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Combined Aerobic and Resistance Training Improves Metabolic Markers in Overweight AdolescentsCombined aerobic and resistance training helps adolescents with obesity

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Key Takeaway
Combined aerobic and resistance training significantly improves fasting insulin and blood pressure in overweight adolescents.

This meta-analysis evaluated the impact of combined aerobic and resistance training (CART) compared to non-exercise controls and isolated aerobic exercise on metabolic profiles in adolescents with overweight or obesity. The analysis focused on key markers including fasting insulin, HOMA-IR, adiponectin levels, and blood pressure dynamics.

Results indicated that CART led to a significant reduction in fasting insulin levels compared to control groups. Furthermore, CART demonstrated superior improvements in insulin sensitivity (HOMA-IR) and adiponectin levels when compared directly against aerobic exercise alone. These findings suggest that concurrent training modalities may offer synergistic benefits for metabolic health.

Regarding cardiovascular markers, participants in the CART group showed notable reductions in both systolic and diastolic blood pressure compared to non-exercise controls. However, no significant changes were observed in fasting glucose or lipid profiles across any study groups.

While the results are promising, clinicians should note that several indicators were characterized by low quality of evidence due to high heterogeneity and lack of blinding. Nevertheless, CART provides a statistically significant intervention for improving insulin sensitivity and blood pressure in this specific pediatric population.

How this fits prior evidence

This meta-analysis extends prior findings regarding exercise interventions for obesity by specifically addressing the adolescent population. While previous evidence suggested that exercise may improve adiposity and physical function in older adults with sarcopenic obesity, this study provides specific data on metabolic markers like fasting insulin and blood pressure in adolescents. It also supports the inclusion of resistance training as a component of lifestyle interventions to manage weight and metabolic health.

Managing health for children and teenagers who are overweight or obese involves more than just weight loss. It is about managing internal markers like insulin and blood pressure that impact long-term health. A review of 12 trials looked at how combining aerobic exercise, like running, with resistance training, like lifting weights, affects these markers compared to doing only cardio or no exercise at all.

The data showed that the combined approach led to a significant drop in fasting insulin levels for these young people. It also showed a tendency toward lower blood pressure and higher adiponectin, which is a hormone that helps regulate metabolism. While some results were consistent, others like cholesterol levels did not show much change across the groups.

It is important to keep these findings in perspective. Because the studies varied so much in how they were designed and many had low-quality evidence for certain markers, we cannot say exactly how much of an impact this will have for every child. These results suggest a promising path for exercise programs, but you should always talk to a doctor to create a safe plan.

What this means for you:
Combining cardio and strength training can improve insulin levels and blood pressure in overweight adolescents.

Common questions

What are the benefits of combining cardio and strength training?

Combining aerobic and resistance training (CART) showed significant improvements in fasting insulin levels compared to no exercise. It also showed a tendency toward lower systolic and diastolic blood pressure, as well as higher adiponectin levels. These results were specifically observed in adolescents who are overweight or have obesity.

Is this type of exercise safe for kids with obesity?

The study did not report any specific adverse events or safety concerns regarding the combined training program. However, because the evidence quality was low to moderate for several markers, you should always consult a healthcare professional before starting a new exercise routine for a child.

Does this type of exercise improve cholesterol levels?

The study found no notable changes in total cholesterol or triglycerides across any of the groups. Because the evidence for these specific markers was very low quality, the results do not confirm an impact on cholesterol.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
Background and objectiveImplementing scientific exercise interventions during childhood and adolescence holds long-term value for vascular protection. This study aimed to systematically evaluate the actual effects of combined aerobic and resistance training (CART) on glucose metabolism parameters, lipid profiles, and blood pressure dynamics in adolescents with overweight or obesity.MethodsElectronic databases including PubMed, Web of Science, Embase, The Cochrane Library, and Scopus were searched from inception up to May 13, 2026, to collect randomized controlled trials (RCTs) investigating CART interventions in adolescents with overweight or obesity. Data analysis was performed using R software. Mean difference (MD) and 95% confidence intervals (CI) were uniformly employed as effect measures, with change-from-baseline values entered into the models. Hierarchical subgroup analyses based on control group type were conducted utilizing the Hartung-Knapp-Sidik-Jonkman (HKSJ) random-effects model, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsA total of 12 RCTs were included. Regarding glucose metabolism, fasting insulin showed a significant reduction in the CART vs. non-exercise control (CON) subgroup (MD = −17.90 μU/mL, 95% CI: −26.04 to −9.76, P < 0.0001), and also demonstrated a notable tendency toward improvement in the CART vs. aerobic exercise (AE) subgroup (MD = −2.70 μU/mL, 95% CI: −4.61 to −0.79, P = 0.01), with a statistically significant difference observed between the two subgroups (P = 0.0004). The homeostatic model assessment of insulin resistance (HOMA-IR) demonstrated a tendency toward improvement in the CART vs. AE subgroup (MD = −0.57, 95% CI: −1.01 to −0.12, P = 0.01). Adiponectin demonstrated a notable tendency toward elevation in the CART vs. AE subgroup (MD = 2.37 μg/mL, 95% CI: 1.53 to 3.21, P < 0.0001). Fasting glucose showed no notable change in either subgroup and exhibited extremely high heterogeneity, making it inappropriate to draw substantial conclusions. Regarding blood pressure, systolic blood pressure (SBP) and diastolic blood pressure (DBP) both demonstrated a notable tendency toward reduction in the CART vs. CON subgroup (SBP: MD = −3.51 mmHg, 95% CI: −6.23 to −0.80, P = 0.01; DBP: MD = −3.72 mmHg, 95% CI: −6.69 to −0.75, P = 0.01), whereas neither showed notable change in the CART vs. AE subgroup. Total cholesterol and triglycerides showed no notable change in any subgroup. The GRADE evidence quality assessment showed that fasting insulin, SBP, and DBP in the CART vs. CON subgroup, as well as fasting insulin and HOMA-IR in the CART vs. AE subgroup, were of moderate quality, while the remaining indicators were of low or very low quality.ConclusionCurrent evidence indicates that CART demonstrates statistically significant improvements in fasting insulin, SBP, DBP, and adiponectin levels in adolescents with overweight or obesity; however, due to limitations including high variability in intervention protocols, absence of blinding, and regional concentration of included studies, the overall quality of evidence is low, and the actual clinical meaningfulness still requires cautious interpretation. All conclusions must be interpreted based on the classification of control group activity status. Future research urgently needs to adopt standardized combined training protocols, establish consistent comparator definitions, and conduct large-sample RCTs with longer follow-up periods for confirmation.
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