29 September 2023 : Review article
Promoting Health in Pediatric Obesity: A Decade's Research of Physical Activity's Influence on Cardiometabolic Parameters
Monika Gesek
12ABCDEFG, Aleksandra D. Fornal 12ABCDEF*, Danuta Zarzycka 12ABCDEFG
DOI: 10.12659/MSM.940742
Med Sci Monit 2023; 29:e940742
Table 3 Qualitative analysis of the articles included in the review.
| Author | Title of the article | Research method research tool sample | Analysis of the results | Literature number/ range | Methodological quality | |
|---|---|---|---|---|---|---|
| 1 | Neil-Sztramko SE, et al. (2021) | School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18 | Method: systematic reviewTools: CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, Sociological AbstractsSample: 89 articles | School-based physical activity interventions may improve physical fitness reported as VO max; they may result in a minor decrease in BMI z-scores, and may not affect BMI expressed in kg/m | 3071985–2020 | 90% |
| 2 | Dietz P, et al. (2012) | Influence of exclusive resistance training on body composition and cardiovascular risk factors in overweight or obese children: A systematic review | Method: systematic reviewTools: MEDLINE, SPORTDiscusSample: 6 articles | Individually planned and supervised whole body resistance training of moderate or submaximal intensity in children appears to be safe and tends to have a positive effect on body composition | 491978–2011 | 60% |
| 3 | Vasconcellos F, et al. (2014) | Physical activity in overweight and obese adolescents: A systematic review of the effects on physical fitness components and cardiovascular risk factors | Method: systematic reviewTools: PubMed, LILACS, Web of Science, Scopus (including Embase), SPORTDiscusSample: 24 articles | The results indicate a positive effect of physical activity on changes in fat, waist circumference, SBP, insulin, LDL-C and total cholesterol, as well as minor changes in DBP and glucose | 891985–2013 | 80% |
| 4 | Busnatu SS, et al (2022) | Effects of exercise in improving cardiometabolic risk factors in overweight children: A systematic review and meta-analysis | Method: meta-analysis, systematic reviewTools: PubMed/Medline, Cochrane Library, and Google ScholarSample: 12 articles | Physical interventions significantly improved several cardiometabolic risk factors, such as BMI, LDL, blood pressure and blood sugar | 831982–2021 | 90% |
| 5 | Cesa CC, et al. (2022) | Physical activity and cardiovascular risk factors in children: Meta-analysis of randomized clinical trials | Method: meta-analysis of randomized clinical trialsTools: PubMed, EMBASE I Cochrane CENTRALSample: 17 studies | Since sports intervention programmes lasting more than 6 months are associated with lower blood pressure and triglyceride levels, they should be included in the programmes for the prevention of cardiovascular diseases in school-age children | 481995–2020 | 80% |
| 6 | Ostman C, et al. (2017) | Clinical outcomes of exercise training in type 1 diabetes: A systematic review and meta-analysis | Method: meta-analysis, systematic reviewTools: MEDLINE search strategy, Cochrane Controlled Trials Registry, CINAHL, SPORTDiscus and Science Citation IndexSample: 15 studies | Exercise training improves insulin doses, waist circumference, LDL and triglycerides in children | 361980–2016 | 90% |
| 7 | Pinheiro G, et al. (2021) | Blood pressure in children: Association with anthropometric indicators, body composition, cardiorespiratory fitness and physical activity | Method: cross-sectional studyTools: Guidelines for Measurement and Tests of PROESP-BrSample: 215 children aged 6–12 years | Moderate or intense physical activity, cardiovascular and respiratory performance, anthropometric variables, age, gender and maturity are important predictors of blood pressure variability in children | 282002–2021 | 75% |
| 8 | Tarp J, et al. (2018) | Physical activity intensity, bout duration, and cardiometabolic risk markers in children and adolescents | Method: cross-sectional studyTools: secondary data from the International Physical Activity Database for Children (ICAD)Sample: 38 306 observations in 29 734 persons aged 4–18 years) | Time spent on increasing physical activity is favourably associated with markers of cardiometabolic risk in adolescents | 601985–2018 | 67% |
