title: Influence of exclusive resistance training on body composition and cardiovascular risk factors in overweight or obese children: a systematic review.
abstract: OBJECTIVE
  Since the last decade, a significant increase in the prevalence of overweight and obesity among children has been reported. Low aerobic fitness and a low compliance with endurance sports in such children are theoretical reasons to favor the use of resistance training in intervention studies, even though positive effects of resistance training on morbidity without accompanying dietary modifications are a matter of debate. In this review we summarize the studies that have shown the isolated effect of resistance training on body composition and cardiovascular risk factors in overweight and obese children.
  
  
  METHODS
  We systematically reviewed interventional studies that exclusively applied resistance training to overweight and obese 3- to 18-year-old children. Outcome measurements were body composition or cardiovascular risk factors.
  
  
  RESULTS
  Only six studies passed the inclusion criteria. All studies preferred an individually planned and supervised whole-body resistance training of moderate to submaximal intensity during treatment. The mean compliance was 84%. Four studies reported significant changes in body composition, with an increase in fat free mass and BMI, along with a decrease in fat mass. Three studies analyzed the effect of resistance training on cardiovascular risk factors, and only one study reported a significant decrease in systolic blood pressure.
  
  
  CONCLUSIONS
  An individually planned and supervised whole-body resistance training of moderate to submaximal intensity in children seems to be safe and tends to show positive effects on body composition. Similar to interventions based on endurance exercise alone or in combination with dietary modifications, the effects on cardiovascular risk factors cannot be substantiated. In consequence, we suggest to substantiate the effect of resistance training on cardiovascular risk factors in overweight and obese children in upcoming randomized controlled trials with high case numbers, applying both resistance training only and resistance training in combination with dietary intervention to get knowledge about whether resistance training alone is effectual in the treatment of overweight and obesity in youth or if a combination of resistance training and dietary interventions is actually needed.
authors.affiliation: Department of Sports Medicine, Rehabilitation and Disease Prevention, Faculty of Social Science, Media and Sports, Johannes Gutenberg-University Mainz, Germany. pdietz@uni-mainz.de
authors.forename: Pavel
authors.initials: P
authors.lastname: Dietz
authors.forename: Sascha
authors.initials: S
authors.lastname: Hoffmann
authors.forename: Ella
authors.initials: E
authors.lastname: Lachtermann
authors.forename: Perikles
authors.initials: P
authors.lastname: Simon
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D001794:Blood Pressure; D001823:Body Composition; D001825:Body Fluid Compartments / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D015444:Exercise; D006801:Humans; D009765:Obesity / Q000628:therapy*; D010349:Patient Compliance; D055070:Resistance Training; D015430:Weight Gain