ObjectiveTo compare the effects of aerobic exercise, resistance exercise, aerobic combined with resistance exercise, routine nursing and no intervention on depression and anxiety in adolescents by means of network meta-analysis. MethodsA computer search was conducted in CNKI, WanFang Data, VIP, CBM, Web of Science, EBSCO, PubMed, Cochrane Library and Embase to collect randomized controlled trials (RCTs) related to exercise intervention for depression and anxiety in children and adolescents from inception to April 2023. After two researchers independently screened the literature, extracted data and evaluated the methodological quality of the included studies, Stata 14.0 and RevMan 5.3 software were used for statistical analysis. ResultsFinally 27 RCTs were included, covering 3 210 children and adolescents. The results of the network meta-analysis showed that in terms of improving depression, resistance exercise (SMD=?0.37, 95%CI ?0.64 to ?0.10, P<0.05) and aerobic exercise (SMD=?0.19, 95%CI ?0.34 to ?0.04, P<0.01) were significantly better than the no intervention group; in relieving anxiety, aerobic exercise (SMD=?0.29, 95%CI ?0.54 to ?0.03, P<0.05) was significantly better than the no intervention group. In improving self-worth, aerobic combined with resistance exercise (SMD=0.26, 95%CI 0.01 to 0.52, P<0.05) was statistically different from the no intervention group. The results of SUCRA probability sequence showed that in reducing depression, resistance exercise (95.0%) > aerobic exercise (64.4%) > aerobic combined with resistance exercise (60.7%) > routine nursing (22.9%) > no intervention (7.0%). In relieving anxiety, aerobic exercise (72.4%) > routine nursing (69.0%) > aerobic combined with resistance exercise (55.3%) > no intervention (3.4%). In improving self-worth, aerobic combined with resistance exercise (94.0%) > resistance exercise (67.3%) > aerobic exercise (35.1%) > no intervention (32.7%) > routine nursing (21.0%). ConclusionLimited evidence suggests that resistance exercise has advantages in improving depression in children and adolescents, aerobic exercise has advantages in relieving anxiety in children and adolescents, and aerobic combined with resistance exercise has advantages in improving self-worth in children and adolescents. Due to the limitation of the number and quality of included studies, more high-quality studies are needed to verify the above conclusions.
ObjectiveTo systematically evaluate the effectiveness of different exercise modalities in reducing visceral adipose tissue (VAT) among overweight and obese children and adolescents, and to determine the optimal exercise dose. MethodsThe CNKI, WanFang Data, Web of Science, PubMed, and Science Direct databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to September 2025. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. The dose-response network meta-analysis was then performed by using R 4.3.1 software and the MBNMAdose package. ResultsA total of 34 RCTs involving 2 269 subjects were included. The results of network meta-analysis showed that all exercise types, involving high-intensity interval training (HIIT), sided games (SG), moderate-intensity continuous training (MICT), combined exercise (CE), resistance exercise (RE), and aerobic exercise (AE), significantly reduced VAT compared with controls. The cumulative area under the sorting curve (SUCRA) results showed that the efficacy ranking from high to low was: HIIT>SG>MICT>CE>RE>AE. Dose-response analysis revealed an L-shaped non-linear association, with a minimal clinically important dose (MCID) of 630 MET min/week. HIIT (430 MET min/week) and SG (470 MET min/week) achieved benefit at lower doses. ConclusionExercise interventions are effective in reducing VAT in overweight and obese children and adolescents, with substantial variation in optimal dose across modalities. HIIT achieves clinically meaningful benefits at lower doses and may warrant priority in practical implementation.