Effects of exercise on BMI z-score in overweight and obese children and adolescents: a systematic review with meta-analysis

Background: Overweight and obesity are major public health problems in children and adolescents. The purpose of this study was to conduct a systematic review with meta-analysis to determine the effects of exercise (aerobic, strength or both) on body mass index (BMI) z-score in overweight and obese children and adolescents. Methods: Studies were included if they were randomized controlled exercise intervention trials ≥ 4 weeks in overweight and obese children and adolescents 2 to 18 years of age, published in any language between 1990–2012 and in which data were available for BMI z-score. Studies were retrieved by searching eleven electronic databases, cross-referencing and expert review. Two authors (GAK, KSK) selected and abstracted data. Bias was assessed using the Cochrane Risk of Bias Assessment Instrument. Exercise minus control group changes were calculated from each study and weighted by the inverse of the variance. All results were pooled using a random-effects model with non-overlapping 95% confidence intervals (CI) considered statistically significant. Heterogeneity was assessed using Q and I 2 while funnel plots and Egger’s regression test were used to assess for small-study effects. Influence and cumulative meta-analysis were performed as well as moderator and meta-regression analyses. Results: Of the 4,999 citations reviewed, 835 children and adolescents (456 exercise, 379 control) from 10 studies representing 21 groups (11 exercise, 10 control) were included. On average, exercise took place 4 x week for 43 minutes per session over 16 weeks. Overall, a statistically significant reduction equivalent to 3% was found for BMI z-score Χ; −0:06; 95% CI; ‐0:09 to ‐0:03;Q ¼ 24:9; p ¼ 0:01; I 2 ¼ 59:8%. No small-study effects were observed and results remained statistically significant when each study was deleted from the model once. Based on cumulative meta-analysis, results have been statistically significant since 2009. None of the moderator or meta-regression analyses were statistically significant. The number-needed-to treat was 107 with an estimated 116,822 obese US children and adolescents and approximately 1 million overweight and obese children and adolescents worldwide potentially improving their BMI z-score by participating in exercise. Conclusions: Exercise improves BMI z-score in overweight and obese children and adolescents and should be recommended in this population group. However, a need exists for additional studies on this topic

Effects of Exercise on BMI Z-Score in Overweight and Obese Children and Adolescents: A Systematic Review With Meta-Analysis

Background: Overweight and obesity are major public health problems in children and adolescents. The purpose of this study was to conduct a systematic review with meta-analysis to determine the effects of exercise (aerobic, strength or both) on body mass index (BMI) z-score in overweight and obese children and adolescents. Methods: Studies were included if they were randomized controlled exercise intervention trials ≥ 4 weeks in overweight and obese children and adolescents 2 to 18 years of age, published in any language between 1990–2012 and in which data were available for BMI z-score. Studies were retrieved by searching eleven electronic databases, cross-referencing and expert review. Two authors (GAK, KSK) selected and abstracted data. Bias was assessed using the Cochrane Risk of Bias Assessment Instrument. Exercise minus control group changes were calculated from each study and weighted by the inverse of the variance. All results were pooled using a random-effects model with non-overlapping 95% confidence intervals (CI) considered statistically significant. Heterogeneity was assessed using Q and I 2 while funnel plots and Egger’s regression test were used to assess for small-study effects. Influence and cumulative meta-analysis were performed as well as moderator and meta-regression analyses. Results: Of the 4,999 citations reviewed, 835 children and adolescents (456 exercise, 379 control) from 10 studies representing 21 groups (11 exercise, 10 control) were included. On average, exercise took place 4 x week for 43 minutes per session over 16 weeks. Overall, a statistically significant reduction equivalent to 3% was found for BMI z-score Χ; −0:06; 95% CI; ‐0:09 to ‐0:03;Q ¼ 24:9; p ¼ 0:01; I 2 ¼ 59:8%. No small-study effects were observed and results remained statistically significant when each study was deleted from the model once. Based on cumulative meta-analysis, results have been statistically significant since 2009. None of the moderator or meta-regression analyses were statistically significant. The number-needed-to treat was 107 with an estimated 116,822 obese US children and adolescents and approximately 1 million overweight and obese children and adolescents worldwide potentially improving their BMI z-score by participating in exercise. Conclusions: Exercise improves BMI z-score in overweight and obese children and adolescents and should be recommended in this population group. However, a need exists for additional studies on this topic

Exercise and Adiposity in Overweight and Obese Children and Adolescents: A Systematic Review with Network Meta-analysis of Randomised Trials

