Top

Sports Medicine

Published in:

01-09-2013 | Systematic Review

What is the Effect of Resistance Training on the Strength, Body Composition and Psychosocial Status of Overweight and Obese Children and Adolescents? A Systematic Review and Meta-Analysis

Authors: Natasha Schranz, Grant Tomkinson, Tim Olds

Published in: Sports Medicine | Issue 9/2013

Abstract

Background

Overweight and obese children and adolescents face many physical and psychosocial hardships. Resistance training is a modality of exercise which allows this at-risk group to excel and therefore has the potential to positively affect not only their physical but also psychosocial health.

Objective

To systematically review and meta-analyse the peer-reviewed literature to determine the effect of resistance training on the strength, body composition and psychosocial status of overweight and/or obese children and/or adolescents.

Data Sources

Relevant databases (MEDLINE, Embase, Scopus, Web of Science, SPORTDiscus, CINAHL, PsycINFO, Cochrane library, ProQuest) were searched up to and including 30 January 2013.

Study Selection

Included studies (n = 40, from the 2,247 identified) were randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs) and uncontrolled trials (UCTs) which had run an exercise intervention, with a resistance training component, for overweight and/or obese children and/or adolescents, and which had examined the effect of resistance training on either strength, body composition or psychosocial outcomes.

Study Appraisal and Synthesis Methods

Studies were initially critically appraised for risk of bias by the lead author, following which both co-authors critically appraised five randomly selected studies to assess reliability.

Results

Randomised controlled trials and NRCTs were analysed separately from UCTs. To determine the overall intervention effect for each outcome variable for each study design group, standardised mean differences were calculated with each individual study/data set weighted by the inverse of the pooled variance. The overall intervention effect reported for RCTs and NRCTs was relative to the control group whereas the effect reported for UCTs shows an overall post-intervention effect. Subgroup analyses, which determined whether the overall intervention effect was influenced by intervention type, training volume, age, sex, risk of bias or study design (for RCT/NRCT group only), were run using the same summary measure. Typically, resistance training had very small to small effects on body composition and moderate to large effects on strength in favour of the intervention. However, the magnitude and direction of the effect of resistance training on psychological outcomes are still unclear given the limited number of studies which looked at psychosocial outcomes and the inconclusive results shown by this review. Uncontrolled trials typically showed larger intervention effects than RCTs and NRCTs; however, these results may be greatly influenced by maturational changes rather than the intervention itself.

Limitations

The included studies employed a number of different exercise intervention types (e.g. resistance training, resistance plus aerobic training etc.) that ranged from 6 to 52 weeks in duration. Studies also employed a number of different methodologies to assess similar outcome measures (e.g. dual energy X-ray absorptiometry versus skinfolds to assess body composition; one-repetition maximum testing versus hand grip strength to assess strength). However, by completing subgroup analyses and using a standardised summary measure these limitations have been accounted for.

Conclusion

While the effect of resistance training on the body composition and strength of overweight and obese children and adolescents is clear, given the paucity of conclusive data more studies are needed to fully understand the effect of resistance training on the psychosocial status of this population.

Olds T, Tomkinson G, Ferrar K, et al. Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008. Int J Obes. 2010;34(1):57–66.CrossRef

Lobstein T, Baur L, Uauy R. Obesity in children and young people: a crisis in public health. Obes Rev. 2004;5:4–85.PubMedCrossRef

Goran M, Ball G, Cruz M. Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab. 2003;88(4):1417–27.PubMedCrossRef

Eremis S, Cetin N, Tamar M, et al. Is obesity a risk factor for psychopathology among adolescents? Pediatr Int. 2004;46(3):296–301.CrossRef

McGuigan M, Tatasciore M, Newton R, et al. Eight weeks of resistance training can significantly alter body composition in children who are overweight or obese. J Strength Cond Res. 2009;23(1):80–5.PubMedCrossRef

Lau P, Kong Z, Choi C, et al. Effects of short-term resistance training on serum leptin levels in obese adolescents. J Exerc Sci Fit. 2010;8(1):54–60.CrossRef

