Improving cardiometabolic health in children and adolescents with obesity: a comparison between in-person and virtual supervised training

Objectives Remote physical activity programs have emerged as a promising strategy to improve adherence to exercise guidelines, specifically among pediatric patients with obesity. This study investigated the effectiveness of in-person vs. virtual supervised training in improving cardiometabolic health in children and adolescents with obesity. Methods Forty-six children and adolescents (BMI z-score ≥ 2SD; aged 8–16) were enrolled and assigned to either in-person or virtual supervised combined training. All participants underwent a 12-week, thrice-weekly exercise program (36 sessions total), and the metabolic syndrome (MetS) z-score was used to assess metabolic risk. Results Both virtual and in-person supervised training programs resulted in improvements in the primary outcome, the MetS z-score, within each group. The virtual group showed a mean reduction of −0.26 (p=0.014), while the in-person group showed a greater reduction of −0.44 (p<0.001). Both interventions also improved waist-to-height ratio and blood pressure (p<0.01). Only the in-person group showed significant reductions in fasting glucose (p<0.001), triglycerides (p<0.001), and BMI z-score (p=0.004). The virtual group showed a greater improvement in diastolic blood pressure (p<0.01). Conclusions Both in-person and virtual exercise programs positively impact cardiometabolic health in children with obesity. The research supports the potential of remote exercise programs to enhance adherence to physical activity.