Effects of Exercise Intervention on Health-Related Physical Fitness and Blood Pressure in Preschool Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Antonio García-HermosoEmail author
  • Alicia M. Alonso-Martinez
  • Robinson Ramírez-Vélez
  • Mikel Izquierdo
Systematic Review



No previous systematic review has quantitatively examined the effect of physical exercise interventions on health-related physical fitness and blood pressure in children younger than 6 years old.


To evaluate the effects of exercise interventions on health-related physical fitness (i.e., physical fitness components and body composition) and blood pressure in preschoolers.


We searched four databases. Only randomized controlled trials (RCTs), evaluating the effectiveness of exercise intervention on weight-related outcomes, blood pressure, and physical fitness components in preschoolers (1–5.99 years old) were included. The effect sizes were reported as Hedges’ g using random-effects models.


A total of 19 RCTs were included. Exercise interventions favored reductions in body mass index (g = − 0.17; 95% confidence interval [CI], − 0.31 to − 0.03), waist circumference (g = − 0.25; 95% CI − 0.47 to − 0.03), and body fat percentage (g = − 0.31; 95% CI − 0.60 to − 0.23); as well as improvement in cardiorespiratory fitness (g = 0.25; 95% CI 0.08–0.42), muscular strength (g = 0.25; 95% CI 0.09–0.40), and speed–agility (g = − 0.51; 95% CI − 0.78 to − 0.24). Blood pressure was not reduced. The subgroup analysis revealed that physical exercise alone favored larger reductions in body mass index and waist circumference compared with physical exercise combined with another intervention. Also, changes in cardiorespiratory fitness, lower-body muscular strength and speed–agility were associated with larger decreases in body composition.


Physical exercise whether combined or not with additional intervention has a small effect on both body weight and physical fitness in preschoolers. Also, it seems that interventions to prevent obesity should be directed towards improving physical fitness of preschoolers.



The authors wish to thank C. A. C. Coloma, for revision of the English text.

Compliance with Ethical Standards


No sources of funding were used to assist in the preparation of this article. Antonio Garcia-Hermoso is a Miguel Servet Fellow (Instituto de Salud Carlos III-CP18/0150).

Conflicts of interest

Antonio Garcia-Hermoso, Alicia M. Alonso-Martinez, Robinson Ramírez-Vélez and Mikel Izquierdo declare that they have no conflicts of interest relevant to the content of this review.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Navarrabiomed, Complejo Hospitalario de Navarra (CHN)Universidad Pública de Navarra (UPNA), IdiSNAPamplonaSpain
  2. 2.Laboratorio de Ciencias de la Actividad Física, el Deporte y la SaludUniversidad de Santiago de Chile, USACHSantiagoChile
  3. 3.Department of Health Sciences, Public University of Navarra, CIBER of Frailty and Healthy Aging (CIBERFES)Instituto de Salud Carlos IIIPamplonaSpain

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