| 9 | Grace J, et al. (2021) | Effect of physical activity and nutrition education on body mass index, blood pressure and biochemical variables in overweight and obese adolescents | Method: quasi-experimentTools: Borg RPE scale, Calculator of American Academy of PaediatricsSample: 129 children aged 13–16 years | 10 weeks of physical activity and nutritional education in adolescents with overweight and obesity significantly lowered BMI and showed tendencies to lower blood pressure and LDL-C | 401985–2020 | 100% |
| 10 | Macdonald-Wallis C, et al. (2017) | A longitudinal study of the associations of children’s body mass index and physical activity with blood pressure | Method: longitudinal studyTools: −Sample: 2047 children aged 6 and 9 years and one or both parents | BMI in children may be a risk factor for the development of hypertension | 471990–2016 | 75% |
| 11 | Sadoh WE, et al. (2016) | Physical activity, body mass index and blood pressure in primary school pupils attending private schools | Method: cross-sectional studyTools: questionnaire assessing physical activity among childrenSample: 353 primary school students | Physical activity may lead to lower average blood pressure in physically active students compared to students who are not independent of body mass index.Obesity and overweight students were more likely to have hypertension than healthy students | 211985–2016 | 58% |
| 12 | Wiersma R, et al. (2020) | Adiposity and high blood pressure during childhood: A prospective analysis of the role of physical activity intensity and sedentary time in the GECKO Drenthe Cohort | Method: cohort studyTools: ActiGraph GT3XSample: 947 children aged 5–6 years and 10–11 years | Physical activity in childhood has a marginal effect on obesity or blood pressure in the later years of a child’s life | 641981–2020 | 83% |
| 13 | Poeta LS, et al. (2013) | Effects of physical exercises and nutritional guidance on the cardiovascular risk profile of obese children | Method: clinical control studyTools: −Sample: 44 children aged 8–11 years | The physical exercise and nutritional guidance programme, in addition to the regular clinical treatment, was effective in reducing BMI, total cholesterol, LDL-V, diastolic arterial pressure and carotid intima-media thickness | 301962–2010 | 70% |
| 14 | Pepera G, et al. (2022) | Associations between cardiorespiratory fitness, fatness, hemodynamic characteristics, and sedentary behavior in primary school-aged children | Method: clinical studyTools: HELENA questionnaoireSample: 105 children aged 6–12 years | Children with optimal BMI tend to present better CRF results than obese and overweight children. Sedentary lifestyle is associated with lower CRF in school-age children | 451984–2021 | 90% |
| 15 | Martínez-Vizcaíno V, et al. (2014) | Gender differences on the effectiveness of a school-based physical activity intervention for reducing cardiometabolic risk: a cluster randomized trial | Method: randomized control studyTools: MOVI-2 programmeSample: 712 children aged 8–10 years | A safe and effective way to reduce obesity in both sexes and improve the cardiometabolic risk profile in girls is an out-of-school intervention based on uncompetitive physical activity | 482003–2012 | 82% |
| 16 | Nqweniso S, et al. (2021) | Physical activity and risk factors of cardio-metabolic diseases in South African children | Method: cross-sectional studyTools: results of KaziAfya researchSample: 832 children aged 5–8 years and 9–13 years | Low levels of physical activity are associated with increased cardiovascular risk factors. Higher CRF, VPA and MVPA were negatively associated with lower body fat percentage and a lower risk of concentrated cardiovascular disease | 451983–2020 | 75% |
| 17 | Ramezani A, et al. (2017) | Effects of three methods of exercise training on cardiovascular risk factors in obese boys | Method: clinical trialTools: Exercise Training ProtocolSample: 60 children with obesity aged 8–12 years | The results of this study show that three routines of regular exercise over 8 weeks, including resistance training (50–75% 1RM) and endurance training (50–75% of target heart rate) had a desired effect on BMI, serum glucose and lipid profile risk factors | 392000–2016 | 70% |
