Exercise and Insulin Resistance Markers in the Overweight and Obese Pediatric Population

Despite reported benefits for various exercise modalities, determining the most effective exercise approaches and optimal exercise dose for reducing insulin resistance in children and adolescents with excess weight remains uncertain.

A recent study aimed to compare exercise training modalities and their impact on insulin resistance markers in children and adolescents with excess weight – aiming to establish the optimal exercise dose.

This was a systematic review and network meta-analysis that included randomized clinical trials (RCTs) that reported outcomes related to aerobic training, resistance training, high-intensity interval training (HIIT), or a combination of these interventions. Overall, 55 studies comprising 3051 participants were analyzed.

It was found that exercise was associated with reductions in fasting insulin and homeostatic model assessment for insulin resistance (HOMA-IR). A nonlinear association was noted, suggesting a required minimal exercise dosage of approximately 900-1200 metabolic equivalent of task minutes per week, especially for those with baseline insulin resistance. Combination HIIT and resistance training, as well as concurrent training, were identified as the most effective approaches for reducing insulin resistance markers. The certainty of evidence ranged from low to moderate.

The results highlighted the role of exercise interventions in improving insulin resistance markers in children and adolescents with overweight and obesity. The authors recommend the inclusion of resistance exercises alongside aerobic and HIIT programs for a minimum of two to three 60-minute sessions per week. High-intensity interval training, either alone or combined with resistance training, demonstrated the greatest reduction in insulin resistance markers. However, the certainty of evidence varied from low to moderate, indicating the need for further research in this area.

Source: García-Hermoso A, López-Gil JF, Izquierdo M, Ramírez-Vélez R, Ezzatvar Y. JAMA Pediatrics. 2023 Oct 9.