A systematic review and meta-analysis of energy and macronutrient intake responses to physical activity interventions in children and adolescents with obesity.

Abstract

The effects of regular physical activity on energy intake in obese adolescents are unknown. The objective is to determine how physical activity interventions affect energy and macronutrient intake in overweight/obese youth. Databases were searched from December 2014 to December 2015 for studies that measured energy and/or macronutrient consumption in response to physical activity intervention in overweight/obese youth. The review comprises primary source articles published in English in peer-reviewed journals. Articles that presented data on energy and/or macronutrient intake before and after a physical activity intervention (without dietary restriction) in overweight or obese children and teenagers (up to 18 years old) were included. Of the initial 307 references found, nine were included. The nine included studies analysed the effect of 15 different physical activity interventions. Nine showed a decrease and six unchanged energy intakes. The effect size for total energy intake ranged from -2.108 to -0.207 (n = 14). Results of the meta-analysis revealed a mean effect of physical intervention to reduce intake of -1.003 (95% confidence interval = -1.261 to -0.745, p < 0.001). Results for heterogeneity among these studies were I2 = 67.421; Q = 39.903; df = 13, p < 0.001. The mean energy intake reduction was -323 ± 286 kcal. Macronutrient intake was assessed in 11 interventions. Protein intake was found decreased in five (reduction of -26.8 ± 19.2 g), seven reported fat decrease (reduction of -26.4 ± 17.8 g) and five a decrease in CHO (reduction of -72.5 ± 22.8 g). The meta-analysis revealed significant decreases of each macronutrient (p < 0.001). Structured physical activity interventions favour decreased daily energy intake in obese adolescents.