Naylor L, Watts K, Sharpe J, et al. Resistance training and diastolic myocardial tissue velocities in obese children. Med Sci Sports Exerc. 2008;40(12):2027–32.PubMedCrossRef

Shaibi G, Cruz M, Ball G, et al. Effects of resistance training on insulin sensitivity in overweight Latino adolescent males. Med Sci Sports Exerc. 2006;38(7):1208–15.PubMedCrossRef

Treuth M, Hunter G, Figueroa-Colon R, et al. Effects of strength training on intra-abdominal adipose tissue in obese prepubertal girls. Med Sci Sports Exerc. 1998;30(12):1738–43.PubMedCrossRef

10.

Treuth M, Hunter G, Pichon C, et al. Fitness and energy expenditure after strength training in obese prepubertal girls. Med Sci Sports Exerc. 1998;30(7):1130–6.PubMedCrossRef

11.

van der Heijden G, Wang Z, Chu Z, et al. Strength exercise improves muscle mass and hepatic insulin sensitivity in obese youth. Med Sci Sports Exerc. 2010;42(11):1973–80.CrossRef

12.

Kim Y. Role of regular exercise in the treatment of abdominal obesity in adolescent boys. Pennsylvania: University of Pittsburgh; 2010.

13.

Lee S, Bacha F, Hannon T, et al. Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys: a randomized, controlled trial. Diabetes. 2012;61(11):2787–95.PubMedCrossRef

14.

Dove J. Effects of a multicomponent school-based intervention on health markers, body composition, physical fitness, and psychological measures in overweight and obese adolescent females. Waco: Baylor University; 2008.

15.

Shalitin S, Ashkenazi-Hoffnung L, Yackobovitch-Gavan M, et al. Effects of a twelve-week randomized intervention of exercise and/or diet on weight loss and weight maintenance, and other metabolic parameters in obese preadolescent children. Horm Res. 2009;72(5):287–301.PubMedCrossRef

16.

Sung R, Yu C, Chang S, et al. Effects of dietary intervention and strength training on blood lipid level in obese children. Arch Dis Child. 2002;86(6):407–10.PubMedCrossRef

17.

Wilson AJ, Jung ME, Cramp A, et al. Effects of a group-based exercise and self-regulatory intervention on obese adolescents’ physical activity, social cognitions, body composition and strength: a randomized feasibility study. J Health Psychol. 2012;17(8):1223–37.PubMedCrossRef

18.

Yu C, Sung R, Hau K, et al. The effect of diet and strength training on obese children’s physical self-concept. J Sports Med Phys Fit. 2008;48(1):76–82.

19.

Yu C, Sung R, So R, et al. Effects of strength training on body composition and bone mineral content in children who are obese. J Strength Cond Res. 2005;19(3):667–72.PubMed

20.

Alberga AS, Sigal RJ, Kenny GP. A review of resistance exercise training in obese adolescents. Phys Sportsmed. 2011;39(2):50–63.PubMedCrossRef

21.

Behringer M, Vom Heede A, Yue Z, et al. Effects of resistance training in children and adolescents: a meta-analysis. Pediatrics. 2010;126(5):e1199–210.PubMedCrossRef

22.

Benson AC, Torode ME, Fiatarone Singh MA. Effects of resistance training on metabolic fitness in children and adolescents: a systematic review. Obes Rev. 2008;9(1):43–66.PubMed

23.

Komorowski J. Effects of resistance exercise training on body composition and metabolic dysregulation in obese prepubertal children. Wychowanie Fizyczne i Sport. 2006;50(1):5–12.

24.

Watts K, Jones TW, Davies E, et al. Exercise training in obese children and adolescents: current concepts. Sports Med. 2005;35(5):375–92.PubMedCrossRef

25.

Shavelson R, Hubner J, Stanton G. Self-concept: validation of construct interpretations. Rev Educ Res. 1976;46(3):407–41.CrossRef

26.

