Effects of exercise modality on body composition and cardiovascular disease risk factors in adolescents with obesity: a randomized clinical trial.

We compared the effects of aerobic exercise, resistance exercise, and combined aerobic and resistance exercise on total, regional subcutaneous adipose tissue (SAT) and visceral AT (VAT), skeletal muscle (SM), and biomarkers of cardiovascular disease in adolescents. Adolescents with overweight/obesity ( = 118; body mass index ≥ 85th percentile; age, 12-17 years) were randomized to 1 of the following groups for 6 months (3 days/week, 180 min/week): aerobic exercise ( = 38), resistance exercise ( = 40), or combined aerobic and resistance exercise ( = 40). After accounting for age, sex, and baseline value, there was a greater ( < 0.05) reduction in body weight in the aerobic exercise group compared with the resistance exercise group and the combined groups. There were reductions ( < 0.05) in total and regional SAT within the aerobic exercise group only, and the reductions in lower-body SAT were greater ( = 0.02) than the combined group. All groups had reductions ( < 0.01) in VAT, with no group differences. There were significant increases in total and regional SM mass in the resistance exercise and combined group, and not in the aerobic exercise group. Although all exercise modalities are effective in reducing VAT, aerobic exercise is superior at reducing total and regional SAT, but inferior for increasing SM in adolescents with obesity. Despite reductions in VAT, carotid-femoral pulse wave velocity and carotid intima-media thickness did not improve with either exercise. Clinicaltrials.gov identifier: NCT01938950. Regular exercise (180 min/week) is associated with reductions in visceral fat independent of exercise modality. Resistance exercise alone and combined resistance and aerobic exercise are similarly effective in increasing SM mass.