Effects of physical activity interventions on cognitive performance of overweight or obese children and adolescents: a systematic review and meta-analysis

Background: Physical activity (PA) and obesity were linked with poor cognition. Our study assessed PA interventions could improve domain-specific cognition among overweight/obese youth. Methods: Systematically searched PubMed to identify relevant studies published up to October 2019. Standardized mean differences (SMD) of pre−post intervention were calculated in meta-analysis. The level of study heterogeneity represented by I² was interpreted as small (I² ≤ 25%), moderate (25% < I² ≤ 50%), substantial (50% < I² ≤ 75%), or considerable (I² > 75%). Results: Seventeen studies met the inclusion criteria; eight were included in the meta-analysis. Meta-analysis revealed that PA interventions improved core executive functions (core-EFs) (SMD = 0.301; 95% CI = 0.002−0.600; I²% = 80.6%) and non-EFs (SMD = 0.159; 95% CI = 0.029−0.289; I²% = 0.0%), but not metacognition and academic performance. Core-EFs benefited from enriched PA (SMD = 0.535; 95% CI = 0.020−1.051; I²% = 72.0%) and enhanced and enriched PA (SMD = 1.005; 95% CI = 0.017−1.993; I²% = 90.8%) interventions, while the non-EFs benefited more from enhanced PA (SMD = 0.166; 95% CI = 0.018−0.314; I²% = 0.0%). Interventions with a favorable effect on adiposity measures resulted in a significantly greater improvement in core-EFs (SMD = 0.438; 95% CI = 0.047−0.829; I²% = 58.8%) than those with no effects. Conclusions: PA interventions can improve several domains of cognition, especially core-EFs and non-EFs, and the effects are affected by PA characteristics among overweight and obese youth. Impact: Our study is the first to quantify the effect of PA interventions on CP among overweight or obese children and adolescents.Physical activity interventions positively affect cognitive performance, especially core executive functions (core-EFs) and non-EFs.Physical activity interventions seem to not positively affect metacognition (higher-level EFs and cognitive life skills) and academic performance.Physical task characteristics could influence the effect of chronic exercise on cognitive performance.Short-term physical activity programs may be particularly beneficial to affect core-EFs.