Improvement of the lipid profile with exercise in obese children: A systematic review

Objective. The objective of this systematic review was to assess the effectiveness of different physical exercise interventions on the lipid profile (high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG)) of obese children. Method. A computerized search was made of seven databases using keywords. Effect sizes (ES) and 95% confidence intervals were calculated, and the heterogeneity (I-2) of the studies was estimated using Cochran's Q-statistic applied to the effect size means. The studies were grouped according to the intervention program-aerobic alone or combined (aerobic fitness, strength, and flexibility). Results. Seven studies were selected for review as satisfying the inclusion criteria. Six were randomized controlled trials (n = 318) and one was a controlled clinical trial (groups not randomly assigned) (n = 38). The main cumulative evidence indicates that the programs based on aerobic exercise alone have a moderate (ES = -0.49; I-2 = 87) and a large effect (ES = -0.55; I-2 = 77) on LDL-C and TG concentrations, respectively; and the programs based on combined exercise have a moderate effect (ES= 0.50; I-2 = 0) on HDL-C concentration. Conclusions. The programs based on aerobic exercise (60 min, 3 times/week, <= 75% maximum heart rate) improve the LDL-C and TG concentrations. Moreover, the programs based on combined exercise (>= 60 min, >75% maximum heart rate) also improve the HDL-C concentration. (C) 2012 Elsevier Inc. All rights reserved.