Could physical activity promote indicators of physical and psychological health among children and adolescents? An umbrella review of meta-analyses of randomized controlled trials

BACKGROUND: We performed an umbrella review to synthesize evidence on the effects of physical activity (PA) interventions on indicators of physical and psychological health among children and adolescents, including body mass index (BMI), blood pressure (BP), depressive symptoms, and cognitive function. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched from inception through 31 July 2023. We included meta-analyses of randomized controlled trials exploring the effects of PA interventions on BMI, BP, depressive symptoms, or cognitive function in healthy or general children and adolescents. Standard Mean Difference (SMD) was calculated for continuous outcome indicators, while Relative Risk (RR) was calculated for categorical outcome indicators. RESULTS: A total of 21 meta-analyses were included. The evidence for the effects of PA interventions on reducing BMI [n = 68,368, SMD = - 0.04, 95% confidence interval (CI) = - 0.07 to - 0.01, P = 0.012, I² = 46.6%], relieving diastolic BP (n = 8204, SMD = - 1.16, 95% CI = - 2.12 to - 0.20, P = 0.018, I² = 83.1%), preventing depressive symptoms (n = 5146, SMD = - 0.21, 95% CI = - 0.31 to - 0.12, P < 0.001, I² = 29.0%), and promoting cognitive function (n = 19,955, SMD = 0.40, 95% CI = 0.27-0.54, P < 0.001, I² = 88.0%) was all weak but significant (class IV evidence). Subgroup analyses demonstrated that school-based and after-school PA interventions, curricular PA interventions, and PA interventions emphasizing enjoyment were more effective in reducing BMI, while curricular PA and sports programs achieved greater executive function. CONCLUSION: PA interventions could weakly reduce BMI, relieve BP, prevent depressive symptoms, and promote cognitive function in general children and adolescents. Targeted interventions on PA should be a priority to promote physical and psychological health for children and adolescents, especially the curricular PA emphasizing enjoyment in the school settings.