A rationale and method for high-intensity progressive resistance training with children and adolescents

The rising prevalence of obesity in children and adolescents is implicated in the metabolic abnormalities that track into adulthood. The associated increased incidence of insulin resistance, metabolic syndrome and type 2 diabetes being identified in younger cohorts has given rise to a critical global health issue. Muscular strength is a vital component of metabolic fitness that provides protection from insulin resistance in adults, and we have recently shown this to be true in children as well. Targeting muscular strength deficiencies at an early age may be an effective preventative strategy for metabolic syndrome and type 2 diabetes.

There is limited evidence-based best practice for progressive resistance training (PRT), adiposity and metabolic fitness in children and adolescents. The purpose of this paper is to describe the methodology we utilized for implementing a PRT program to avoid publication bias, enable replication of the study and share a novel program that we have found safe and suitable for use with youth.

We conducted the first randomized controlled trial (RCT) prescribing high-intensity PRT to children and adolescents (10-15 years) as a community-based primary prevention program to address adiposity and metabolic health. Participants were instructed to complete 2 sets of 8 repetitions of 11 exercises targeting all the major muscle groups twice a week at an RPE of 15-18 for 8 weeks.

Primary outcome was waist circumference; secondary outcomes included insulin resistance, lipid levels, muscle strength, cardiorespiratory fitness, body composition, self-efficacy, self-concept, habitual physical activity, nutritional and sedentary behavior patterns.

The supervised PRT program that we used with children and adolescents has been described in detail. The efficacy of this modality of exercise for metabolic fitness and other health outcomes is now under investigation.