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Randomized Controlled Study of Factors Influencing Body Composition and Exercise Quality of Male Adolescents Aged 13–15 Years Based on

Cross-Lagged Models: Obesity Level, Salivary Testosterone, and Exercise Combined with Caloric Restriction Intervention

  • Xiang Pan1
  • Tian Xia2
  • Yibo Gao1
  • Lupei Jiang1
  • Yanfeng Zhang1,*,

1China Institute of Sport Science, 100061 Beijing, China

2Sports Coaching College, Beijing Sports University, 100061 Beijing, China

DOI: 10.31083/j.jomh1810204 Vol.18,Issue 10,October 2022 pp.1-11

Published: 26 October 2022

(This article belongs to the Special Issue Physical and Mental Health in Sports)

*Corresponding Author(s): Yanfeng Zhang E-mail:


Background: Obesity is a worldwide health problem with many disadvantages for children and adolescents, especially for the sexual development of boys. Exercise and caloric restriction are effective in improving obesity; however, the factors influencing these improve-ments should be studied in detail. We conducted a randomized controlled study of factors affecting changes in body composition and physical capacity in males aged 13–15 years. Methods: Subjects were divided into three groups based on body fat percentage (BFP), and randomly divided into control and intervention groups. The experimental conditions of this study were based on an exercise camp with a 12-week closed training period. The intervention group received a combination of aerobic exercise, resistance exercise, and caloric restriction. All subjects were uniformly housed and had a standard time for diet and rest, whereas the control group performed their coursework during the exercise intervention time and had no dietary restrictions. The subjects were tested for body composition and physical capacity before and after the intervention. Results: The effect of exercise training and energy-restricted diets on fat loss and physical capacity was limited to relatively lower extremity explosive strength and cardiorespiratory endurance, with a significant effect on body composition. Fat mass reduction was influenced by obesity with a high level of individual variability, with higher levels of obesity resulting in greater reductions in fat mass. The reduction in BFP was not affected by the level of obesity, and there was a mild causal relationship with salivary testosterone (ST) in the intervention group but not in the control group. ST was predictive of future BFP in exercisers; individuals with high ST had a greater reduction in BFP under conditions of prolonged exercise and caloric restriction. Conclusions: More obese male adolescents can obtain greater fat mass reduction with the intervention, but fat-free mass and exercise quality are minimally affected by the level of obesity. Adolescent males with higher ST ground tend to gain improvements in body composition, and ST can be predictive of future BFP but needs to be in the context of an exercise intervention.


obesity; exercise; salivary testosterone; body composition; physical capacity; cross-lagged

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Xiang Pan,Tian Xia,Yibo Gao,Lupei Jiang,Yanfeng Zhang. Randomized Controlled Study of Factors Influencing Body Composition and Exercise Quality of Male Adolescents Aged 13–15 Years Based onCross-Lagged Models: Obesity Level, Salivary Testosterone, and Exercise Combined with Caloric Restriction Intervention. Journal of Men's Health. 2022. 18(10);1-11.


[1] Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a sys-tematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384: 766–781.

[2] Zhou Y, Zhang Q, Wang T, Zhang Y, Xu B. Prevalence of over-weight and obesity in Chinese children and adolescents from 2015. Annals of Human Biology. 2017; 44: 642–643.

[3] Skog H, Lintu N, Haapala HL, Haapala EA. Associations of car-diorespiratory fitness, adiposity, and arterial stiffness with cog-nition in youth. Physiological Reports. 2020; 8: e14586.

[4] Hayes LD, Grace FM, Sculthorpe N, Herbert P, Ratcliffe JW, Kilduff LP, et al. The effects of a formal exercise training pro-gramme on salivary hormone concentrations and body compo-sition in previously sedentary aging men. SpringerPlus. 2013; 2: 18.

[5] Escobar-Morreale HF, Santacruz E, Luque-Ramírez M, Botella Carretero JI. Prevalence of ‘obesity-associated gonadal dysfunc-tion’ in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis. Human Reproduction Update. 2017; 23: 390–408.

[6] Carrageta DF, Oliveira PF, Alves MG, Monteiro MP. Obesity and male hypogonadism: Tales of a vicious cycle. Obesity Re-views. 2019; 20: 1148–1158.

[7] Busch AS, Hollis B, Day FR, Sørensen K, Aksglaede L, Perry JRB, et al. Voice break in boys—temporal relations with other pubertal milestones and likely causal effects of BMI. Human Re-production. 2019; 34: 1514–1522.

[8] Mezzullo M, Di Dalmazi G, Fazzini A, Baccini M, Repaci A, Gambineri A, et al. Impact of age, body weight and metabolic risk factors on steroid reference intervals in men. European Jour-nal of Endocrinology. 2020; 182: 459–471.

[9] French SA, Wall M, Corbeil T, Sherwood NE, Berge JM, Neu-mark‐Sztainer D. Obesity in Adolescence Predicts Lower Edu-cational Attainment and Income in Adulthood: the Project EAT Longitudinal Study. Obesity. 2018; 26: 1467–1473.