Objectives Determine both the effects and hierarchy of effectiveness for exercise interventions (aerobic, strength training or both) on selected measures of adiposity (body mass index (BMI) in kg/m2 , fat mass and per cent body fat) in overweight and obese children and adolescents. Design Network meta-analysis of randomised exercise intervention trials. Setting Any setting where a randomised trial could be conducted. Participants Overweight and obese male and/or female children and adolescents 2–18 years of age. Interventions Randomised exercise intervention trials\u3e4 weeks, published between 1 January 1973 and 22 August 2018, and which included direct and/or indirect evidence for aerobic, strength training or combined aerobic and strength training. Primary outcomes Changes in BMI in kg/m2 , fat mass and per cent body fat. Results Fifty-seven studies representing 127 groups (73 exercise, 54 control) and 2792 participants (1667 exercise, 1125 control) met the criteria for inclusion. Length of training (‍ − X ± SD) averaged 14.1±6.2 weeks, frequency, 3.3±1.1 days per week and duration 42.0±21.0min per session. Significant and clinically important reductions in BMI, fat mass and per cent body fat were observed in aerobic versus control comparisons (BMI, mean, 95%CI -1.0, 1.4 to −0.6; fat mass -2.1, –3.3 to −1.0 kg; per cent fat -1.5, –2.2 to −0.9%) and combined aerobic and strength versus control comparisons (BMI -0.7, –1.4 to −0.1; fat mass -2.5, –4.1 to −1.0 kg; per cent fat, -2.2, –3.2 to −1.2%). A significant reduction in per cent fat was also found for strength vs control comparisons (-1.3,–2.5 to −0.1%). Combined aerobic and strength training was ranked first for improving both fat mass (kg) and per cent body fat while aerobic exercise was ranked first for improving BMI. Conclusions Aerobic and combined aerobic and strength training are associated with improvements in adiposity outcomes in overweight and obese children and adolescents. PROSPERO registration number CRD42017073103

Cultural Resources Investigations for the Proposed Espada Road Widening Project City of San Antonio Bexar County, Texas

Between February 2014 and October 2015, Atkins North America, Inc. (Atkins), conducted cultural resources investigations for the City of San Antonio’s (COSA’s) proposed Espada Road Widening Project. The project area extends from Southeast Interstate Loop 410 to approximately 137 meters (450 feet) west of the intersection of East Ashley Road and Espada Road, a distance of approximately 1.6 kilometers (1.0 mile), comprising 7.99 acres (3.2 hectares). The project area was subjected to an intensive pedestrian survey, which was supplemented by mechanical trenching. In total, 27 shovel tests and 9 backhoe trenches were placed in locations across the Area of Potential Effects (APE), with particular emphasis on areas potentially containing remnants of distribution laterals extending from the Espada Acequia. Although the locations of a few of the acequia laterals were visible from the surface, most have been backfilled and affected by modern disturbances. Mechanical trenching was employed in an attempt to catch the acequia laterals in cross-section, but no such features were observed. No new archaeological resources were identified during the survey. An archival review hypothesized the presence of three acequia laterals extending into the parcel immediately south of Rilling Road. Because the property currently houses a construction yard and no excavation was possible, the parcel could not be examined at the time of the surveys. Therefore, Atkins recommends that any construction within that section of the APE be monitored by a qualified archaeologist. Atkins also recommends monitoring the property at the northern end of Espada Road, where an outfall will be located. Due to the APE’s proximity to existing archaeological site 41BX260 at that location, excavation within that portion of the APE should be monitored as well

Searching for Inclusion: Campus Conversations with People of Color in Predominantly White Institutions

“The purpose of this study is to share perceptions of students of color regarding their perceived acceptance and inclusion in Nebraska’s public schools and universities.

Mid-Infrared Spectrophotometric Observations of Fragments B and C of Comet 73P/Schwassmann-Wachmann 3

We present mid-infrared spectra and images from the GEMINI-N (+Michelle) observations of fragments SW3-[B] and SW3-[C] of the ecliptic (Jupiter Family) comet 73P/Schwassmann-Wachmann 3 pre-perihelion. We observed fragment B soon after an outburst event (between 2006 April 16 - 26 UT) and detected crystalline silicates. The mineralogy of both fragments was dominated by amorphous carbon and amorphous pyroxene. The grain size distribution (assuming a Hanner modified power-law) for fragment SW3-[B] has a peak grain radius of a_p ~ 0.5 micron, and for fragment SW3-[C], a_p ~ 0.3 micron; both values larger than the peak grain radius of the size distribution for the dust ejected from ecliptic comet 9P/Tempel 1 during the Deep Impact event (a_p = 0.2 micron. The silicate-to-carbon ratio and the silicate crystalline mass fraction for the submicron to micron-size portion of the grain size distribution on the nucleus of fragment SW3-[B] was 1.341 +0.250 -0.253 and 0.335 +0.089 -0.112, respectively, while on the nucleus of fragment SW3-[C] was 0.671 +0.076 -0.076 and 0.257 +0.039 -0.043, respectively. The similarity in mineralogy and grain properties between the two fragments implies that 73P/Schwassmann-Wachmann 3 is homogeneous in composition. The slight differences in grain size distribution and silicate-to-carbon ratio between the two fragments likely arises because SW3-[B] was actively fragmenting throughout its passage while the activity in SW3-[C] was primarily driven by jets. The lack of diverse mineralogy in the fragments SW3-[B] and SW3-[C] of 73P/Schwassmann-Wachmann 3 along with the relatively larger peak in the coma grain size distribution suggests the parent body of this comet may have formed in a region of the solar nebula with different environmental properties than the natal sites where comet C/1995 O1 (Hale-Bopp) and 9P/Tempel 1 nuclei aggregated.Comment: 31 pages, 5 figure, accepted for publication in A