The Impact of Different Types of Exercise on Executive Functions in Overweight/Obese Individuals: A Systematic Review and Network Meta-Analysis

To compare the effects of different exercise training on executive function (EF) in obese or overweight individuals. PubMed, Web of Science, SPORTDiscus, MEDLINE, and CINAHL. The included articles, in English, should have been published from January 2000 to February 2024. All included studies were randomized controlled trials (RCTs) of exercise intervention in overweight or obese populations. The primary outcomes are EFs, which encompass core functions (e.g., inhibitory control, working memory (WM), and cognitive flexibility (CF)) and higher-level functions (e.g., responding, planning, and problem-solving). Therefore, the primary outcomes should include at least one of the above indicators. Additionally, given the focus of many exercise intervention studies on academic performance (AP) in obese adolescents, a secondary outcome includes AP. This meta-analysis synthesizes findings from 20 RCTs published between 2010 and 2023, encompassing a total of 1183 overweight or obese participants. Interventions were categorized into seven types: control training (CT), aerobic exercise (AE), resistance training (RT), coordinated physical activity (CPA), prolonged time of exercise (PTE), high-intensity interval training (HIIT), and AE combined with RT (mix mode, MIX). The surface under the cumulative ranking curve (SUCRA) results demonstrated the preferable effects of various interventions on EF improvement. SUCRA values indicate that CPA performs best in improving the accuracy and reaction speed of CF, as well as the reaction speed of inhibitory control in children and adolescents. AE shows significant effects in enhancing AP in this population. Additionally, PTE excels in improving CF and inhibitory control in middle-aged and older adults. Through subgroup analysis based on age and intervention duration, we found AE exhibited a significant effect on interventions for the 0-17 age group (SMD = 0.84, 95%CI = 0.31~1.38, = 0.002) and interventions lasting 8-16 weeks showed significant improvement in EFs (SMD = 0.53, 95%CI = 0.00~1.05, = 0.048). There was also a significant difference between CPA intervention and CT (SMD = 1.12, 95%CI = 0.45~1.80, = 0.001) in children and adolescents. Additionally, PTE showed significant effects for middle-aged adults aged 17-59 (SMD = 0.93, 95%CI = 0.11~1.96, < 0.027). Conclusions: This NMA found that CPA and AE have significant benefits for CF, inhibitory control, and AP in children and adolescents. Furthermore, PTE improves EFs in adult