《中国康复理论与实践》

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (3): 296-305.doi: 10.3969/j.issn.1006-9771.2025.03.006

• 循证研究 • 上一篇    下一篇

肥胖和超重儿童参与身体活动的健康效益：系统综述的系统综述

朱志强, 徐巧玲, 邵雪云()   

  1. 深圳大学体育学院，广东深圳市 518060
  • 收稿日期:2025-01-13 修回日期:2025-01-15 出版日期:2025-03-25 发布日期:2025-03-25
  • 通讯作者: 邵雪云(1982-)，女，汉族，浙江宁波市人，博士，副教授，硕士研究生导师，主要研究方向：运动与脑科学、儿童身体活动与健康，E-mail：shaoxy@szu.edu.cn。
  • 作者简介:朱志强(1988-)，男，汉族，江西赣州市人，博士，副研究员，硕士研究生导师，主要研究方向：运动与脑科学、神经调控。

Health benefits of physical activity for obese and overweight children: a systematic review of systematic reviews

ZHU Zhiqiang, XU Qiaoling, SHAO Xueyun()   

  1. School of Sports, Shenzhen University, Shenzhen, Guangdong 518060, China
  • Received:2025-01-13 Revised:2025-01-15 Published:2025-03-25 Online:2025-03-25
  • Contact: SHAO Xueyun, E-mail: shaoxy@szu.edu.cn

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摘要：

目的 评估身体活动对肥胖和超重儿童青少年身体健康、心理健康以及身体活动相关的健康行为的效益。

方法 遵循PRISMA指南，系统性检索Web of Science、PubMed、Scopus、PsycINFO、Cochrane Library和中国知网中2016年至2024年间发表在科学引文索引Q4区及以上期刊的系统综述或Meta分析，内容涵盖身体活动或运动干预对6~18岁肥胖或超重儿童和青少年身体或心理健康的影响。采用AMSTAR 2工具对纳入文献进行质量评估，对中高水平质量文献进行系统综述。

结果 共纳入8篇系统综述和Meta分析，涉及24 567例儿童和青少年，其中6篇为高质量，2篇为中等质量。在身体健康方面，结合有氧和阻力训练的复合运动干预在降低体质量指数(BMI)和体脂率方面表现最佳。每次60 min以上、每周3次、持续12周或更长时间的中、高强度运动干预可以显著降低肥胖和超重儿童的BMI和体脂率，且能提升心肺耐力和肌肉力量。在心理健康方面，身体活动对缓解儿童青少年抑郁和焦虑、提升自尊心具有积极效果。特别是舞蹈、户外探险活动和团队运动对改善儿童青少年的社交能力和情绪状态具有显著作用。对于神经发育障碍群体，低强度的运动形式如水中步行和瑜伽对提升自我调节能力和社交互动能力效果显著。在身体活动相关的健康行为方面，有助于促进社交互动能力，养成运动习惯，提高学生的身体活动参与水平，减少久坐行为，增加有关健康及身体活动的知识。多模式干预(如将有氧运动与营养教育或心理辅导结合)在改善整体健康方面的效果远优于单一干预模式。健康促进学校策略通过学校、家庭和社区的协同作用，可以有效提高学生的身体活动水平，减少肥胖发生率，提升心理健康水平。

结论 身体活动对肥胖和超重儿童青少年的身体和心理健康具有显著的健康效益。中、高强度有氧和阻力训练、舞蹈及户外活动是改善身体成分和心理健康的有效干预手段。多模式干预和健康促进学校策略能够产生长期健康效益。

关键词: 身体活动, 身体与心理健康, 身体活动相关的健康行为, 肥胖, 超重, 系统综述

Abstract:

Objective To evaluate the benefits of physical activity on the physical health, mental health and health behaviors related to physical activity in obese and overweight children and adolescents.

Methods Following the PRISMA guidelines, a systematic search was conducted in Web of Science, PubMed, Scopus, PsycINFO, Cochrane Library and CNKI for systematic reviews or meta-analyses published between 2016 and 2024 in Science Citation Index Q4 or higher journals, related to physical activity or exercise for physical and mental health in obese and overweight children and adolescents. They were assessed using AMSTAR 2 tool to ensure that the methodological quality was medium to high.

Results A total of eight systematic reviews and meta-analyses involving 24 567 participants were included. Six studies were of high quality, and two were of moderate quality. In terms of physical health, combined aerobic and resistance exercise interventions demonstrated the most significant improvements in reducing body mass index (BMI) and body fat percentage. Moderate-to-high-intensity exercise performed three times per week, at least 60 minutes per session, over twelve weeks or longer significantly reduced BMI and body fat percentage in obese and overweight children while improving cardiorespiratory endurance and muscular strength. In terms of mental health, physical activity was positive in reducing depression and anxiety, and improving self-esteem in children and adolescents. Activities such as dance, outdoor adventure programs and team sports notably enhanced social skills and emotional well-being. For neurodevelopmental disorders, low-intensity activities like aquatic walking and yoga significantly improved self-regulation and social interaction abilities. In terms of health-related behaviors, physical activity interventions promoted the development of exercise habits, improved social interaction skills, increased physical activity participation, reduced sedentary behavior, and enhanced health and physical activity knowledge. In terms of multi-modal interventions, programs combining aerobic exercise with nutrition education or psychological counseling were more effective in improving overall health compared to single-modal interventions. Health-promoting schools (HPS) approach, integrating school, family and community involvement, effectively increased students' physical activity levels, reduced obesity rates, and improved mental health outcomes.

Conclusion Physical activity is benefit in physical and mental health for obese and overweight children and adolescents. Moderate-to-high-intensity aerobic and resistance training, dance, and outdoor activities are effective interventions for improving body composition and mental health. Multi-modal interventions and HPS strategies can yield sustained health benefits.

Key words: physical activity, physical and mental health, health behaviors related to physical activity, obesity, overweight, systematic review

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