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

ImportanceChildhood 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. ObjectiveThe 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 SourcesA comprehensive search was conducted across seven databases (PubMed, EMBASE, ERIC, SportDiscus, Cochrane Database, PROSPERO and Google) from inception to January 2023. Study SelectionEligible 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 synthesisData 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 measuresThis 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. ResultsFrom 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 relevanceThis 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 PointsO_ST_ABSQuestionC_ST_ABSWhat are the main health outcomes for children and adolescents with overweight and obesity exposed to physical activity interventions? FindingsIn this umbrella review, including 138 studies, the main outcomes mentioned were related to body composition, lipid profile and blood pressure, covering over 370,000 trial participants. MeaningThe outcomes found will serve for the development of a Core Outcome Set (COS), guiding new clinical trials, reducing inconsistencies and heterogeneity among possible future outcomes.