Fox K. The effects of exercise on self-perceptions and self-esteem. In: Biddle S, Fox K, Boutcher S, editors. Physical activity and psychological well-being. London: Routledge; 2000.

27.

Sonstroem R. Exercise and self-esteem. Exercise Sports Sci Rev. 1984;12(1):123–65.

28.

de Mello M, de Piano A, Carnier J, et al. Long-term effects of aerobic plus resistance training on the metabolic syndrome and adiponectinemia in obese adolescents. J Clin Hypertens. 2011;13(5):343–50.CrossRef

29.

Lewis L, Williams M, Olds T. Short-term effects on the mechanism of intervention and physiological outcomes but insufficient evidence of clinical benefits for breathing control: a systematic review. Aust J Physiother. 2007;53(4):219–27.PubMedCrossRef

30.

Egger M, Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.PubMedCrossRef

31.

Rosenthal R. The “File Drawer Problem” and tolerance for null results. Psychol Bull. 1979;86(3):638–41.CrossRef

32.

Davis J, Gyllenhammer L, Vanni A, et al. Start-up circuit training program reduces metabolic risk in Latino adolescents. Med Sci Sports Exer. 2011;43(11):2195–203.CrossRef

33.

Davis J, Kelly L, Lane C, et al. Randomized control trial to improve adiposity and insulin resistance in overweight Latino adolescents. Obesity. 2009;17(8):1542–8.PubMedCrossRef

34.

Davis J, Tung A, Chak S, et al. Aerobic and strength training reduces adiposity in overweight Latina adolescents. Med Sci Sports Exer. 2009;41(7):1494–503.CrossRef

35.

Kim H, Lee S, Kim T, et al. Effects of exercise-induced weight loss on acylated and unacylated ghrelin in overweight children. Clin Endocrinol. 2008;68(3):416–22.

36.

Wong P, Chia M, Tsou I, et al. Effects of a 12-week exercise training programme on aerobic fitness, body composition, blood lipids and C-reactive protein in adolescents with obesity. Ann Acad Med Singap. 2008;37(4):286–93.PubMed

37.

Woo K, Chook P, Yu C, et al. Effects of diet and exercise on obesity-related vascular dysfunction in children. Circulation. 2004;109(16):1981–6.PubMedCrossRef

38.

de Piano A, Carnier J, Corgosinho F, et al. Long-term effects of aerobic plus resistance training on the adipokines and neuropeptides in nonalcoholic fatty liver disease obese adolescents. Eur J Gastroenterol Hepatol. 2012;24(11):1313–24.PubMed

39.

Lison JF, Real-Montes JM, Torro I, et al. Exercise intervention in childhood obesity: a randomized controlled trial comparing hospital- versus home-based groups. Acad Pediatr. 2012;12(4):319–25.PubMed

40.

Park JH, Miyashita M, Kwon YC, et al. A 12-week after-school physical activity programme improves endothelial cell function in overweight and obese children: a randomised controlled study. BMC Pediatr. 2012;12:111.PubMedCrossRef

41.

Suh S, Jeong IK, Kim MY, et al. Effects of resistance training and aerobic exercise on insulin sensitivity in overweight Korean adolescents: a controlled randomized trial. Diabetes Metab J. 2011;35(4):418–26.PubMedCrossRef

42.

Lee Y, Song Y, Kim H, et al. The effects of an exercise program on anthropometric, metabolic, and cardiovascular parameters in obese children. Korean Circ J. 2010;40(4):179–84.PubMedCrossRef

43.

Farris JW, Taylor L, Williamson M, et al. A 12-week interdisciplinary intervention program for children who are obese. Cardiopulm Phys Ther J. 2011;22(4):12–20.PubMed

44.

Hardy OT, Wiecha J, Kim A, et al. Effects of a multicomponent wellness intervention on dyslipidemia among overweight adolescents. J Pediatr Endocrinol Metab. 2012;25(1–2):79–82.PubMed

45.

