Ronald J Sigal1, Angela S Alberga2, Gary S Goldfield3, Denis Prud'homme4, Stasia Hadjiyannakis3, Réjeanne Gougeon5, Penny Phillips6, Heather Tulloch7, Janine Malcolm6, Steve Doucette8, George A Wells9, Jinhui Ma10, Glen P Kenny11. 1. 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. 2. School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada7Werklund School of Education, University of Calgary, Calgary, Alberta, Canada. 3. Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. 4. Institut de Recherche de l'Hôpital Montfort, Ottawa, Ontario, Canada. 5. Crabtree Laboratories, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada. 6. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 7. Prevention and Rehabilitation Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. 8. Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. 9. Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. 10. Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 11. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada6School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
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 facilitiesin 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.
RCT Entities:
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.
Authors: C Álvarez; R Ramírez-Campillo; R Ramírez-Vélez; C Martínez; M Castro-Sepúlveda; A Alonso-Martínez; M Izquierdo Journal: Int J Obes (Lond) Date: 2017-07-31 Impact factor: 5.095
Authors: SoJung Lee; Ingrid Libman; Kara Hughan; Jennifer L Kuk; Jong H Jeong; Di Zhang; Silva Arslanian Journal: J Pediatr Date: 2018-12-13 Impact factor: 4.406
Authors: Yuanshu Zou; Rhonda Szczesniak; Alexis Teeters; Lee Ann E Conard; Daniel H Grossoehme Journal: Qual Life Res Date: 2018-03-21 Impact factor: 4.147
Authors: Natalie A Stephens; Hui Xie; Neil M Johannsen; Timothy S Church; Steven R Smith; Lauren M Sparks Journal: Metabolism Date: 2015-06-16 Impact factor: 8.694
Authors: Lauren B Shomaker; Lauren Gulley; Allison M Hilkin; Emma Clark; Shelly Annameier; Sangeeta Rao; Bonny Rockette-Wagner; Andrea Kriska; Kenneth P Wright; Eric Stice; Kristen J Nadeau; Megan M Kelsey Journal: Contemp Clin Trials Date: 2018-10-17 Impact factor: 2.226