Diabetes Metab J.  2011 Aug;35(4):418-426. 10.4093/dmj.2011.35.4.418.

Effects of Resistance Training and Aerobic Exercise on Insulin Sensitivity in Overweight Korean Adolescents: A Controlled Randomized Trial

• Suh S
• Jeong IK
• Kim MY
• Kim YS
• Shin S
• Kim SS
• Kim JH

• KMID: 2281650
• DOI: http://doi.org/10.4093/dmj.2011.35.4.418

Abstract

BACKGROUND
Data on the impact of resistance training on insulin resistance in overweight or obese children are inconclusive.
METHODS
Thirty overweight South Korean adolescents (mean age of 13.10 years) were divided by sex, and then randomly assigned to one of three treatment groups, which were the diet only (DO), diet with aerobic exercise (AE), or diet with resistance training (RT) group. Physiologic and metabolic parameters were assessed at baseline and after 12 weeks of exercise training and diet modification.
RESULTS
Both exercise groups (aerobic and resistance) showed significant improvements in their insulin area under the curve and insulin sensitivity index values when compared to their baseline values while the DO group showed no significant changes in these variables. Age-, sex-, and body mass index (BMI)-adjusted intergroup comparison analyses showed a marked reduction in BMI and a significant reduction in muscle mass in the AE group when compared to the RT group and the DO group, respectively.
CONCLUSION
A 12-week exercise training program of either resistance or aerobic activity improved insulin sensitivity in overweight adolescents, although it failed to show superiority over a DO program. Aerobic exercise decreased both body weight and BMI, and it was noted that this group also had a significant reduction in muscle mass when compared to the DO group.

Keyword

Adolescent; Aerobic exercise; Insulin sensitivity; Resistance training

MeSH Terms

Adolescent
Body Mass Index
Body Weight
Child
Diet
Exercise
Humans
Insulin
Insulin Resistance
Muscles
Overweight
Resistance Training
Insulin

Figure

• 

  Fig. 1 Individual changes in insulin area under the curve (AUC) of each group. DO, diet only; AE, diet with aerobic exercise; RT, diet with resistance training.

Reference

1. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. JAMA. 2001. 286:1195–1200.

2. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003. 289:76–79.

3. Janssen I, Katzmarzyk PT, Boyce WF, Vereecken C, Mulvihill C, Roberts C, Currie C, Pickett W. Health Behaviour in School-Aged Children Obesity Working Group. Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns. Obes Rev. 2005. 6:123–132.

4. Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F, Silink M. Consensus Workshop Group. Type 2 diabetes in the young: the evolving epidemic--the International Diabetes Federation consensus workshop. Diabetes Care. 2004. 27:1798–1811.

5. Ehtisham S, Barrett TG, Shaw NJ. Type 2 diabetes mellitus in UK children: an emerging problem. Diabet Med. 2000. 17:867–871.

6. McMahon SK, Haynes A, Ratnam N, Grant MT, Carne CL, Jones TW, Davis EA. Increase in type 2 diabetes in children and adolescents in Western Australia. Med J Aust. 2004. 180:459–461.

7. Goran MI, Ball GD, Cruz ML. Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab. 2003. 88:1417–1427.

8. Despres JP, Lemieux S, Lamarche B, Prud'homme D, Moorjani S, Brun LD, Gagne C, Lupien PJ. The insulin resistance-dyslipidemic syndrome: contribution of visceral obesity and therapeutic implications. Int J Obes Relat Metab Disord. 1995. 19:Suppl 1. S76–S86.

9. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988. 37:1595–1607.

10. Hollmann M, Runnebaum B, Gerhard I. Impact of waist-hip-ratio and body-mass-index on hormonal and metabolic parameters in young, obese women. Int J Obes Relat Metab Disord. 1997. 21:476–483.

11. Csabi G, Torok K, Jeges S, Molnar D. Presence of metabolic cardiovascular syndrome in obese children. Eur J Pediatr. 2000. 159:91–94.

12. Ronnemaa T, Knip M, Lautala P, Viikari J, Uhari M, Leino A, Kaprio EA, Salo MK, Dahl M, Nuutinen EM. Serum insulin and other cardiovascular risk indicators in children, adolescents and young adults. Ann Med. 1991. 23:67–72.

13. Weiss R, Dufour S, Taksali SE, Tamborlane WV, Petersen KF, Bonadonna RC, Boselli L, Barbetta G, Allen K, Rife F, Savoye M, Dziura J, Sherwin R, Shulman GI, Caprio S. Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning. Lancet. 2003. 362:951–957.

14. Arslanian S, Suprasongsin C. Insulin sensitivity, lipids, and body composition in childhood: is "syndrome X" present? J Clin Endocrinol Metab. 1996. 81:1058–1062.

15. Poehlman ET, Dvorak RV, DeNino WF, Brochu M, Ades PA. Effects of resistance training and endurance training on insulin sensitivity in nonobese, young women: a controlled randomized trial. J Clin Endocrinol Metab. 2000. 85:2463–2468.

