OBJECTIVES: 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. PARTICIPANTS: 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 to 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 250kcal. 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 -16.2cm2 in aerobic (p = 0.04 versus control), -22.7cm2 in resistance (p = 0.009 versus control) and -18.7cm2 in combined (p = 0.02 versus control). Combined training reduced ApoB levels from 0.81 +/- 0.02 to 0.78 +/- 0.02g/l (p = 0.04 versus control) and ApoB/ApoA-1 ratio from 0.67 +/- 0.02 to 0.64 +/- 0.02 (p = 0.02 versus control and p = 0.04 versus 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.

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