Effects of 12-week supervised combined aerobic and resistance training on body composition and physical function in overweight or obese adults with multiple cardiometabolic risk factors: a randomized trial

Abstract

Background Combined aerobic and resistance training is recommended for adults with cardiometabolic risk factors, but evidence from hospital-based integrated sports and health service settings remains limited. Objective This 12-week randomized trial evaluated the effects of supervised combined aerobic and resistance training on body composition and physical function in overweight or obese adults with multiple cardiometabolic risk factors. Methods Adults with overweight or obesity and at least one additional clinically diagnosed cardiometabolic risk factor were randomized in a planned 2:1 ratio to intervention or control using a computer-generated stratified permuted-block sequence with allocation concealment. The intervention group completed supervised exercise three times weekly for 12 weeks. Each 60 min session included warm-up, aerobic exercise, resistance exercise, and flexibility/cool-down, with intensity monitored using heart rate, heart-rate reserve, perceived exertion, symptoms, and tolerance. Controls maintained usual lifestyle and dietary habits and received weekly telephone follow-up. Co-primary outcomes were whole-body fat mass and handgrip strength. Baseline-adjusted linear mixed-effects models estimated week 12 between-group differences. Results Of 60 individuals screened, 52 were randomized, and all completed week 12 assessment. At week 12, the intervention group had greater reductions in whole-body fat mass than controls (adjusted difference, −1.48 kg; 95% CI, −1.85 to −1.11; Holm-adjusted P < 0.001) and greater improvement in handgrip strength (1.16 kg; 95% CI, 0.56 to 1.77; Holm-adjusted P < 0.001). Exploratory secondary analyses with unadjusted P values suggested improvements in body weight, body mass index, body fat percentage, trunk fat mass, lower-limb explosive power, 4-m gait speed, one-leg standing balance, and sit-and-reach flexibility. Trunk muscle mass and whole-body response time were not statistically significant. Mean attendance was 86.7%, with no serious adverse events. Conclusion In this single-center randomized trial, 12-week supervised combined aerobic and resistance training was associated with modest improvements in fat-related body composition and selected physical-function outcomes in overweight or obese adults with multiple cardiometabolic risk factors. Cardiometabolic biomarkers were not reassessed at follow-up, and findings should be interpreted as preliminary.