Hens W, et al. - This systematic review aimed to summarize the evidence for the use of diet and/or exercise on ectopic adiposity in children and adolescents with obesity. In this meta-analysis, the researchers demonstrated that among youth with obesity, diet and/or exercise was effective to reduce hepatic adiposity.

• The researchers performed a systematic literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement.
• They searched clinical trials that evaluated ectopic fat deposition and included study arms with diet and/or exercise in PubMed, PEDro and the Cochrane database.

• The researchers described hepatic fat content and intramyocellular lipid content in 9 studies and 3 studies, respectively.
• Most studies included teenagers.
• Study duration ranged between 3 and 12 months without follow-up.
• The standardized mean difference of the change in hepatic adiposity (totalling 320 subjects) was -0.54 Hedges' g using random-effects weights (95% confidence interval: -0.69 to -0.38 with p < 0.0001).
• It was seen that diet and/or exercise resulted in an absolute reduction of intrahepatic lipid with 2%, which accorded with a relative reduction up to 70%, by re-expressing this effect size.
• No significant changes in intramyocellular lipid were observed although there were significant ameliorations of insulin sensitivity.