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Exercise and adiposity in overweight and obese children and adolescents: protocol for a systematic review and network meta-analysis of randomised trials
  1. George A Kelley1,
  2. Kristi S Kelley1,
  3. Russell R Pate2
  1. 1 Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
  2. 2 Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
  1. Correspondence to Professor George A Kelley; gkelley{at}


Introduction Overweight and obesity is a worldwide public health problem among children and adolescents. However, the magnitude of effect, as well as hierarchy of exercise interventions (aerobic, strength training or both), on selected measures of adiposity is not well established despite numerous trials on this issue. The primary purposes of this study are to use the network meta-analytical approach to determine the effects and hierarchy of exercise interventions on selected measures of adiposity in overweight and obese children and adolescents.

Methods and analysis Randomised exercise intervention trials >4 weeks, available in any language up to 31 August 2017 and which include direct and/or indirect evidence, will be included. Studies will be located by searching seven electronic databases, cross-referencing and expert review. Dual selection and abstraction of data will occur. The primary outcomes will be changes in body mass index (in kg/m2), fat mass and percent body fat. Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument while confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation instrument for network meta-analysis. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of exercise treatments (aerobic, strength or both).

Ethics and dissemination This study does not require ethics approval. Findings will be presented at a professional conference and published in a peer-reviewed journal.

PROSPERO registration number CRD42017073103.

  • exercise
  • overweight
  • obesity
  • children
  • adolescents
  • network meta-analysis

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 and the use is non-commercial. See:

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  • Contributors GAK is the guarantor. GAK, KSK and RRP drafted the manuscript. All authors contributed to the development of the data sources to search for relevant literature, including search strategy, selection criteria, data extraction criteria and risk of bias assessment strategy. GAK provided statistical expertise while RRP provided content expertise on exercise and adiposity in overweight and obese children and adolescents. All authors read, provided feedback and approved the final manuscript.

  • Funding This study is funded by the American Heart Association, Grant #17GRNT33630158 (GA Kelley, Principal Investigator). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the American Heart Association.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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