observed increase in BMI in the diet plus exercise group, especially
when resistance training was added, may be due to gain in LBM,
which is beneficial for long-term weight loss.This reiterates thatBMI
is a less sensitive indicator of body composition and weight change
in children and adolescents. Future dietary and exercise interventions
should consider including other outcome measures of adiposity,
such as %BF and LBM.
Subgroup analyses demonstrated that diet plus aerobic training
resulted in significantly greater improvement in HDL-C levels
comparedwith diet plus resistance training.Thiswas consistent with
others38 who showed that aerobic exercise resulted in a greater
change inHDL-C levels in school-aged youths (including healthy and
overweight participants) compared with resistance training. However,
our meta-analyses showed that diet plus aerobic and resistance
training in combination was superior to diet plus either modality
alone in decreasing fasting glucose and insulin concentrations.
This suggests that future lifestyle interventions should incorporate
both aerobic and resistance training to achieve a better metabolic
outcome.