Mediation of obesity-related variables in the association between physical fitness and cardiometabolic risk in children and adolescents: a systematic review and meta-analysis

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dc.contributor.authorCastro Silveira, João Francisco de
dc.contributor.authorLópez Gil, José Francisco
dc.contributor.authorReuter, Cézane Priscila
dc.contributor.authorSehn, Ana Paula
dc.contributor.authorBorfe, Letícia
dc.contributor.authorCarvas Junior, Nelson
dc.contributor.authorPfeiffer, Karin Allor
dc.contributor.authorGuerra, Paulo Henrique
dc.contributor.authorAndersen, Lars Bo
dc.contributor.authorGarcía Hermoso, Antonio
dc.contributor.authorGaya, Anelise
dc.contributor.departmentCiencias de la Saludes_ES
dc.contributor.departmentOsasun Zientziakeu
dc.date.accessioned2025-07-02T13:18:34Z
dc.date.available2025-07-02T13:18:34Z
dc.date.issued2025-04-03
dc.date.updated2025-07-02T12:51:04Z
dc.description.abstractObjective. To examine the mediation of obesity-related variables in the association between physical fitness and cardiometabolic risk in children and adolescents. Design. Systematic review and meta-analysis. Data sources. Studies from electronic databases from inception to 31 December 2023. Eligibility criteria for selecting studies. Included were 123 observational studies (cross-sectional and longitudinal) that assessed risk by constructing a continuous score incorporating cardiometabolic parameters. Studies were considered if they evaluated at least one fitness component as an exposure in children and adolescents (5–19 years). Thirty-one were included in the main meta-analyses. Results. Cross-sectional findings indicate that cardiorespiratory fitness is modestly but beneficially associated with cardiometabolic risk, either indirectly via obesity-related variables (indirect standardized beta coefficient [βIndirect]=−0.17; 95% confidence interval [CI] −0.23; −0.11; inconsistency index [I2]=94.4%) or directly and independently from obesity-related variables (r=−0.11; 95% CI −0.15; −0.07; I2=87.4%), whereas muscular fitness seems to be associated with risk only via obesity-related variables (βIndirect=−0.34; 95% CI −0.47; −0.20; I2=85.1%). There was no cross-sectional difference between biological sexes (p≥0.199). Longitudinal findings indicate no total (r=−0.12; 95% CI −0.24; 0.01; I2=23.1%) and direct (r=−0.03; 95% CI −0.08; 0.03; I2=0%) associations. Conclusion. The association between fitness and risk appears to take place either indirectly through the reduction of obesity-related levels or directly by influencing risk. The latter underscores that the inverse association extends beyond a mere reduction in obesity-related variables, encompassing specific enhancements linked to exercise training, including increased metabolic efficiency, and cardiovascular capacity. PROSPERO registration number. CRD42022354628.en
dc.format.mimetypeapplication/pdf
dc.identifier.citationCastro Silveira, J. F. de López-Gil, J. F., Reuter, C. P., Sehn, A. P., Borfe, L., Carvas Junior, N., Pfeiffer, K. A., Guerra, P. H., Andersen, L. B., Garcia-Hermoso, A., Gaya, A. R. (2025) Mediation of obesity-related variables in the association between physical fitness and cardiometabolic risk in children and adolescents: a systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine, 11(2), 1-14. https://doi.org/10.1136/bmjsem-2024-002366.
dc.identifier.doi10.1136/bmjsem-2024-002366
dc.identifier.issn2055-7647
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/54371
dc.language.isoeng
dc.publisherBMJ
dc.relation.ispartofBMJ Open Sport & Exercise Medicine 2025, 11(2): e002366
dc.relation.publisherversionhttps://doi.org/10.1136/bmjsem-2024-002366
dc.rights© Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See rights and permissions. Published by BMJ Group.
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectCardiovascularen
dc.subjectMetabolismen
dc.subjectPerformanceen
dc.subjectYoungen
dc.titleMediation of obesity-related variables in the association between physical fitness and cardiometabolic risk in children and adolescents: a systematic review and meta-analysisen
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dspace.entity.typePublication
relation.isAuthorOfPublicationa8a724dc-bd51-4ab2-8e46-97e362d3ba8f
relation.isAuthorOfPublicatione84ae68a-fa4a-4e00-be27-bedfffc8612e
relation.isAuthorOfPublication.latestForDiscoverya8a724dc-bd51-4ab2-8e46-97e362d3ba8f

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