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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



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.


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.


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.


Changes in SAT at L4–L5 were −16.2 cm2 in aerobic (P=0.04 vs control), −22.7 cm2 in resistance (P=0.009 vs control) and −18.7 cm2 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.


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.

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The HEARTY trial was supported by a Canadian Institutes of Health Research (CIHR) grant (MCT-71979). Dr Alberga was supported by a Doctoral Student Research Award from the Canadian Diabetes Association (held at the Human and Environmental Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa) and currently by an Eyes High Postdoctoral Fellowship at the University of Calgary. Dr Goldfield was supported by a New Investigator Award from the Canadian Institutes of Health Research for part of the trial, and subsequently by an Endowed Research Scholarship from the Children's Hospital of Eastern Ontario Volunteer Association Board. Dr Sigal is supported by a Health Senior Scholar award from Alberta Innovates-Health Solutions, and was supported by a Research Chair from the Ottawa Hospital Research Institute during part of this trial. Dr Kenny is supported by a University of Ottawa Research Chair. We gratefully thank the HEARTY participants and all HEARTY research staff who assisted with training, data collection and analysis. Trial Registration: ClinicalTrials.Gov NCT00195858.

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Alberga, A., Prud'homme, D., Kenny, G. et al. 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. Int J Obes 39, 1494–1500 (2015).

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