Diana P Pozuelo-Carrascosa1, Iván Cavero-Redondo2, Ángel Herráiz-Adillo1,3, Ana Díez-Fernández1,4, Mairena Sánchez-López1,5, Vicente Martínez-Vizcaíno1,6. 1. Social and Health Care Research Center and. 2. Social and Health Care Research Center and ivan.cavero@uclm.es. 3. Department of Primary Care, Health Service of Castilla-La Mancha, Tragacete, Cuenca, Spain. 4. Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain. 5. Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain; and. 6. Faculty of Health Science, Universidad Autónoma de Chile, Talca, Chile.
Abstract
CONTEXT: The effects of school-based physical activity (PA) programs on different cardiometabolic risk factors and the most appropriate features of PA programs to achieve maximum effectiveness are unclear. OBJECTIVE: To provide a comprehensive synthesis of the effectiveness of school-based PA interventions on cardiometabolic risk factors in children. DATA SOURCES: We identified studies from database inception to February 22, 2018. STUDY SELECTION: We selected studies that were focused on examining the effect of school-based PA interventions on cardiometabolic risk factors in children. DATA EXTRACTION: Random-effects models were used to calculate the pooled effect size (ES) for the included cardiometabolic risk factors (waist circumference [WC], triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure and diastolic blood pressure (DBP), and fasting insulin and glucose). RESULTS: Nineteen randomized controlled trials (which included 11 988 children aged 3-12 years) were included in the meta-analysis. School-based PA programs were associated with a significant small improvement in WC (ES = -0.14; 95% confidence interval [CI]: -0.22 to -0.07; P < .001), DBP (ES = -0.21; 95% CI: -0.42 to -0.01; P = .040), and fasting insulin (ES = -0.12; 95% CI: -0.20 to -0.04; P = .003). LIMITATIONS: Authors of few studies described the implementation conditions of their interventions in detail, and compliance rates were lacking in most studies. In addition, results by sex were provided in a small number of studies. CONCLUSIONS: School-based PA interventions improve some cardiometabolic risk factors in children, such as WC, DBP, and fasting insulin.
CONTEXT: The effects of school-based physical activity (PA) programs on different cardiometabolic risk factors and the most appropriate features of PA programs to achieve maximum effectiveness are unclear. OBJECTIVE: To provide a comprehensive synthesis of the effectiveness of school-based PA interventions on cardiometabolic risk factors in children. DATA SOURCES: We identified studies from database inception to February 22, 2018. STUDY SELECTION: We selected studies that were focused on examining the effect of school-based PA interventions on cardiometabolic risk factors in children. DATA EXTRACTION: Random-effects models were used to calculate the pooled effect size (ES) for the included cardiometabolic risk factors (waist circumference [WC], triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure and diastolic blood pressure (DBP), and fasting insulin and glucose). RESULTS: Nineteen randomized controlled trials (which included 11 988 children aged 3-12 years) were included in the meta-analysis. School-based PA programs were associated with a significant small improvement in WC (ES = -0.14; 95% confidence interval [CI]: -0.22 to -0.07; P < .001), DBP (ES = -0.21; 95% CI: -0.42 to -0.01; P = .040), and fasting insulin (ES = -0.12; 95% CI: -0.20 to -0.04; P = .003). LIMITATIONS: Authors of few studies described the implementation conditions of their interventions in detail, and compliance rates were lacking in most studies. In addition, results by sex were provided in a small number of studies. CONCLUSIONS: School-based PA interventions improve some cardiometabolic risk factors in children, such as WC, DBP, and fasting insulin.
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