Arterial Stiffness is Reduced Regardless of Ecercise Training in Obese Paediatric Populations: A Meta-analysis of Randomised Controlled Trials
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PURPOSE: In paediatric populations, the use of carotid intima-media thickness (IMT) as a marker of cardiovascular risk has increased. However, previous studies examining the effects of exercise training on arterial structure and function in obese children and adolescents have shown inconsistent findings. The primary aim of this systematic review and meta-analysis is to expand on the current body of literature by providing a quantitative estimate of the change in carotid IMT following exercise training, as well as to provide an exploratory analysis of potential moderators associated with the variation in response to an exercise training intervention in overweight and obese youth.METHODS: A search of the literature was performed using the electronic databases CENTRAL, EMBASE, and MEDLINE. The terms used were: [‘Obesity’ and ‘Overweight’ OR], [‘Exercise’ and ‘Training’ and ‘physical activity’ and ‘sport’ OR]. All medical subject heading terms were combined with intima-media thickness* and children and adolescent as limiters. Studies reported in languages other than English were not explored. The analysis was restricted to studies that examined the effect of exercise interventions on carotid IMT in paediatric obesity (6-18-year-olds). Six randomised controlled trials (RCTs) (303 youths) were included. Hedges´g and 95% confidence intervals were calculated.RESULTS: Exercise was associated with a small-to-moderate but significant reduction in carotid IMT (g=−0.306; 95% CI, −0.540 to −0.072; p=0.011). Likewise, exercise programme duration per week significantly influenced the effect of exercise on carotid IMT (β=-0.060; p=0.015). The meta-regression analysis shows that there was a greater decrease in carotid IMT in studies with a duration of more than a week. The slope regression coefficient was -0.060 [95% CI = -0.136 to -0.015] and was significant (p=0.015). These data indicate that greater decrease in carotid IMT was observed in individuals that achieved larger interventions in terms of minutes per week.CONCLUSIONS: Exercise seems to reduce carotid IMT in childhood obesity. Therefore, encouraging obese paediatric individuals to become physically active can lead to favourable changes in the arterial wall.