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Objective <p>This study aimed to systematically compare, through a network meta-analysis (NMA), the effects of different exercise modalities—including aerobic exercise (AE), resistance training (RT), high-intensity interval training (HIIT), and combined training (COM)—on the lipid profile of overweight/obese children and adolescents.</p> Methods <p>The study followed the PRISMA-NMA guidelines and systematically searched randomized controlled trials (RCTs) published from 1999 to August 31, 2025 in the PubMed, Embase, Cochrane, Web of Science, and EBSCO databases. A total of 35 RCTs (<i>n</i> = 1601 participants) were included. Random-effects models in Stata 16.0 were applied to calculate pooled effect sizes with 95% confidence intervals (CIs). Network meta-analysis was performed to synthesize and analyze the data, and intervention effects were ranked using the Surface Under the Cumulative Ranking (SUCRA) curve.</p> Results <p>The findings revealed differential effects of exercise modalities on lipid regulation. RT ranked highest for reducing total cholesterol (TC). AE was the only intervention that significantly increased high-density lipoprotein cholesterol (HDL-C). HIIT demonstrated the greatest efficacy in lowering low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). COM showed no superior effect for any single outcome among the four indicators. From an integrated perspective, AE intervention was most effective in elevating HDL-C but relatively weak in reducing LDL-C. Conversely, although RT and HIIT were less effective for raising HDL-C, they exhibited the strongest effects in reducing LDL-C. Compared with the no-exercise control group (CON), resistance training (RT) and high-intensity interval training (HIIT) significantly reduced total cholesterol (TC) levels in individuals with overweight or obesity. Aerobic exercise (AE) significantly increased HDL-C levels in this population. HIIT and combined exercise (COM) significantly reduced LDL-C levels, while HIIT, AE, and COM significantly lowered triglyceride (TG) levels.</p> Conclusion <p>The findings suggest that different exercise modalities may exert differential effects on specific lipid parameters. These distinct patterns offer preliminary support for phenotype-targeted exercise prescription, providing an evidence base for refining clinical guidelines and enhancing the precision of cardiovascular health interventions.</p>

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Effects of different exercise modalities on lipid profiles in overweight and obese children and adolescents: a systematic review and network meta-analysis of randomized controlled trials

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月19日

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  • Qinzheng Liu,
  • Xianyang Xin,
  • Hai Wang,
  • Bingjie Zhai,
  • Ni Dong,
  • Yongqing Guo,
  • Jun Xie

摘要

Objective

This study aimed to systematically compare, through a network meta-analysis (NMA), the effects of different exercise modalities—including aerobic exercise (AE), resistance training (RT), high-intensity interval training (HIIT), and combined training (COM)—on the lipid profile of overweight/obese children and adolescents.

Methods

The study followed the PRISMA-NMA guidelines and systematically searched randomized controlled trials (RCTs) published from 1999 to August 31, 2025 in the PubMed, Embase, Cochrane, Web of Science, and EBSCO databases. A total of 35 RCTs (n = 1601 participants) were included. Random-effects models in Stata 16.0 were applied to calculate pooled effect sizes with 95% confidence intervals (CIs). Network meta-analysis was performed to synthesize and analyze the data, and intervention effects were ranked using the Surface Under the Cumulative Ranking (SUCRA) curve.

Results

The findings revealed differential effects of exercise modalities on lipid regulation. RT ranked highest for reducing total cholesterol (TC). AE was the only intervention that significantly increased high-density lipoprotein cholesterol (HDL-C). HIIT demonstrated the greatest efficacy in lowering low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). COM showed no superior effect for any single outcome among the four indicators. From an integrated perspective, AE intervention was most effective in elevating HDL-C but relatively weak in reducing LDL-C. Conversely, although RT and HIIT were less effective for raising HDL-C, they exhibited the strongest effects in reducing LDL-C. Compared with the no-exercise control group (CON), resistance training (RT) and high-intensity interval training (HIIT) significantly reduced total cholesterol (TC) levels in individuals with overweight or obesity. Aerobic exercise (AE) significantly increased HDL-C levels in this population. HIIT and combined exercise (COM) significantly reduced LDL-C levels, while HIIT, AE, and COM significantly lowered triglyceride (TG) levels.

Conclusion

The findings suggest that different exercise modalities may exert differential effects on specific lipid parameters. These distinct patterns offer preliminary support for phenotype-targeted exercise prescription, providing an evidence base for refining clinical guidelines and enhancing the precision of cardiovascular health interventions.