Combined aerobic and resistance exercise improves glucose metabolism and insulin resistance in children and adolescents with overweight or obesity: a meta-analysis
Abstract
Children and adolescents with overweight or obesity commonly exhibit impaired glucose metabolism and insulin resistance, increasing their future metabolic risk. Although combined aerobic and resistance exercise is a promising non-pharmacological strategy for pediatric obesity management, its effects on glucose metabolism and insulin resistance remain inconclusive. This systematic review and meta-analysis evaluated randomized controlled trials of combined aerobic and resistance exercise in children and adolescents aged 18 years or younger with overweight or obesity. PubMed, Cochrane Library, Web of Science, and Embase were searched from inception to March 1, 2026. Risk of bias was assessed using RoB 2, and certainty of evidence using GRADE. Eighteen trials involving 682 participants were included. Compared with control conditions, combined aerobic and resistance exercise significantly reduced fasting plasma glucose and fasting insulin, and may be associated with reductions in HOMA-IR. Subgroup and meta-regression analyses suggested that effects varied by sex, session duration, age, and continent. Evidence certainty was low for fasting plasma glucose and fasting insulin and very low for HOMA-IR. Combined aerobic and resistance exercise may improve glucose metabolism and alleviate insulin resistance in this population, although the findings for HOMA-IR should be interpreted cautiously because of the very low certainty of evidence.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 682 participants or records.
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