The effect of diet or exercise on ectopic adiposity in children and adolescents with obesity: a systematic review and meta-analysis

Obes Rev. 2017 Nov;18(11):1310-1322. doi: 10.1111/obr.12577. Epub 2017 Sep 14.


Objective: Ectopic fat depostion in youth with obesity is associated with an increased cardiovascular disease risk. The aim of this meta-analysis was to summarize the evidence for the use of diet and/or exercise on ectopic adiposity in this population.

Methods: A systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Clinical trials that assessed ectopic fat deposition and included study arms with diet and/or exercise were searched in PubMed, PEDro and the Cochrane database.

Results: Hepatic fat content and intramyocellular lipid content were described in nine studies and three studies, respectively. Most studies included teenagers, and study duration ranged between 3 and 12 months without follow-up. Using random-effects weights, the standardized mean difference of the change in hepatic adiposity (totalling 320 subjects) was -0.54 Hedges' g (95% confidence interval: -0.69 to -0.38 with p < 0.0001). By re-expressing this effect size, it is seen that diet and/or exercise results in an absolute reduction of intrahepatic lipid with 2%, which accords with a relative reduction up to 70%. Although there were significant ameliorations of insulin sensitivity, no significant changes in intramyocellular lipid were observed.

Conclusions: This meta-analysis showed that diet and/or exercise is effective to reduce hepatic adiposity in youth with obesity.

Keywords: Diet; ectopic fat; exercise; paediatric obesity.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adiposity*
  • Adolescent
  • Anthropometry
  • Child
  • Diet*
  • Exercise*
  • Humans
  • Non-Randomized Controlled Trials as Topic
  • Pediatric Obesity / epidemiology*
  • Pediatric Obesity / prevention & control
  • Randomized Controlled Trials as Topic