Clinical Scorecard: Impact of Physical Activity on Targeted Fat Deposits in Children: A Comprehensive Review
At a Glance
Category
Detail
Condition
Childhood obesity with specific fat depot accumulation
Key Mechanisms
Exercise reduces visceral, subcutaneous, hepatic, and intermuscular fat through moderate-to-vigorous aerobic or combined aerobic and resistance training
Target Population
Children and adolescents, particularly those living with overweight or obesity
Care Setting
Pediatric healthcare and lifestyle intervention programs
Key Highlights
Moderate-to-vigorous aerobic or combined aerobic and resistance training effectively reduces visceral, subcutaneous, hepatic, and intermuscular fat in children.
Limited evidence suggests potential benefits of exercise on pancreatic and bone marrow fat, while data on epicardial fat in children are scarce.
Most studies lack detailed reporting on exercise dose, limiting conclusions on optimal frequency, duration, and intensity for targeting specific fat depots.
Guideline-Based Recommendations
Diagnosis
Assess specific fat depots including visceral, subcutaneous, hepatic, intermuscular, pancreatic, bone marrow, and epicardial fat in children with obesity when possible.
Management
Implement moderate-to-vigorous aerobic or combined aerobic and resistance exercise programs to reduce targeted fat depots.
Incorporate supervised exercise programs as part of family-based lifestyle interventions for children with overweight or obesity.
Monitoring & Follow-up
Monitor changes in specific fat depots using imaging or validated assessment tools when feasible.
Track adherence to exercise modality, frequency, duration, and intensity to optimize fat depot reduction.
Risks
Physical inactivity is linked to increased adiposity and associated cardiometabolic risks including insulin resistance, hepatic steatosis, and cardiovascular disease.
Lack of physical activity in children increases risk for persistence of obesity and related comorbidities into adulthood.
Patient & Prescribing Data
Children and adolescents with overweight or obesity
Exercise interventions focusing on moderate-to-vigorous aerobic or combined aerobic and resistance training show reductions in visceral, subcutaneous, hepatic, and intermuscular fat; evidence for pancreatic and bone marrow fat is limited; epicardial fat data are lacking.
Clinical Best Practices
Prioritize structured, supervised exercise programs combining aerobic and resistance training for effective fat depot reduction.
Emphasize the importance of achieving at least 60 minutes of moderate-to-vigorous physical activity daily as per WHO guidelines.
Consider individualized exercise prescriptions accounting for modality, frequency, duration, and intensity to optimize outcomes.
Incorporate family-based lifestyle interventions to support adherence and sustainability of physical activity.
Recognize the need for further research to define optimal exercise dosing for targeting specific fat depots.
by Cristina Cadenas-Sanchez, David Rodriguez-Sanchez, Maria Herrada-Robles, Maria Bermudez-Cordoba, Gemma Bermejo-Martínez, Maria Atencia-Rodriguez, Unai Azcárate, Marta Ortiz-Gómez, Jesús García-Arive, Maddi Osés, María Medrano