| 18 | Moschonis G, et al. (2013) | “Leaner and less fit” children have a better cardiometabolic profile than their “heavier and more fit” peers: The Healthy Growth Study | Method: cross-sectional studyTools: standardised questionnaire of free time physical activity, endurance 20-m shuttle run test (ERT)Sample: 1222 boys and 1188 girls aged 9–13 years | Slender and less fit boys and girls had better cardiometabolic risk profiles than their heavier and more athletic peers, which probably suggests a greater importance of a slim figure over fitness in children in terms of cardiometabolic health benefits | 401955–2012 | 67% |
| 19 | Pablos A, et al. (2017) | Effectiveness of a school-based program focusing on diet and health habits taught through physical exercise | Method: clinical studyTools: Inventory of Healthy Habits (IHH) questionnaireSample: 158 primary school students | The School Physical Activity Program (HHP) has initiated a significant improvement in the incidence of normal total cholesterol levels, blood pressure and BMI | 521989–2017 | 60% |
| 20 | Fridolfsson J, et al. (2021) | High-intensity activity is more strongly associated with metabolic health in children compared to sedentary time: a cross-sectional study of the I.Family cohort | Method: cross-sectional studyTools: IDEFICS Metabolic Syndrome Score ToolSample: 2592 children aged 8–11 years | The results suggest a higher physical actibity corresponding to the intensity of at least brisk walking with the inclusion of intense exercise, rather than limited sitting time, which is of greater importance for metabolic health in children | 481984–2021 | 67% |
| 21 | Delgado-Floody P, et al. (2019) | Influence of Mediterranean diet adherence, physical activity patterns, and weight status on cardiovascular response to cardiorespiratory fitness test in Chilean school children | Method: cross-sectional studyTools: Multistage Fitness (Beep) test, standing long jump testSample: 605 children aged 12.00±1.23 years | Overweight children had lower physical fitness, and a higher percentage of them had high blood pressure. Decreased SBP was associated with cardiovascular strength and performance | 411988–2017 | 75% |
| 22 | Carson V, et al. (2019) | Compositional analyses of the associations between sedentary time, different intensities of physical activity, and cardiometabolic biomarkers among children and youth from the United States | Method: cross-sectional studyTools: National Health and Nutrition Examination SurveySample: 2544 children and adolescents aged 6–17 years | The composition of ST, LPA, MPA and VPA in this large representative sample of children and adolescents was significantly related to many aspects of cardiometabolic health, also suggesting that compositions with more time for more intense activities may be superior in some aspects of cardiometabolic health | 312002–2019 | 67% |
| 23 | Kamal NN, Ragy MM (2012) | The effects of exercise on CRP, insulin, leptin and some cardiometabolic risk factors in Egyptian children with or without metabolic syndrome | Method: clinical trialTools: absentSample: 93 children aged od 8 do 12 years | After 12 weeks of exercise, both groups of children with obesity, with and without metabolic syndrome, showed reduced body weight, BMI and CRP levels, and increased HDL-C levels | 411972–2009 | 60% |
| 24 | Brzeziński M, et al. (2020) | “PoZdro!” as an example of a successful multicenter programme for obesity management and healthy lifestyle promotion in children and adolescents – programme protocol and preliminary results from the first intervention site | Method: multicentre clinical trialTools: diet diaries, approved structured interviewSample: 603 children aged 13 years | Preliminary results show that the participants observed a noticeable change in the body weight index and body fat content during the two-year intervention process | 101992–2018 | 75% |