Rynders C, Weltman A, Delgiorno C, et al. Lifestyle intervention improves fitness independent of metformin in obese adolescents. Med Sci Sports Exer. 2012;44(5):786–92.CrossRef

46.

Bell L, Watts K, Siafarikas A, et al. Exercise alone reduces insulin resistance in obese children independently of changes in body composition. J Clin Endocrinol Metab. 2007;92(11):4230–5.PubMedCrossRef

47.

Evans R, Franco R, Stern M, et al. Evaluation of a 6-month multi-disciplinary healthy weight management program targeting urban, overweight adolescents: effects on physical fitness, physical activity, and blood lipid profiles. Int J Pediatr Obes. 2009;4(3):130–3.PubMedCrossRef

48.

Foschini D, Arajo R, Bacurau R, et al. Treatment of obese adolescents: the influence of periodization models and ACE genotype. Obesity. 2010;18(4):766–72.PubMedCrossRef

49.

Lazzer S, Boirie Y, Montaurier C, et al. A weight reduction program preserves fat-free mass but not metabolic rate in obese adolescents. Obes Res. 2004;12(2):233–40.PubMedCrossRef

50.

Lazzer S, Boirie Y, Poissonnier C, et al. Longitudinal changes in activity patterns, physical capacities, energy expenditure, and body composition in severely obese adolescents during a multidisciplinary weight-reduction program. Int J Obes. 2005;29(1):37–46.CrossRef

51.

Lazzer S, Vermorel M, Montaurier C, et al. Changes in adipocyte hormones and lipid oxidation associated with weight loss and regain in severely obese adolescents. Int J Obes. 2005;29(10):1184–91.CrossRef

52.

Sothern M, Almen T, Schumacher H, et al. A multidisciplinary approach to the treatment of childhood obesity. Del Med J. 1999;71:255–61.PubMed

53.

Sothern M, Loftin J, Udall J, et al. Inclusion of resistance exercise in a multidisciplinary outpatient treatment program for preadolescent obese children. South Med J. 1999;92(6):585–92.PubMedCrossRef

54.

Sothern M, Udall J, Suskind R, et al. Weight loss and growth velocity in obese children after very low calorie diet, exercise, and behavior modification. Acta Paediatr. 2000;89(9):1036–43.PubMedCrossRef

55.

Wickham E, Stern M, Evans R, et al. Prevalence of the metabolic syndrome among obese adolescents enrolled in a multidisciplinary weight management program: clinical correlates and response to treatment. Metab Syndr Relat Disord. 2009;7(3):179–86.PubMedCrossRef

56.

Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New Jersey: Erlbaum; 1988.

57.

Elloumi M, Ben Ounis O, Makni E, et al. Effect of individualized weight-loss programmes on adiponectin, leptin and resistin levels in obese adolescent boys. Acta Paediatr. 2009;98(9):1487–93.PubMedCrossRef

58.

Tjonna A, Stolen T, Bye A, et al. Aerobic interval training reduces cardiovascular risk factors more than a multitreatment approach in overweight adolescents. Clini Sci. 2009;116:317–26.CrossRef

59.

Daley A, Copeland R, Wright N, et al. Exercise therapy as a treatment for psychopathologic conditions in obese and morbidly obese adolescents: a randomized controlled trial. Pediatrics. 2006;118(5):2126–35.PubMedCrossRef

60.

Kim E, Im J, Kim K, et al. Improved insulin sensitivity and adiponectin level after exercise training in obese Korean youth. Obesity. 2007;15(12):3023–30.PubMedCrossRef

61.

Nassis G, Papantakoua K, Skenderia K, et al. Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls. Metabolism. 2005;54(11):1472–9.PubMedCrossRef

62.

Stella S, Vilar A, Lacroix C, et al. Effects of type of physical exercise and leisure activities on the depression scores of obese Brazilian adolescent girls. Braz J Med Biol Res. 2005;38(11):1683–9.PubMedCrossRef

63.

van der Heijden G, Wang Z, Chu Z, et al. A 12-week aerobic exercise program reduces hepatic fat accumulation and insulin resistance in obese, Hispanic adolescents. Obesity. 2010;18(2):384–90.PubMedCrossRef

64.

