title: Effects of aerobic and resistance training on abdominal fat, apolipoproteins and high-sensitivity C-reactive protein in adolescents with obesity: the HEARTY randomized clinical trial.
abstract: OBJECTIVE
  To investigate the effects of aerobic training, resistance training, or both on abdominal subcutaneous fat (subcutaneous adipose tissue (SAT)) (deep and superficial), visceral fat (visceral adipose tissue (VAT)), apolipoproteins A-1 and B (ApoA-1, ApoB), ApoB/ApoA-1 ratio and high-sensitivity C-reactive protein (HSCRP) in post-pubertal adolescents with obesity.
  
  
  METHODS
  After a 4-week supervised moderate-intensity exercise run-in period, 304 postpubertal adolescents with overweight (body mass index (BMI) ⩾85th percentile for age and sex+diabetes risk factor) or obesity (⩾95th BMI percentile) aged 14-18 years were randomized to four groups for 22 weeks (5 months): aerobic training, resistance training, combined training or a non-exercising control.
  
  
  METHODS
  This study used a randomized controlled design. All groups received dietary counseling designed to promote healthy eating with a maximum daily energy deficit of 250 kcal. Abdominal fat (SAT and VAT) at the level of the fourth and fifth lumbar vertebrae (L4-L5) was measured by magnetic resonance imaging and ApoA-1, ApoB and HSCRP were measured after a 12-h fast at baseline and after 6 months.
  
  
  RESULTS
  Changes in SAT at L4-L5 were -16.2 cm(2) in aerobic (P=0.04 vs control), -22.7 cm(2) in resistance (P=0.009 vs control) and -18.7 cm(2) in combined (P=0.02 vs control). Combined training reduced ApoB levels from 0.81±0.02 to 0.78±0.02 g l(-1) (P=0.04 vs control) and ApoB/ApoA-1 ratio from 0.67±0.02 to 0.64±0.02 (P=0.02 vs control and P=0.04 vs aerobic). There were no significant differences in VAT, ApoA-1 or HSCRP levels between groups.
  
  
  CONCLUSIONS
  Aerobic and resistance training and their combination decreased abdominal SAT in adolescents with obesity. Combined training caused greater improvements in ApoB/ApoA-1 ratio compared with aerobic training alone.
authors.affiliation: School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.|Werklund School of Education, University of Calgary, Calgary, Alberta, Canada.
authors.forename: A S
authors.initials: AS
authors.lastname: Alberga
authors.affiliation: School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.|Institut de recherche de l'Hôpital Montfort, Ottawa, Ontario, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Prud'homme
authors.affiliation: School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.|Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: G P
authors.initials: GP
authors.lastname: Kenny
authors.affiliation: School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.|Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: G S
authors.initials: GS
authors.lastname: Goldfield
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Hadjiyannakis
authors.affiliation: Crabtree Laboratories, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Gougeon
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Phillips
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Malcolm
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Wells
authors.affiliation: Capital District Health Authority, Halifax, Nova Scotia, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Doucette
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Ma
authors.affiliation: School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.|Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Departments of Medicine, Cardiac Sciences and Community Health Sciences and Institute of Public Health, Cumming School of Medicine, and Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: R J
authors.initials: RJ
authors.lastname: Sigal
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism; D000293:Adolescent; D001053:Apolipoproteins / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002170:Canada / Q000453:epidemiology; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology / Q000378:metabolism* / Q000517:prevention & control; D055070:Resistance Training; D016896:Treatment Outcome; D061217:Weight Reduction Programs
chemical_list: D001053:Apolipoproteins; D015415:Biomarkers; D002097:C-Reactive Protein