@misc{10481/85218,
year = {2023},
month = {7},
url = {https://hdl.handle.net/10481/85218},
abstract = {IMPORTANCE Childhood obesity is a risk factor associated with type 2 diabetes, cardiovascular
disease, and mental disorders later in life. Investigation of the parallel effects of a defined exercise
program on cardiometabolic and mental health in children with overweight or obesity may provide
new insights on the potential benefits of exercise on overall health.
OBJECTIVE To investigate the effects of a 20-week exercise program on cardiometabolic and
mental health in children with overweight or obesity.
DESIGN, SETTING, AND PARTICIPANTS This secondary analysis of a parallel-group randomized
clinical trial was conducted in Granada, Spain, from November 1, 2014, to June 30, 2016. Data
analyses were performed between February 1, 2020, and July 14, 2022. Children with overweight or
obesity aged 8 to 11 years were eligible, and the study was performed in an out-of-school context.
INTERVENTION The exercise program included 3 to 5 sessions/wk (90 min/session) of aerobic plus
resistance training for 20 weeks. The wait-list control group continued with their usual routines.
MAIN OUTCOMES AND MEASURES Cardiometabolic outcomes as specified in the trial protocol
included body composition (fat mass, fat-free mass, and visceral adipose tissue), physical fitness
(cardiorespiratory, speed-agility, and muscular), and traditional risk factors (waist circumference,
blood lipid levels, glucose levels, insulin levels, and blood pressure). Cardiometabolic risk score (z
score) was calculated based on age and sex reference values for levels of triglycerides, inverted high-
density lipoprotein cholesterol, and glucose, the mean of systolic and diastolic blood pressure, and
waist circumference. An additional cardiometabolic risk score also included cardiorespiratory fitness.
Mental health outcomes included an array of psychological well-being and ill-being indicators.
RESULTS The 92 participants included in the per-protocol analyses (36 girls [39%] and 56 boys
[61%]) had a mean (SD) age of 10.0 (1.1) years. The exercise program reduced the cardiometabolic risk
score by approximately 0.38 (95% CI, −0.74 to −0.02) SDs; decreased low-density lipoprotein
cholesterol level by −7.00 (95% CI, −14.27 to 0.37) mg/dL (to convert to mmol/L, multiply by
0.0259), body mass index (calculated as weight in kilograms divided by height in meters squared) by
−0.59 (95% CI, −1.06 to −0.12), fat mass index by −0.67 (95% CI, −1.01 to −0.33), and visceral adipose
tissue by −31.44 (95% CI, −58.99 to −3.90) g; and improved cardiorespiratory fitness by 2.75 (95%
CI, 0.22-5.28) laps in the exercise group compared with the control group. No effects were observed
on mental health outcomes.
CONCLUSIONS AND RELEVANCE In this secondary analysis of a randomized clinical trial, an aerobic
plus resistance exercise program improved cardiometabolic health in children with overweight or
obesity but had no effect on mental health.},
organization = {Spanish Ministry of Economy and Competitiveness  DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC-2011-09011},
organization = {Fondo Europeo de Desarrollo Regional (FEDER)},
organization = {MCIN/AEI /10.13039/501100011033: PID2020-120249RB-I00},
organization = {Andalusian Operational Programme  B-CTS-355-UGR18},
organization = {European Regional Development Fund (FEDER in Spanish)},
organization = {Spanish Ministry of Science and Innovation FJC2018-037925-I},
organization = {European Union’s Horizon 2020 research and innovation programme Marie Sklodowska Curie 101028929},
organization = {Spanish Ministry of Education, Culture and Sport FPU15/02645},
organization = {Swedish Research Council for Health, Working Life and Welfare  2012–00036},
organization = {Spanish Ministry of Science, Innovation and Universities FPU17/04802},
organization = {Ramón Areces Foundation DEP2017-91544-EXP},
organization = {Alicia Koplowitz Foundation ALICIAK-2018},
organization = {University of Granada},
organization = {Junta de Andalucía},
organization = {EXERNET Research Network on Exercise and Health in Special Populations DEP2005-00046/ACTI},
organization = {Instituto de Salud Carlos III: CB22/03/00058},
organization = {Ministerio de Ciencia e Innovación and Unión Europea–European Regional Development Fund},
publisher = {American Medical Association.},
title = {Effects of an Exercise Program on Cardiometabolic and Mental Health in Children With Overweight or Obesity: A Secondary Analysis of a Randomized Clinical Trial},
doi = {10.1001/jamanetworkopen.2023.24839},
author = {Hidalgo Migueles, Jairo and Cadenas Sánchez, Cristina and Torres López, Lucía Victoria and Rodríguez Ayllon, María and Plaza Florido, Abel Adrián and Gil Cosano, José Juan and Escolano Margarit, María Victoria and Maldonado Lozano, José and Ruiz Ruiz, Jonatan and Labayen, Idoia and Ortega Porcel, Francisco Bartolomé},
}