Abstract
BACKGROUND: Weight control in children depends on executive function. Previous studies have shown that exercise interventions can effectively improve children's executive function. However, the effects of these interventions on children with overweight and obesity remain unclear and require further investigation. This systematic review and meta-analysis was conducted to evaluate the effects of exercise interventions on executive function-related indicators in children with overweight and obesity. METHODS: Randomized controlled trials (RCTs) investigating the effects of exercise interventions on executive functions in children with overweight and obesity were included by searching PubMed, Web of Science, EMbase, Cochrane Library, ProQuest, Scopus, CNKI, China Wanfang, and VIP databases. The quality of the included studies was assessed using the Cochrane risk of bias assessment tool. RevMan 5.4 software was used for effect size pooling, forest plot creation, and subgroup analyses. Stata 16.0 software was employed for publication bias testing and sensitivity analysis. The evidence levels of the results were evaluated using the GRADEpro tool. RESULTS: This meta-analysis included a total of 13 studies. The results indicate that exercise interventions may help improve executive functions in children with overweight and obesity. Specifically, inhibitory control (standardized mean (SMD) = -0.59, 95% confidence interval (CI) [-0.89 to -0.29], Z = 3.85, P < 0.001) and cognitive flexibility (SMD = -0.54, 95% CI [-1.06 to -0.01], Z = 2.01, P < 0.05) showed moderate effect sizes. Working memory exhibited a smaller effect size (SMD = 0.40, 95% CI [-0.69 to -0.10], Z = 2.61, P < 0.01), while attention did not show significant improvement (SMD = 0.13, 95% CI [-0.39 to 0.65], Z = 0.50, P > 0.05). CONCLUSION: The results of this meta-analysis indicate that exercise interventions have significant benefits for inhibitory control, working memory, and cognitive flexibility in children with overweight and obesity, but the impact on attention is not significant. Moreover, the effects of inhibitory control interventions are influenced by exercise duration, exercise intensity, exercise type, and age.