90.9%; 95% CI: 87.6% to 93.4%;D2=91.5%). Trial sequential meta-analysis showed that changes in BMI crossed the monitoring boundary for a type 1 error in 2010, remaining stable thereafter. The number needed to treat was 5 while the percentile improvement was 26.9. It was estimated that approximately 2.5 million overweight and obese children in the US and 22.0 million overweight and obese children worldwide could reduce their BMI by participating in a regular exercise program. Overall quality of evidence was rated as moderate.Conclusions. Exercise is associated with improvements in BMI among overweight and obese children and adolescents. This trial is registered with PROSPERO Trial Registration #CRD42015017586.

scholarly journals Exercise and adiposity in overweight and obese children and adolescents: a systematic review with network meta-analysis of randomised trials

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031220 ◽  
Author(s):  
George A Kelley ◽  
Kristi S Kelley ◽  
Russell R Pate
Keyword(s):  
Strength Training ◽  
Children And Adolescents ◽  
Body Fat ◽  
Fat Mass ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Randomised Trial ◽  
Obese Children ◽  
Exercise Interventions ◽  
Intervention Trials

ObjectivesDetermine both the effects and hierarchy of effectiveness for exercise interventions (aerobic, strength training or both) on selected measures of adiposity (body mass index (BMI) in kg/m2, fat mass and per cent body fat) in overweight and obese children and adolescents.DesignNetwork meta-analysis of randomised exercise intervention trials.SettingAny setting where a randomised trial could be conducted.ParticipantsOverweight and obese male and/or female children and adolescents 2–18 years of age.InterventionsRandomised exercise intervention trials>4 weeks, published between 1 January 1973 and 22 August 2018, and which included direct and/or indirect evidence for aerobic, strength training or combined aerobic and strength training.Primary outcomesChanges in BMI in kg/m2, fat mass and per cent body fat.ResultsFifty-seven studies representing 127 groups (73 exercise, 54 control) and 2792 participants (1667 exercise, 1125 control) met the criteria for inclusion. Length of training (X- ± SD) averaged 14.1±6.2 weeks, frequency, 3.3±1.1 days per week and duration 42.0±21.0 min per session. Significant and clinically important reductions in BMI, fat mass and per cent body fat were observed in aerobic versus control comparisons (BMI, mean, 95% CI -1.0, 1.4 to −0.6; fat mass -2.1, –3.3 to −1.0 kg; per cent fat -1.5, –2.2 to −0.9%) and combined aerobic and strength versus control comparisons (BMI -0.7, –1.4 to −0.1; fat mass -2.5, –4.1 to −1.0 kg; per cent fat, -2.2, –3.2 to −1.2%). A significant reduction in per cent fat was also found for strength vs control comparisons (-1.3,–2.5 to −0.1%). Combined aerobic and strength training was ranked first for improving both fat mass (kg) and per cent body fat while aerobic exercise was ranked first for improving BMI.ConclusionsAerobic and combined aerobic and strength training are associated with improvements in adiposity outcomes in overweight and obese children and adolescents.PROSPERO registration numberCRD42017073103.

scholarly journals Efficacy and Effectiveness of Exercise on Tender Points in Adults with Fibromyalgia: A Meta-Analysis of Randomized Controlled Trials

Arthritis ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
George A. Kelley ◽  
Kristi S. Kelley ◽  
Dina L. Jones
Keyword(s):  
Exercise Intervention ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Controlled Trials ◽  
Major Public Health Problem ◽  
Tender Points ◽  
Random Effects Models ◽  
Intention To Treat ◽  
Randomized Controlled ◽  
Intervention Trials

Fibromyalgia is a major public health problem affecting an estimated 200 to 400 million people worldwide. The purpose of this study was to use the meta-analytic approach to determine the efficacy and effectiveness of randomized controlled exercise intervention trials (aerobic, strength training, or both) on tender points (TPs) in adults with fibromyalgia. Using random effects models and 95% confidence intervals (CI), a statistically significant reduction in TPs was observed based on per-protocol analyses (8 studies representing 322 participants) but not intention-to-treat analyses (5 studies representing 338 participants) (per-protocol, , −0.68, 95% CI, −1.16, −0.20; intention-to-treat, , −0.24, 95% CI, −0.62, 0.15). Changes were equivalent to relative reductions of 10.9% and 6.9%, respectively, for per-protocol and intention-to-treat analyses. It was concluded that exercise is efficacious for reducing TPs in women with FM. However, a need exists for additional well-designed and reported studies on this topic.

scholarly journals Community-deliverable exercise and anxiety in adults with arthritis and other rheumatic diseases: a systematic review with meta-analysis of randomised controlled trials

