Work

Comparative effects of exercise modalities on visceral adipose tissue in children and adolescents with overweight or obesity: a systematic review and three-level meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Objective Previous syntheses included broader age ranges and heterogeneous exercise classifications, leaving uncertainty about comparative effects across exercise modalities in pediatric populations. This review examined whether exercise modalities differ in their effects on visceral adipose tissue (VAT) and waist circumference (WC) in children and adolescents with overweight or obesity, and whether any modality shows superior effectiveness. Methods Randomized and partially randomized controlled trials were identified from PubMed, Embase, the Cochrane Library, Web of Science, SPORTDiscus, and CNKI. VAT and WC were primary outcomes; SAT, body fat percentage, BMI, body weight, fat mass, and VO₂max were secondary outcomes. Hedges’ g was synthesized using three-level random-effects models to accommodate dependent effect sizes within studies. Risk of bias was assessed with the Cochrane tool. Results Twenty-one trials involving 1,754 participants were included. Exercise interventions were associated with lower VAT (g = −0.725, 95% CI [−1.120, −0.330], p < 0.001) and WC (g = −0.692, 95% CI [−0.984, −0.400], p < 0.001). HIIT showed the largest VAT point estimate (g = −1.332, 95% CI [−1.874, −0.789]), but between-modality differences were not significant for VAT ( p = 0.116) or WC ( p = 0.184). Prediction intervals for both primary outcomes crossed the null, indicating uncertainty across study settings. Secondary outcomes generally favored exercise. Conclusion Exercise-based interventions were associated with reductions in VAT and WC, but current evidence does not establish the superiority of any single modality. Although HIIT showed the largest VAT point estimate, non-significant between-modality tests and prediction intervals crossing the null preclude firm conclusions about an optimal exercise modality. Systematic review registration CRD420261431627, https://www.crd.york.ac.uk/PROSPERO/view/CRD420261431627 .

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1922842

Authors: Chuan Chen, Wei Zhang, Kaihua Liu, Xianming Ding, Peng Tong

Institution: Jishou University

Language: English

Topic: Obesity, Physical Activity, Diet

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801