The benefits of swimming as a treatment for overweight children are undefined. We investigated the effects of recreational swimming on cardiometabolic risk in children/adolescents with normal and excess weight. Participants (
n = 49, 26 girls, 10.3 ± 1.8 y) were grouped as ‘eutrophic swimming’ (EU-Swim,
n = 14); ‘excess weight swimming’ (EW-Swim,
n = 20) with an ‘obese swimming’ subgroup (OB-Swim,
n = 10); and ‘excess weight sedentary’ (EW-Sed,
n = 15) with an ‘obese sedentary’ subgroup (OB-Sed,
n = 11). Swimming (50 min, twice/week, moderate-vigorous intensity) was an extra activity during the school year (6 + 3 months with a 3-month school break). Nutritional status, blood pressure (BP), physical activity, cardiorespiratory fitness, biochemical variables, autonomic modulation, endothelial function, abdominal fat, and carotid thickness were assessed at baseline, 6, and 12 months. Greater improvements (
p < 0.05) occurred in EW-Swim vs. EW-Sed in body mass index (z-BMI, −16%,
d+ 0.52), waist-to-height ratio (W/H, −8%,
d+ 0.59–0.79), physical activity (37–53%,
d+ 1.8–2.2), cardiorespiratory fitness (30–40%,
d+ 0.94–1.41), systolic BP (SBP, −6–8%,
d+ 0.88–1.17), diastolic BP (DBP, −9–10%,
d+ 0.70–0.85), leptin (−14–18%,
d+ 0.29–0.41), forearm blood flow (FBF, 26–41%,
d+ 0.53–0.64), subcutaneous fat (SAT, −6%,
d+ 0.18), and intra-abdominal fat (VAT, −16%,
d+ 0.63). OB-Swim showed improvements vs. OB-Sed in TNFα (−17%,
d+ 1.15) and adiponectin (22%,
d+ 0.40). Swimming improved fitness and cardiometabolic risk in children/adolescents with overweight/obesity. (TCTR20220216001)
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