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019138 ◽  
Author(s):  
George A Kelley ◽  
Kristi S Kelley ◽  
Leigh F Callahan
Keyword(s):  
Rheumatic Diseases ◽  
Randomised Controlled Trials ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Small Study ◽  
Controlled Trials ◽  
Number Needed To Treat ◽  
Significant Heterogeneity ◽  
Inclusion Length ◽  
Randomised Controlled

Background/purposeGiven conflicting findings, the purpose of this study was to use the meta-analytic approach to examine the effects of exercise (aerobic, strength training or both) on anxiety in adults with arthritis and other rheumatic diseases (AORD).MethodsRandomised controlled exercise intervention trials ≥4weeks in adults ≥18 years of age with osteoarthritis, rheumatoid arthritis or fibromyalgia were included. Studies were located by searching eight electronic databases, cross-referencing and expert review. Dual selection and data abstraction of studies were performed. Hedge’s standardised effect size (ES) was calculated for each result and pooled using the recently developed inverse heterogeneity model. Two-tailedz-alpha values ≤0.05 and non-overlapping 95% CI were considered statistically significant. Heterogeneity was estimated using Q andI2with alpha values ≤0.10 for Q considered statistically significant. Small-study effects were examined using funnel plots and Egger’s regression test. In addition, the number needed to treat (NNT), percentile improvement and meta-regression were conducted.ResultsOf the 639 citations screened, 14 studies representing 926 initially enrolled participants (539 exercise, 387 control) met the criteria for inclusion. Length of training (mean±SD) averaged 15.8±6.7 weeks, frequency 3.3±1.3 times per week and duration 28.8±14.3 min per session. Overall, statistically significant reductions in anxiety were found (exercise minus control changes ES=−0.40, 95% CI −0.65 to −0.15, tau2=0.14; Q=40.3, P=0.0004;I2=62.8%). The NNT was 6 with a percentile improvement of 15.5% and an estimated 5.3 million inactive US adults with AORD improving their anxiety if they started exercising regularly. Statistically significant small-study effects were observed (P<0.0001).ConclusionsExercise is associated with reductions in anxiety among adults with selected types of AORD. However, a need exists for additional, well-designed, randomised controlled trials on this topic.PROSPERO registration numberCRD42016048728.

scholarly journals Is there a benefit of vitamin D supplementation in deficient children and adolescents suffering from obesity? A meta-analysis

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M F Nassar ◽  
E K Emam ◽  
M F Allam
Keyword(s):  
Vitamin D ◽  
Children And Adolescents ◽  
Vitamin D Deficiency ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Obese Children ◽  
Intramuscular Dose ◽  
Vitamin D Levels ◽  
Pubmed Search ◽  
Lower Vitamin

Abstract Background and objectives Both childhood obesity and vitamin D deficiency are common in the Middle East. This systematic review/meta-analysis aims to highlight the effect of vitamin D supplementation in deficient children suffering from obesity. Methods Published clinical studies on vitamin D supplementation in obese children and adolescents with vitamin D deficiency were identified through a comprehensive MEDLINE/PubMed search (from July 1966 to November 2017). Outcomes intended after vitamin D supplementation were improvements in vitamin D status, BMI alterations and appetite changes. The inclusion criteria were children aged 2 to 18 years of both sexes in clinical trials that specified the oral and/or intramuscular dose of vitamin D supplementation. Results Ten studies were retrieved, but only six were relevant. First, supplemented obese children and adolescents were compared to non-obese controls; thereafter, supplemented obese children and adolescents were compared to matching obese peers given placebo. Pooled risks from the two studies that evaluated the number of obese and non-obese children and adolescents who improved upon vitamin D supplementation revealed that obesity poses a risk for not benefiting from the vitamin D supplementation regardless of the dose and the duration of supplementation. Pooled results from the six retrieved studies that compared supplemented obese children and adolescents to matching non-obese or obese peers given placebo revealed significantly lower vitamin D levels in obese participants than in non-obese peers. Conclusion Vitamin D levels are significantly lower in obese children and adolescents with obesity, posing a risk for not benefiting from vitamin D supplementation regardless of the dose and duration of supplementation. Our results suggest that only with simultaneous weight adjustment strategies, vitamin D sufficiency would be achieved more effectively. Vitamin D supplementation in deficient children suffering from obesity.

Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis

2013 ◽  
Vol 14 (8) ◽  
pp. 634-644 ◽  
Author(s):  
J. A. Black ◽  
B. White ◽  
R. M. Viner ◽  
R. K. Simmons
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Obese Children
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