Health outcomes in children and adolescents with overweight or obesity exposed to physical activity interventions: an umbrella review covering over 1,200 trials

Importance

Childhood and adolescent obesity are linked to health risks. Standardizing outcome measurements in physical activity interventions for this group can increase evidence comparability and foster knowledge translation.

Objective

The objective of our study is to summarize individual health outcomes reported in systematic reviews and classify individual outcomes under an existing taxonomy of health domains for the development of a Core Outcome Set.

Data Sources

A comprehensive search was conducted across seven databases (PubMed, EMBASE, ERIC, SportDiscus, Cochrane Database, PROSPERO and Google) from inception to January 2023.

Study Selection

Eligible studies were systematic reviews with or without meta-analyses involving children and adolescents aged 4 to 19 years, with overweight or obesity, reporting on health outcomes from interventions including physical activity.

Data extraction and synthesis

Data extraction was carried out by independent reviewers in pairs. It included publication year, country, study characteristics, intervention details, participants demographics and health outcomes. Outcomes were classified into taxonomy-based domains.

Main outcomes and measures

This review identified key outcomes related to body composition, lipid profile, blood pressure, and physical functioning. In body composition, the most frequent outcomes were BMI, body weight, and body fat. For lipid profile, the common outcomes included HDL, total cholesterol, and LDL. Blood pressure outcomes encompassed systolic and diastolic blood pressure. Physical functioning was primarily assessed by time spent in physical activity.

Results

From the 138 included reviews, we cumulatively extracted 845 outcomes, with the identification of 169 unique outcomes distributed along 16 domains. The highest cumulative frequencies was in General (with 255 outcomes), Physical Functioning (128) and Blood and Lymphatic System (118) domains. The most frequently reported unique outcomes were body mass index (BMI) (52.2% of the reviews), followed by body weight, body fat, high-density lipoprotein (HDL), and systolic blood pressure.

Conclusions and relevance

This study highlights the focus on body composition in reviews of physical activity interventions for children and adolescents with overweight or obesity, while other outcomes showed inconsistencies. Establishing a Core Outcome Set (COS) is key to standardizing outcomes and improving the effectiveness of interventions for better pediatric health.

Key Points