16. DeFronzo RA, Sherwin RS, Kraemer N. Effect of physical training on insulin action in obesity. Diabetes. 1987. 36:1379–1385.

17. Henriksson J. Influence of exercise on insulin sensitivity. J Cardiovasc Risk. 1995. 2:303–309.

18. Buemann B, Tremblay A. Effects of exercise training on abdominal obesity and related metabolic complications. Sports Med. 1996. 21:191–212.

19. Perseghin G, Price TB, Petersen KF, Roden M, Cline GW, Gerow K, Rothman DL, Shulman GI. Increased glucose transport-phosphorylation and muscle glycogen synthesis after exercise training in insulin-resistant subjects. N Engl J Med. 1996. 335:1357–1362.

20. Cauza E, Hanusch-Enserer U, Strasser B, Ludvik B, Metz-Schimmerl S, Pacini G, Wagner O, Georg P, Prager R, Kostner K, Dunky A, Haber P. The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus. Arch Phys Med Rehabil. 2005. 86:1527–1533.

21. Holloszy JO, Narahara HT. Studies of tissue permeability. X. Changes in permeability to 3-methylglucose associated with contraction of isolated frog muscle. J Biol Chem. 1965. 240:3493–3500.

22. Winett RA, Carpinelli RN. Potential health-related benefits of resistance training. Prev Med. 2001. 33:503–513.

23. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B. American College of Sports Medicine. American Diabetes Association. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010. 33:e147–e167.

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

25. Kim Y, Lee S. Physical activity and abdominal obesity in youth. Appl Physiol Nutr Metab. 2009. 34:571–581.

26. Korea Centers for Disease Control and Prevention TKPS, 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). Government report online [in Korean]. Available from: http://www.cdc.go.kr/kcdchome/jsp/home/common/brd/COMMBRD0200Detail.jsp?menuid=100049&boardid=1012&pageNum=0&sub=0&boardseq=20915. updated 2008 Aug 21.

27. Goodpaster BH, Thaete FL, Kelley DE. Thigh adipose tissue distribution is associated with insulin resistance in obesity and in type 2 diabetes mellitus. Am J Clin Nutr. 2000. 71:885–892.

28. Ryo M, Maeda K, Onda T, Katashima M, Okumiya A, Nishida M, Yamaguchi T, Funahashi T, Matsuzawa Y, Nakamura T, Shimomura I. A new simple method for the measurement of visceral fat accumulation by bioelectrical impedance. Diabetes Care. 2005. 28:451–453.

29. Stumvoll M, Mitrakou A, Pimenta W, Jenssen T, Yki-Jarvinen H, Van Haeften T, Renn W, Gerich J. Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity. Diabetes Care. 2000. 23:295–301.

30. Martin SB, Morrow JR Jr, Jackson AW, Dunn AL. Variables related to meeting the CDC/ACSM physical activity guidelines. Med Sci Sports Exerc. 2000. 32:2087–2092.

31. Kuramoto AK, Payne VG. Predicting muscular strength in women: a preliminary study. Res Q Exerc Sport. 1995. 66:168–172.

32. Watts K, Jones TW, Davis EA, Green D. Exercise training in obese children and adolescents: current concepts. Sports Med. 2005. 35:375–392.

33. Bar-Or O, Foreyt J, Bouchard C, Brownell KD, Dietz WH, Ravussin E, Salbe AD, Schwenger S, St Jeor S, Torun B. Physical activity, genetic, and nutritional considerations in childhood weight management. Med Sci Sports Exerc. 1998. 30:2–10.

34. Tremblay A, Despres JP, Bouchard C. The effects of exercise-training on energy balance and adipose tissue morphology and metabolism. Sports Med. 1985. 2:223–233.

35. Goran MI, Poehlman ET. Endurance training does not enhance total energy expenditure in healthy elderly persons. Am J Physiol. 1992. 263(5 Pt 1):E950–E957.

36. Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab. 2004. 89:108–113.

37. Bell LM, Watts K, Siafarikas A, Thompson A, Ratnam N, Bulsara M, Finn J, O'Driscoll G, Green DJ, Jones TW, Davis EA. Exercise alone reduces insulin resistance in obese children independently of changes in body composition. J Clin Endocrinol Metab. 2007. 92:4230–4235.

38. Burt Solorzano CM, McCartney CR. Obesity and the pubertal transition in girls and boys. Reproduction. 2010. 140:399–410.

39. Laakso M. How good a marker is insulin level for insulin resistance? Am J Epidemiol. 1993. 137:959–965.

40. Mikines KJ, Sonne B, Farrell PA, Tronier B, Galbo H. Effect of physical exercise on sensitivity and responsiveness to insulin in humans. Am J Physiol. 1988. 254(3 Pt 1):E248–E259.