| 25 | D’Agostino EM, et al. (2018) | Effect of participation in a park-based afterschool programme on cardiovascular disease risk among severely obese youth | Method: cohort studyTools: fitness tests and a test of knowledge about health and well-beingSample: children aged 6–14 years | The findings provide evidence of a significant improvement in the risk of cardiovascular disease in adolescents with obesity after attending an after-school programme at the park for at least a year | 321986–2018 | 83% |
| 26 | Fam B, et al. (2013) | Association between Physical activity and metabolic risk factors in adolescents: Tehran lipid and glucose study | Method: cross-sectional studyTools: interview questionnaireSample: 777 adolescents aged 12–18 years | The results of this study confirm the association between physical activity and some individual MetS components, such as waist circumstance and HDL-C | 271996–2012 | 67% |
| 27 | Plavsic L, et al. (2020) | Effects of high-intensity interval training and nutrition advice on cardiometabolic markers and aerobic fitness in adolescent girls with obesity | Method: randomized control clinical trialTools: medical recordsSample: 44 adolescents with obesity aged 13–19 years | The 12-week HIIT intervention combined with nutritional counseling led to improvements in some anthropometric and biochemical parameters such as BMI, BMI-SDS, WC, WtHR, glucose and insulin during OGTT and insulin sensitivity compared to the non-training group | 431984–2019 | 73% |
| 28 | Howie EK, et al. (2020) | Physical activity trajectories from childhood to late adolescence and their implications for health in young adulthood | Method: cohort studyTools: International Physical Activity Questionnaire (IPAQ), the Short-Form 12 Health Survey (SF-20)Sample: 2868 participants aged respectively 8, 10, 14, 17, 20 and 22 | Selected directions of physical activity show clear associations with a variety of physical and mental health interventions in early adulthood, including obesity, cardiometabolic health, depression and cognitive performance | 351998–2019 | 75% |
| 29 | Gallardo-Escribano C, et al. (2021) | Lifestyle modification improves insulin resistance and carotid intima-media thickness in a metabolically healthy obese prepubescent population | Method: cross-sectional studyTools: food questionnaires relating to food frequency, questionnaires of compliance MedDietSample: 131 children aged 4–9 years | Results show a decrease in both body weight and BMI in the whole population after 12 months of intervention. The most effective interventions to reduce weight in the pediatric population are those that involve dietary modification and regular physical activity | 332003–2020 | 83% |
| 30 | Cuenca-García M, et al. (2012) | Combined influence of healthy diet and active lifestyle on cardiovascular disease risk factors in adolescents | Method: cross-sectional studyTools: HELENA-DIAT (Dietary Assessment Tool), Young Adolescents’ Nutrition Assessment on Computer (YANA-C), Diet Quality Index for Adolescents (DQI-A)Sample: 1513 children aged 12.5–17.5 | The combination of a healthy diet and an active lifestyle is associated with a healthier level of key cardovascular disease risk factors, such as cardiovascular and respiratory performance, obesity and blood lipid profile. Physical activity can reduce the harmful effects of an unhealthy diet | 441976–2013 | 67% |
| 31 | Larouche R, et al. (2014) | Active transportation and adolescents’ health: The Canadian Health Measures Survey | Method: cross-sectional studyTools: modified Canadian Aerobic Fitness Test (mCAFT)Sample: 1016 adolescents aged 12–19 | Compared to adolescents who did not cycle, those who cycled ≥1 hour a week accumulated more light physical activity, had greater aerobic fitness and lower BMI, WC and ratio of total cholesterol to LDL-C; those who reported cycling <1 hour a week had lower total cholesterol | 711979–2014 | 83% |
| 32 | Barker AR, et al. (2018) | Physical activity, sedentary time, TV viewing, physical fitness and cardiovascular disease risk in adolescents: The HELENA study | Method: cross-sectional studyTools: Family Affluence Scale (FAS), validated self-report sedentary behavior questionnaire, 20 m shuttle run testSample: 534 adolescents aged 12.5–17.5 years | Physical activity affects body composition and cardiometabolic risk | 421976–2016 | 67% |
