Aim: The aim of present meta-analysis was to determine the effects of exercise training (Exe) on insulin resistance (IR) and body weight in children and adolescents with overweight or obesity.Methods: PubMed, Web of Science, and Scopus were searched for original articles, published through October 2022 that included exercise versus control interventions on fasting glucose, insulin, HOMA-IR, and body weight outcomes in children and adolescents with overweight or obesity. Standardized mean differences (SMD) for fasting insulin, and weighted mean differences (WMD) for fasting glucose, HOMA-IR, body weight (BW), and 95% confidence intervals were determined using random effects models.Results: Thirty-five studies comprising 1,550 children and adolescents with overweight and obesity were included in the present meta-analysis. Exercise training reduced fasting glucose (WMD=-2.52 mg/dL, p=0.001), fasting insulin (SMD=-0.77, p=0.001), HOMA-IR (WMD=-0.82, p=0.001), and BW (WMD=-1.51 kg, p=0.001), as compared to a control. Subgroup analyses showed that biological sex, intervention duration, type of exercise training, BMI percentile, and health status (with or without diagnosed condition), were sources of heterogeneity.Conclusion: Exercise training is effective for lowering fasting glucose, fasting insulin, HOMA-IR, and BW in children and adolescents with overweight or obesity and could provide an important strategy for controlling IR and related factors. With clear evidence for the effectiveness of exercise interventions in this vulnerable population, it is important to determine effective approaches for increasing exercise training in children and adolescents with overweight or obesity.

Irisin is a myokine that is secreted from skeletal muscle during exercise and increases lipid metabolism, converting white adipose tissue to brown adipose tissue. Recent studies have shown conflicting results in relation to chronic and acute exercise and irisin. The aim of this study was to evaluate the effects of chronic and acute exercise training on circulating (plasma/serum) irisin level in healthy subjects. We conducted a search of Cochrane Library, PubMed, ISI, Scopus, Embase, and Pedro up to September 2021. A random effects network meta‐analysis was performed to calculate the pooled estimate of standardized mean difference (SMD) for acute and chronic exercise effects on irisin level, using Hedge’s g statistic. Of the 16 studies included, six were acute exercise studies (175 participants). The aerobic (Hedge’s g = 0.23; 95% CI: ‐0.58, 1.03) and the anaerobic exercises (Hedge’s g = 0.12; 95% CI: ‐0.45, 0.70) were associated with the increased level of irisin, compared to the control. In the ten chronic exercise studies (433 participants), the resistance training was superior to anaerobic and aerobic training (P score = 0.632). However, comparing acute and chronic exercise studies, acute training showed the most excellent potential as the best treatment to improve the irisin level (P score = 0.721). This network meta‐analysis showed that acute aerobic exercise has a more effect on irisin levels than acute anaerobic exercise. Also, chronic resistance training has the greatest additive effect on irisin levels compared to chronic aerobic and anaerobic training.

Context: Different intermittent fasting (IF) protocols have been proven to be efficient in improving cardiometabolic markers, but further research is needed to examine whether or not combining IF regimens plus physical exercise is superior to control diets (ie, nonfasting eating) plus physical exercise in this setting. Objective: The aim of this study was to determine whether or not combining IF plus exercise interventions is more favorable than a control diet plus exercise for improving cardiometabolic health outcomes. Data Source: PubMed, Scopus, and Web of Science were comprehensively searched until April 2023. Data Extraction: Electronic databases were searched for clinical trials that determined the effect of IF plus exercise vs a control diet plus exercise on body weight, lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol), and systolic and diastolic blood pressure (SBP and DBP, respectively). Analyses were conducted for IF plus exercise vs a nonfasting diet plus exercise to calculate weighted mean differences (WMDs). Data Analysis: The meta-analysis included a total of 14 studies, with a total sample of 360 adults with or without obesity. The duration ranged from 4 to 52 weeks. IF plus exercise decreased body weight (WMD = –1.83 kg; P = 0.001), LDL (WMD = –5.35 mg/dL; P = 0.03), and SBP (WMD = –2.99 mm Hg; P = 0.003) significantly more than a control diet plus exercise. HDL (WMD = 1.57 mg/dL; P = 0.4) and total cholesterol (WMD = –2.24 mg/dL; P = 0.3) did not change significantly for IF plus exercise vs a control diet plus exercise, but there was a trend for reducing triglycerides (WMD = –13.13 mg/dL; P = 0.07) and DBP (WMD = 2.13 mm Hg; P = 0.05), which shows clinical magnitude. Conclusion: IF plus exercise improved some cardiometabolic outcomes (body weight, blood pressure, and lipid profile) compared with a control diet plus exercise. Systematic Review Registration: PROSPERO registration no. CRD42023423878.