Effect of Dietary and Physical Activity Interventions Combined with Psychological and Behavioral Strategies on Preventing Metabolic Syndrome in Adolescents with Obesity: A Meta-Analysis of Clinical Trials.

Unlabelled: Bacground/Objectives: Obesity in adolescents is escalating, accompanied by comorbidities such as insulin resistance and cardiovascular disease, which favor the early onset of metabolic syndrome (MetS). There is an urgent need for effective interventions to prevent and treat MetS. We aimed to analyze intervention studies targeting lifestyle improvements in adolescents with obesity. We also determined the effect of combining dietary and/or physical activity interventions with educational, psychological, and emotional support-based interventions compared to traditional interventions in preventing MetS in adolescents with obesity.

Methods: The PubMed, Cochrane, Web of Science, CINAHL, and Scopus databases were consulted. Ten clinical trials were included in the systematic review, of which six were eligible for the meta-analysis.

Results: Combined interventions significantly decreased body weight (-1.10 [-1.64, -0.55], < 0.001). Although not statistically significant improvements were observed in the meta-analysis for zBMI and waist circumference. The results indicate that diet- and exercise-based interventions are associated with a further decrease in body composition and non-anthropometric variables associated with MetS when combined with educational, psychological, and behavioral interventions.

Conclusions: Some studies suggest potential long-term benefits, but further research is necessary to define effective interventions for improving body composition and preventing MetS in obese adolescents, addressing the inconsistencies in current clinical trials. Systematic Review Registration (PROSPERO CRD42023463428).