| 33 | Momoniyi MM, et al. (2020) | “AMPE” exercise programme has positive effects on anthropometric and physiological parameters of school children: A pilot study | Method: pilot studyTools:Sample: 78 children aged 9–12 years | The AMPE exercise program is effective because it reduces body weight and body mass index and improves the following parameters: SBP, DPB and heart rate | 202001–2019 | 78% |
| 34 | Chansavang Y, et al. (2015) | Feasibility of an after-school group-based exercise and lifestyle programme to improve cardiorespiratory fitness and health in less-active Pacific and Maori adolescents | Method: feasibility studyTools: International Physical Activity Questionnaire (IPAQ)Sample: 18 secondary school students | The programme improved the results of VO max, SBP, HbA1c and intense and moderate physical activity | 261985–2014 | 60% |
| 35 | Gonçalves R, et al. (2014) | Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children | Method: cross-sectional studyTools: 20 m shuttle run testSample: 290 children aged 6–10 years | Significant associations and an increased likelihood of cardiovascular risk factors have been shown in children with poorer oxygen performance and higher BMI | 291984–2010 | 58% |
| 36 | Bustos-Barahona R, et al. (2020) | Lifestyle associated with physical fitness related to health and cardiometabolic risk factors in Chilean school children | Method: cross-sectional studyTools: Kreece plus testSample: 582 children aged 10–13 years | Lifestyles of school-aged children are linked to CMR (i.e., abdominal obesity and hypertension) and health-related physical fitness, which requires promoting interventions to promote active lifestyles, including more physical activity weekly and less screen time during the day | 391988–2020 | 67% |
| 37 | Kokkvoll AS, et al. (2019) | No additional long-term effect of group vs individual family intervention in the treatment of childhood obesity – a randomized trial | Method: randomized control clinical trialTools: validated Andersen intermittent running testSample: 97 children aged 6–12 years | Analysis results from the combination of data from both intervention groups showed a decrease in BMI-SDS, improvements in total and LDL-C, CRF, and the incidence of hypertension | 301985–2018 | 82% |
| 38 | Willis EA, et al. (2015) | Length of moderate-to-vigorous physical activity bouts and cardio-metabolic risk factors in elementary school children | Method: latent profile analysisTools: Progressive Aerobic Cardiovascular Endurance Run (PACER), growth charts CDCSample: 396 second- and third-grade students aged 7.6±0.6 years | Longer rather than shorter MVPA seizures are associated with reduced cardiovascular risk factors, especially lower BMI percentiles and WC in children | 401963–2013 | 67% |
| 39 | Heshmat R, et al. (2016) | Joint association of screen time and physical activity with cardiometabolic risk factors in a national sample of Iranian adolescents: The CASPIANIII Study | Method: cross-sectional studyTools: author’s questionnaireSample: 5625 children and adolescents aged 10–18 years | Adolescents with low physical activity/high screen time were shown to have higher BMI scores with, WC, LDL-C, SBP and DBP and lower HDL-C levels compared to other physical activity/screen time combinations. In contrast, patients with high physical activity/low screen time had the highest mean total serum cholesterol | 631987–2014 | 67% |
| 40 | Verduci E, et al. (2015) | Change in metabolic profile after 1-year nutritional-behavioral intervention in obese children | Method: clinical studyTools: standardized interview questionnaire, Feeding Frequency Questionnaire (FFQ)Sample: 90 children with obesity, age ≥6 years | Nutritional-behavioral interventions may improve the blood lipid profile and insulin sensitivity in children with obesity, and may benefit the metabolic syndrome | 491985–2015 | 70% |
