A systematic review and meta-analysis of energy and macronutrient intake responses to physical activity interventions in children and adolescents with obesity.

BACKGROUND: The effects of regular physical activity on energy intake in obese adolescents are unknown. OBJECTIVE: The objective is to determine how physical activity interventions affect energy and macronutrient intake in overweight/obese youth. DATA SOURCES: Databases were searched from December 2014 to December 2015 for studies that measured energy and/or macronutrient consumption in response to physical activity intervention in overweight/obese youth. DATA SELECTION: The review comprises primary source articles published in English in peer-reviewed journals. Articles that presented data on energy and/or macronutrient intake before and after a physical activity intervention (without dietary restriction) in overweight or obese children and teenagers (up to 18 years old) were included. Of the initial 307 references found, nine were included. RESULTS: The nine included studies analysed the effect of 15 different physical activity interventions. Nine showed a decrease and six unchanged energy intakes. The effect size for total energy intake ranged from -2.108 to -0.207 (n = 14). Results of the meta-analysis revealed a mean effect of physical intervention to reduce intake of -1.003 (95% confidence interval = -1.261 to -0.745, p < 0.001). Results for heterogeneity among these studies were I2 = 67.421; Q = 39.903; df = 13, p < 0.001. The mean energy intake reduction was -323 ± 286 kcal. Macronutrient intake was assessed in 11 interventions. Protein intake was found decreased in five (reduction of -26.8 ± 19.2 g), seven reported fat decrease (reduction of -26.4 ± 17.8 g) and five a decrease in CHO (reduction of -72.5 ± 22.8 g). The meta-analysis revealed significant decreases of each macronutrient (p < 0.001). CONCLUSION: Structured physical activity interventions favour decreased daily energy intake in obese adolescents