Childhood obesity is a growing global health concern, associated with increased risks of metabolic disorders and mental health issues. Exercise interventions are widely recognized as effective non-pharmacological strategies for improving body composition in overweight and obese individuals. However, the comparative effectiveness of different exercise modalities remains unclear. This study aims to systematically evaluate the impact of over ten exercise types on key body composition indicators—body mass index (BMI) and body fat percentage (BF%)—through a network meta-analysis, providing robust evidence to inform targeted intervention strategies. Method: A systematic search of Scopus, OVID, Cochrane Library, PubMed, and Web of Science databases was conducted for randomized controlled trials (RCTs) on exercise interventions in overweight and obese individuals, covering studies available up to November 1, 2024. Two independent reviewers screened studies, extracted data, and assessed risk of bias. Pairwise meta-analysis and Bayesian network meta-analysis were performed using R software to compare intervention effects and establish rankings of exercise effectiveness. A total of 61 RCTs involving 2,590 participants were included. Pairwise meta-analysis showed that 50% of exercise types had no significant impact on BMI, and 38% showed no significant impact on BF%. Network meta-analysis identified Jump Rope, Multi-component Exercise, High-Intensity Interval Training (HIIT), Moderate-Intensity Continuous Training (MICT), and Aerobic Exercise as the most effective interventions for reducing BMI. For BF%, the most effective were HIIT, MICT, Multi-component, Aerobic Exercise, and Jump Rope. Jump rope exercises emerged as the most effective for BMI reduction, while HIIT demonstrated the greatest impact on reducing BF%. Multi-component exercise exhibited a well-balanced effect across multiple body composition indicators, suggesting its suitability for holistic obesity interventions. These findings emphasize the necessity of individualized exercise prescriptions tailored to specific body composition goals. Moreover, given the challenges associated with exercise adherence and long-term effectiveness, future research should explore strategies to enhance engagement, optimize training intensity and duration, and integrate exercise with other lifestyle interventions such as dietary modifications and behavioral therapy. Large-scale, long-term randomized controlled trials are warranted to validate these findings and further refine exercise-based obesity management strategies for children and adolescents.
Wu et al. (Thu,) studied this question.