| 41 | Delgado-Floody P, et al. (2018) | Psychosocial, physical and anthropometric variables in Chilean school children. A comparative study according to physical activity levels | Method: comparative studyTools: PAQ-C questionnaire for children, TAE-Alumno test, The Body Shape QuestionnaireSample: 605 children aged 11–14 years | The main result of this study was that the results of children with lower physical activity values were noticeable in psychosocial, physical and anthropometric variables compared to those that performed physical activity | 401988–2018 | 60% |
| 42 | D’Agostino EM, et al. (2017) | Longitudinal analysis of cardiovascular disease risk profiles in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA | Method: longitudinal studyTools: Fit2Play study protocol, the Presidential Youth Fitness Programme testing protocol, modified sit and reach test, PACER testSample: 2264 children and adolescents (average age: 9.4 age) | Results show that the youth programme can maintain or improve cardiovascular health in at-risk teens over 5 years of age, including blood pressure, weight status, and physical fitness | 411982–2017 | 75% |
| 43 | Nişancı-Kılınç F, Çağdaş DN (2013) | Diet and physical activity interventions do have effects on body composition and metabolic syndrome parameters in overweight and obese adolescents and their mothers | Method: clinical trialTools: Ozturk’s growth charts, Harpenden Skinfold Caliper, the charts of fat percentage percentilesSample: 19 adolescents with an average age of 12.52±2.85 years and their mothers | Nutritional and motor interventions affect body composition and metabolic syndrome parameters in adolescents with obesity and their mothers with overweight and obesity | 381993–2013 | 60% |
| 44 | Vasconcellos F, et al. (2015) | Health markers in obese adolescents improved by a 12-week recreational soccer program: a randomised controlled trial | Method: randomized control clinical trialTools: recreational soccer programme (RSP)Sample: 30 adolescents aged 12–17 years | Recreational soccer performer 3 times a week during 12 weeks resulted in beneficial changes in body mass and composition, VOpeak, resting blood pressure, autonomic activity, plasma lipid and glukose profile, CRP and endothelial-dependent vasodilation | 441962–2014 | 73% |
| 45 | Messiah SE, et al. (2016) | Impact of a park-based afterschool program replicated over five years on modifiable cardiovascular disease risk factors | Method: cohort studyTools: The Presidential Youth Fitness Programme protocol; the modified sit and reach test, PACER test. EmpowerMe4Life 9-item scale Sample: children aged 6–14 years | People of normal body weight maintained a healthy BMI, overweight/obese people had reduced both BMI z-score and percentiles, all weight groups lowered blood pressure, improved fitness and knowledge about health and wellbeing | 521965–2016 | 75% |
| 46 | Antunesn B de MM, et al. (2015) | Effect of concurrent training on gender-specific biochemical variables and adiposity in obese adolescents | Method: clinical trialTools:Sample: 25 adolescents aged 12–15 years | Significant increase in height and decrease in BMI (=0.002 and =0.017), BMI z-score (=0.033 and =0.004), FM% (=0.002 and =0.002), TFM% (=0.009 and =0.018), total cholesterol (=0.042 and =0.001) and LDL-C (=0.006 and =0.001) was found in the male and female groups, respectively, after 20 weeks of intervention when compared with baseline | 321999–2015 | 60% |
| 47 | Horner K, et al. (2015) | Effect of aerobic vs resistance exercise on pulse wave velocity, intima media thickness and left ventricular mass in obese adolescents | Method: clinical trialTools: graded treadmill testSample: 66 children aged 12–18 years | In adolescents with obesity, CRF was significantly associated with cIMT and LVMI at baseline. Also, total fat and improvements in CRF after 3 months of aerobic and resistance exercise were noticed | 431988–2014 | 70% |
| 48 | Moura BP, et al. (2019) | Effects of isotemporal substitution of sedentary behavior with light-intensity or moderate-to-vigorous physical activity on cardiometabolic markers in male adolescents | Method: cross-sectional studyTools: interview-based questionnaire, ActiGraph GT3X+Sample: 140 adolescents aged 14–18 years | Replacing sedentary behavior with light-intensity physical activity showed positive results on metabolic (HDL-C and HOMA2-S) and physiological (SBP) indicators, while replacing sedentary behavior with MVPA was only associated with one obesity indicator (BF%) | 491972–2019 | 75% |
