Discussion
obesity, FM
OBESITY
The present study showed that 3-week in-hospital multidisciplinary BWRP with COMB or a MICT training program in adolescents with obesity (1) significantly reduced BM and FM in both groups, although more pronounced in the MICT group; (2) maintained FFM only in the COMB group; (3) significantly improved V′OThe first important finding was that both COMB and the MICT program helped to reduce BM and FM, by ~ 5 and 8 kg for BM and ~ 4 kg in both groups for FM. Although MICT was found to be more effective in reducing BM, both types of training contributed equally to reducing FM. A recent meta-analysis showed that both MICT and HIIT produced similar reductions in BM (i.e., between 2 and 5 kg) kg in adolescents with obesity over an average period of 12 weeksThe second important finding was that COMB training significantly increased V′OThe third finding was that the increase in MFO occurred only in the COMB group (i.e., + 0.04 g minThe present study has several limitations. First, although we have reported that 3 weeks of COMB or MICT training combined with moderate energy restriction and nutrition education improves body composition and physical performance, it is difficult to determine the determining factor for body composition improvement because we did not have an inactive control group to rule out the dietary factors. Second, since the recruited boys are still growing, we do not know to what extent this factor was decisive for the improvement in body composition and physical capacities. Third, in the present study we did not measured the amount of energy spent in aerobic leisure activity. Therefore, we are unable to know what extent this might have had an impact on improving body composition and physical capacities in our study population. Fourth our study was conducted on adolescents with obesity in a specialized institution; therefore, it is not possible to generalize our results to home-based training. Finally, because we compared a priori only one COMB training with MICT, it is difficult to assess whether the combination ratio we chose was indeed optimal or whether there are even better combinations.In summary, COMB and MICT training helped in improving body composition. In contrast, only the COMB group improved cardiovascular parameters and MFO. Thus, COMB training could be a reasonable alternative to MICT or HIIT to improve body composition and physical capacities in adolescents with obesity. Future studies should examine different combinations of HIIT and MICT (i.e., polarized, pyramidal, or threshold training) over a longer period of time (12 weeks) and compare them with HIIT and MICT alone to determine the optimal combination of HIIT and MICT.