Effects of Aerobic Training, Resistance Training, or Both on Percentage Body Fat and Cardiometabolic Risk Markers in Obese Adolescents: The Healthy Eating Aerobic and Resistance Training in Youth Randomized Clinical Trial | Adolescent Medicine | JAMA Pediatrics | JAMA Network
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Original Investigation
November 2014

Effects of Aerobic Training, Resistance Training, or Both on Percentage Body Fat and Cardiometabolic Risk Markers in Obese Adolescents: The Healthy Eating Aerobic and Resistance Training in Youth Randomized Clinical Trial

Author Affiliations
  • 1Department of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 2Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada
  • 3Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  • 4Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
  • 5Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  • 6School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
  • 7Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
  • 8Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
  • 9Institut de Recherche de l’Hôpital Montfort, Ottawa, Ontario, Canada
  • 10Crabtree Laboratories, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
  • 11Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
  • 12Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
  • 13Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
  • 14Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
JAMA Pediatr. 2014;168(11):1006-1014. doi:10.1001/jamapediatrics.2014.1392
Abstract

Importance  Little evidence exists on which exercise modality is optimal for obese adolescents.

Objective  To determine the effects of aerobic training, resistance training, and combined training on percentage body fat in overweight and obese adolescents.

Design, Setting, and Participants  Randomized, parallel-group clinical trial at community-based exercise facilities in Ottawa (Ontario) and Gatineau (Quebec), Canada, among previously inactive postpubertal adolescents aged 14 to 18 years (Tanner stage IV or V) with body mass index at or above the 95th percentile for age and sex or at or above the 85th percentile plus an additional diabetes mellitus or cardiovascular risk factor.

Interventions  After a 4-week run-in period, 304 participants were randomized to the following 4 groups for 22 weeks: aerobic training (n = 75), resistance training (n = 78), combined aerobic and resistance training (n = 75), or nonexercising control (n = 76). All participants received dietary counseling, with a daily energy deficit of 250 kcal.

Main Outcomes and Measures  The primary outcome was percentage body fat measured by magnetic resonance imaging at baseline and 6 months. We hypothesized that aerobic training and resistance training would each yield greater decreases than the control and that combined training would cause greater decreases than aerobic or resistance training alone.

Results  Decreases in percentage body fat were −0.3 (95% CI, −0.9 to 0.3) in the control group, −1.1 (95% CI, −1.7 to −0.5) in the aerobic training group (P = .06 vs controls), and −1.6 (95% CI, −2.2 to −1.0) in the resistance training group (P = .002 vs controls). The −1.4 (95% CI, −2.0 to −0.8) decrease in the combined training group did not differ significantly from that in the aerobic or resistance training group. Waist circumference changes were −0.2 (95% CI, −1.7 to 1.2) cm in the control group, −3.0 (95% CI, −4.4 to −1.6) cm in the aerobic group (P = .006 vs controls), −2.2 (95% CI −3.7 to −0.8) cm in the resistance training group (P = .048 vs controls), and −4.1 (95% CI, −5.5 to −2.7) cm in the combined training group. In per-protocol analyses (≥70% adherence), the combined training group had greater changes in percentage body fat (−2.4, 95% CI, −3.2 to −1.6) vs the aerobic group (−1.2; 95% CI, −2.0 to −0.5; P = .04 vs the combined group) but not the resistance group (−1.6; 95% CI, −2.5 to −0.8).

Conclusions and Relevance  Aerobic, resistance, and combined training reduced total body fat and waist circumference in obese adolescents. In more adherent participants, combined training may cause greater decreases than aerobic or resistance training alone.

Trial Registration  clinicaltrials.gov Identifier: NCT00195858

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