| 49 | Ogawa M, et al. (2021) | Comparative evaluation of obesity-related parameters in junior sumo wrestlers and children with obesity | Method: clinical studyTools:Sample: 70 children aged 9–17 years | The BMI z-score, obesity rate, WC (<0.05, along with the non-exercising group), and sedentary behavior were significantly higher and the HDL-C level was lower in the sumo group than in the other sports group (<0.05). WtHR was significantly higher in the non-exercising group than in other sports group | 301976–2021 | 70% |
| 50 | Mendoza JA, et al. (2012) | General vs central adiposity and relationship to pediatric metabolic risk | Method: cross-sectional studyTools: National Health and Nutrition Examination Survey (NHANES)Sample: 2155 participants aged 6–19 years | Participants with more minutes of MVPA had lower SBP and higher HDL-C, daily minutes of MVPA were significantly associated with SBP, HDL-C and WC. WC significantly mediated the relationship between minutes of MVPA and CRP and HDL-C, and was independently associated with several metabolic risk factors, such as higher CRP, glycohemoglobin, fasting TG, fasting insulin, and lower HDL-C | 401986–2011 | 83% |
| 51 | Aadland E, et al. (2020) | Accelerometer epoch setting is decisive for associations between physical activity and metabolic health in children | Method: cross-sectional studyTools: Andersen intermittent running test, ActiGraph GT3X+Sample: 841 children | The explained variance in models of metabolic health improved when epoch durations decreased | 381972–2018 | 75% |
| 52 | Gopinath B, et al. (2014) | Activity behaviors in school children and subsequent 5-year change in blood pressure | Method: cohort studyTools: activity questionnairesSample: 821 children aged 6–11 years | Adhering to the recommended guidelines of 60 minutes or more a day of physical activity in the long term was associated with an appreciable reduction in blood pressure 5 years later among school children. In contrast, higher levels of total screen time were prospectively associated with higher levels of blood pressure | 292008–2018 | 73% |
| 53 | Aguilar-Cordero MJ, et al. (2020) | Influence of physical activity on blood pressure in children with overweight/obesity: A randomized clinical trial | Method: randomized control clinical trialTools: clinical historySample: 98 children | An intervention based on physical activity and nutritional recommendations is shown to be effective in reducing hypertension in children with overweight or obesity | 292008–2018 | 73% |
| 54 | Herbst A, et al. (2014) | Impact of regular physical activity on blood glucose control and cardiovascular risk factors in adolescents with type 2 diabetes mellitus – a multicenter study of 578 patients from 225 centres | Method: multicentre clinical trialTools: Pediatric Quality Initiative (DPV)Sample: 578 children aged 10–20 years with type 2 diabetes | An intervention based on physical activity and nutritional recommendations is shown to be effective in reducing hypertension in children with overweight or obesity | 391991–2013 | 90% |
| 55 | Nightingale CM, et al. (2018) | The contribution of physical fitness to individual and ethnic differences in risk markers for type 2 diabetes in children: The Child Heart and Health Study in England (CHASE) | Method: cross-sectional studyTools: 8-minute submaximal step testSample: 1445 children aged 9–10 years | Higher VO max was associated with lower FMI, insulin, HOMA-IR, HbA1c, glucose, urate, CRP, triglycerides, LDL-C, blood pressure and higher HDL-C. Physical activity is associated with risk markers for T2D and cardiovascular diseases, which persist after adjustment for adiposity | 321980–2016 | 75% |
| BMI – body mass index; CRP – C-reactive protein; CRF – cardio-metabolic risk factors; DBP – diastolic blood pressure; HOMA-IR – homeostasis model assessment of insulin resistance; SBP – systolic blood pressure; LDL-C – low-density lipoprotein cholesterol; HDL-C – high-density lipoprotein cholesterol; LIPA – light-intensity physical activity; MVPA – moderate to vigorous physical activity; WC – waist circumference. | ||||||