title: 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.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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
  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.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00195858.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada2Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada3Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada4Faculties of M.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Sigal
authors.affiliation: School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada7Werklund School of Education, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Angela S
authors.initials: AS
authors.lastname: Alberga
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Goldfield
authors.affiliation: Institut de Recherche de l'Hôpital Montfort, Ottawa, Ontario, Canada.
authors.forename: Denis
authors.initials: D
authors.lastname: Prud'homme
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Stasia
authors.initials: S
authors.lastname: Hadjiyannakis
authors.affiliation: Crabtree Laboratories, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada.
authors.forename: Réjeanne
authors.initials: R
authors.lastname: Gougeon
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Penny
authors.initials: P
authors.lastname: Phillips
authors.affiliation: Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Tulloch
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Janine
authors.initials: J
authors.lastname: Malcolm
authors.affiliation: Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Doucette
authors.affiliation: Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.affiliation: Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Jinhui
authors.initials: J
authors.lastname: Ma
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada6School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Glen P
authors.initials: GP
authors.lastname: Kenny
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology*; D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D063766:Pediatric Obesity / Q000178:diet therapy / Q000628:therapy*; D055070:Resistance Training; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D008055:Lipids