A meta-analysis pooling data from four studies yielded a combined SMD of −0.387 (95% CI: −7.78 to 0.03; τ2 = 15.40, p = 0.052), indicating that HIT was not effective in reducing TNF-α levels in children with obesity (Figure 5A). This evidence concerns the gene TNF and obesity due to melanocortin 4 receptor deficiency.