Background The aim of this study was to systematically evaluate the effects of exercise on cardiovascular disease (CVD) risk factors in overweight and obese children and adolescents. Methods Two independent reviewers conducted a comprehensive search of databases, including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, and Wan Fang, covering the period from January 1, 2008, to May 19, 2025. Eligible randomised controlled trials (RCTs) were included in the meta-analysis. Sensitivi...