Resumen de The effect of diet or exercise on visceral adipose tissue in overweight youth

Dirk Vissers, Wendy Hens, Dominique Hansen

• Objective: Excess visceral adipose tissue (VAT) in children with obesity is associated with the development of cardiovascular and metabolic disease. This meta-analysis investigated if lifestyle interventions can reduce VAT in overweight and obese youth.

  Methods: Pubmed, Cochrane, and PEDro were searched for clinical trials that objectively assessed VAT and included study arms with supervised diet, exercise, or a combination of both. If there was a no-therapy control group, the data of the control group and the intervention groups were used to meta-analyze the data. In all other cases, the preintervention and the postintervention data were used to meta-analyze. Effect sizes were calculated as standardized mean differences or changes of VAT and expressed as Hedges’ g.

  Results: The overall weighted mean effect size on VAT of all included interventions was −0.69 (95% confidence interval [CI] = −0.90 to −0.48) (P < 0.001). Subgroup analysis showed that the overall weighted mean effect size of diet-only interventions on VAT was 0.23 (95% CI = −0.22 to 0.68) (P = 0.311). Interventions that combined diet and exercise showed a pooled effect size on VAT of −0.55 (95% CI = −0.75 to −0.39) (P < 0.001). The pooled effect size of exercise-only interventions on VAT was −0.85 (95% CI = −1.20 to −0.57) (P < 0.001).

  Conclusions: Supervised exercise-only or combined diet and exercise interventions can reduce VAT in overweight and obese children and adolescents. The strongest effect was found in exercise-only groups. However, high-quality randomized controlled trials describing the effect of supervised dietary interventions on VAT in children are lacking.