Impact of Aerobic vs. Resistance Exercise on Insulin Sensitivity and Lipid‑Metabolism Enzymes in Overweight Children

Introduction: Exercise interventions are recommended for improving metabolic health, but the comparative effects of aerobic versus resistance exercise on insulin sensitivity and lipid metabolism enzymes in children remain unclear.Objective: To investigate the impact of aerobic (AE) versus resistance exercise (RE) on insulin sensitivity and lipid metabolism enzymes in overweight children.Methods: Fifty-six overweight children (aged 8–12 years) were randomly assigned to AE, RE, or CON groups. AE consisted of moderate-intensity aerobic training, and RE included progressive resistance exercises targeting major muscle groups. Primary outcomes were fasting insulin, HOMA-IR, LPL and HL. Secondary outcomes included body composition and physical fitness. ANCOVA adjusted for baseline values was employed to compare post-intervention differences, with effect sizes reported as partial η². Results: Both AE and RE significantly improved insulin sensitivity (HOMA-IR: AE −1.2 ± 0.3; RE −1.3 ± 0.3; CON −0.0 ± 0.2; p < 0.001, partial η² = 0.75) and enhanced LPL and HL activities (p < 0.001, partial η² > 0.50). AE led to greater reductions in body fat and improvements in VO₂max, whereas RE produced larger gains in lean mass and muscular strength. Both interventions demonstrated robust, clinically relevant effects compared with controls.Conclusion: Aerobic and resistance exercise both improve insulin sensitivity and lipid metabolism in overweight children, with complementary modality-specific benefits. Structured exercise programs should incorporate both modalities to maximize metabolic health and physical fitness in pediatric populations.