LeMura LM, Maziekas MT. Factors that alter body fat, body mass, and fat-free mass in pediatric obesity. Med Sci Sports Exer. 2002;34(3):487–96.CrossRef

65.

Maziekas MT, LeMura LM, Stoddard NM, et al. Follow up exercise studies in paediatric obesity: implications for long term effectiveness. Br J Sports Med. 2003;37(5):425–9.PubMedCrossRef

66.

Centers for Disease Control and Prevention; Department of Health and Human Services. Resource guide for nutrition and physical activity interventions to prevent obesity and other chronic diseases. 2000. http://www.cdc/gov/nccdphp/dnpa/obesity/state_programs/index.htm.

67.

Committee on Nutrition and Committee on Child Health and Statistics. Guideline of diagnosis and treatment in childhood obesity. J Korean Pediatr Soc. 1999;42:1338–45.

68.

Cole T, Bellizzi M, Flegal K, et al. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.PubMedCrossRef

69.

The Committee for the Development of Growth Standard for Korean Children and Adolescents: 2007 Korean children and adolescents growth standard (commentary for the development of 2007 growth chart). In: The Committee for the Development of Growth Standard for Korean Children and Adolescents.

70.

Leung S, Lau J, Tse L. Weight-for-age and weight-for-height references for Hong Kong children from birth to 18 years. J Paediatr Child Health. 1996;32:103–9.PubMedCrossRef

71.

Hamill P, Drizd T, Johnson C, et al. Physical growth: national center for health statistics percentiles. Am J Clin Nutr. 1979;32:607–29.PubMed

72.

Arkansas Center for Health Improvement (ACHI). Year five assessment of childhood and adolescent obesity in Arkansas Little Rock. Arkansas, ACHI; September 2008.

73.

Rolland-Cachera M, Cole T, Sempe M, et al. Body mass index variations: centiles from birth to 87 years. Eur J Clin Nutr. 1991;45:13–21.PubMed

74.

Freedman D, Ogden C, Berenson GS, et al. Body mass index and body fatness in childhood. J Clin Nutr Metab Care. 2005;8:618–23.CrossRef

75.

Kuczamarski R, Ogden C, Guo S, et al. CDC growth charts for the United States: methods and development. National Center Health Stat. 2000; (246).

Title: What is the Effect of Resistance Training on the Strength, Body Composition and Psychosocial Status of Overweight and Obese Children and Adolescents? A Systematic Review and Meta-Analysis
Authors: Natasha Schranz
Grant Tomkinson
Tim Olds
Publication date: 01-09-2013
Publisher: Springer International Publishing
Published in: Sports Medicine / Issue 9/2013
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI: https://doi.org/10.1007/s40279-013-0062-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

What is the Effect of Resistance Training on the Strength, Body Composition and Psychosocial Status of Overweight and Obese Children and Adolescents? A Systematic Review and Meta-Analysis

Abstract

Background

Objective

Data Sources

Study Selection

Study Appraisal and Synthesis Methods

Results

Limitations

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Data Sources

Study Selection

Study Appraisal and Synthesis Methods

Results

Limitations

Conclusion

Please log in to get access to this content

Other articles of this Issue 9/2013

Effects of Weight-Bearing Exercise on Bone Health in Girls: A Meta-Analysis

Role of Intensive Training in the Growth and Maturation of Artistic Gymnasts

Training Adaptation and Heart Rate Variability in Elite Endurance Athletes: Opening the Door to Effective Monitoring

Estimation of Maximal Oxygen Uptake via Submaximal Exercise Testing in Sports, Clinical, and Home Settings

Genes for Elite Power and Sprint Performance: ACTN3 Leads the Way

Shared Knowledge or Shared Affordances? Insights from an Ecological Dynamics Approach to Team Coordination in Sports