The impact of different types of exercise on executive functions in overweight/obese individuals: A Systematic Review and Network Meta-Analysis
Authors: Guo Jia , Liu Jingqi , Liu Guochun , Zheng Man , Li Jianyu , Cao Chunmei 
Published: June 2024

(1)
Objective:
To compare the effects of different exercise training for obese or overweight individuals’ executive function (EF) ; (2) Methods: Randomized controlled trials (RCTs) of exercise intervention in overweight or obese populations were included from PubMed, Web of Science, SPORTDiscus, MEDLINE, and CINAHL. The included articles in English should be published from January 2000 to February 2024. The Jadad scale with a total score of 7 was used to assess the quality of the literature. Using the random-effects model within the framework of frequency statistics in Stata 17.0 software for data synthesis; (3) Results: This NMA included 20 studies published between 2010 and 2023, encompassing a total of 1161 overweight or obese participants. The outcomes were inhibitory control, working memory(WM), cognitive flexibility(CF), and academic performance. 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), AE combines RT (mix mode, MIX). The surface under the cumulative ranking curve(SUCRA) results demonstrated the preferable effects of various interventions on EF improvement. Specifically, for CF accuracy, CPA (SUCRA = 99.6%) and PTE (SUCRA = 75.4%) were notable. For CF reaction time, CPA (SUCRA = 96.6%) and PTE (SUCRA = 78.2%) ranked highly. In terms of inhibitory accuracy, there were HIIT (SUCRA = 62.8%), RT (SUCRA = 57.7%), and PTE (SUCRA = 56.5%). As for inhibitory reaction time, there were CPA (SUCRA = 97.3%) and RT (SUCRA = 76.8%). Regarding WM accuracy, RT (SUCRA = 93.0%) ranked highly. For WM reaction time, CT (SUCRA = 62.1%) and AE (SUCRA = 60.1%) ranked highly. In terms of AP, AE (SUCRA = 92.9%) ranked highly. 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 = 0.60,95%CI = 0.19 ~ 1.01, P = 0.005), while in the intervention duration subgroup analysis, interventions lasting 8–16 weeks showed significant improvement in EFs (SMD = 0.53,95%CI = 0.00 ~ 1.05, P = 0.048). And there was a significant difference between one-time CPA intervention and CT (SMD = 1.12,95%CI = 0.45 ~ 1.80, P = 0.001). Additionally, PTE showed significant effects for children and adolescents aged 0–17 (SMD = 1.47,95%CI = 0.98 ~ 1.96, P < 0.001); (4) Conclusions: This research focuses on the impact of exercise on multiple outcome indicators of EFs in different obese or overweight populations. Due to the demand of children and adolescents for AP, AE is recommended. Considering the physiological characteristics of the elderly, PTE is most suitable for them and significantly improves their EFs. Lastly, considering the benefits of CF and inhibitory control in improving both health-related decision-making and adaptation to complex environments, CPA and PTE are identified as suitable intervention strategies.