[10] Lee K, Shin Y, Lee K, Jun T, Song W. Aerobic Exercise Training-Induced Decrease in Plasma Visfatin and Insulin Re-sistance in Obese Female Adolescents. International Journal of Sport Nutrition and Exercise Metabolism. 2010; 20: 275–281.

[11] Bales CW, Porter Starr KN, Orenduff MC, McDonald SR, Mol-nar K, Jarman AK, et al. Influence of Protein Intake, Race, and Age on Responses to a Weight-Reduction Intervention in Obese Women. Current Developments in Nutrition. 2017; 1: e000703.

[12] Dote-Montero M, De-la OA, Jurado-Fasoli L, Ruiz JR, Castillo MJ, Amaro-Gahete FJ. The effects of three types of exercise training on steroid hormones in physically inactive middle-aged adults: a randomized controlled trial. European Journal of Ap-plied Physiology. 2021; 121: 2193–2206.

[13] Hayes LD, Herbert P, Sculthorpe NF, Grace FM. Exercise train-ing improves free testosterone in lifelong sedentary aging men. Endocrine Connections. 2017; 6: 306–310.

[14] Ferguson DB. Current diagnostic uses of saliva. J Dent Res. 1987; 66: 420–424.

[15] Vining RF, McGinley RA, Symons RG. Hormones in saliva: mode of entry and consequent implications for clinical interpretation. Clinical Chemistry. 1983; 29: 1752–1756.

[16] Hagen J, Gott N, Miller DR. Reliability of Saliva Hormone Tests. Journal of the American Pharmacists Association. 2003; 43: 724–726.

[17] Gröschl M, Wagner R, Rauh M, Dörr HG. Stability of salivary steroids: the influences of storage, food and dental care. Steroids. 2001; 66: 737–741.

[18] Korot’ko GF, Gotovtseva LP. Pituitary, adrenal and sex hormones in saliva. Fiziologiia Cheloveka. 2002; 28: 137–139. (In Russian)

[19] Smith RG, Besch PK, Buena Dill MT, Buttram VC. Saliva as a Matrix for Measuring free Androgens: Comparison with Serum Androgens in Polycystic Ovarian Disease. Fertility and Sterility. 1979; 31: 513–517.

[20] Herrera-Espiñeira C, de Pascual YMAM, López-Morales M, Díaz Jiménez P, Rodríguez Ruiz A, Expósito-Ruiz M. Dif-ferences in Dietary Habits, Physical Exercise, and Quality of Life between Patients with Obesity and Overweight. Healthcare. 2021; 9: 916.

[21] Dorling JL, Bhapkar M, Das SK, Racette SB, Apolzan JW, Fearnbach SN, et al. Change in self-efficacy, eating behaviors and food cravings during two years of calorie restriction in hu-mans without obesity. Appetite. 2019; 143: 104397.

[22] Chiu K, Nevadunsky N, Van Arsdale A. Association of Obe-sity with Transtheoretical Stage of Change and Self-Efficacy in Women with Endometrial Cancer [5J]. Obstetrics and Gynecol-ogy. 2017; 129: 104S.

[23] Chinese Nutrition Society Obesity Prevention and Control Sec-tion, Chinese Nutrition Society Clinical Nutrition Section, Chi-nese Preventive Medicine Association Behavioral Health Sec-tion, Chinese Preventive Medicine Association Sports and Health Section. Expert Consensus on Obesity Prevention and Treatment in China. Chinese Preventive Medicine. 2022;,23: 21–339.

[24] Guo Y, Chen W. Influencing factors over obesity and exercise induce weight loss. Journal of Shanghai University of Sport. 2010; 34: 64–66.

[25] Schoenfeld BJ. The Mechanisms of Muscle Hypertrophy and their Application to Resistance Training. Journal of Strength and Conditioning Research. 2010; 24: 2857–2872.

[26] Gellish RL, Goslin BR, Olson RE, McDonald A, Russi GD, Moudgil VK. Longitudinal Modeling of the Relationship be-tween Age and Maximal Heart Rate. Medicine and Science in Sports and Exercise. 2007; 39: 822–829.

[27] Roza AM, Shizgal HM. The Harris Benedict equation reevalu-ated: resting energy requirements and the body cell mass. The American Journal of Clinical Nutrition. 1984; 40: 168–182.

[28] Kargarfard M, Shariat A, Shaw I, Haddadi P, Shaw BS. Ef-fects of Resistance and Aerobic Exercise Training or Education Associated with a Dietetic Program on Visfatin Concentrations and Body Composition in Overweight and Obese Women. Asian Journal of Sports Medicine. 2017. (in press)

[29] Ogilvie AR, Schlussel Y, Sukumar D, Meng L, Shapses SA. Higher protein intake during CR improves diet quality and at-tenuates loss of lean body mass. Obesity. 2022; 30: 1411–1419.

[30] Liu S, Chen Y, Xie K, Zhang W. Effects of aerobic exercise combined with resistance training on the cardiorespiratory fit-ness and exercise capacity of patients with stable coronary artery disease. Chinese Journal of Cardiology. 2017; 45: 1067–1071.

[31] Schroeder EC, Franke WD, Sharp RL, Lee DC. Comparative ef-fectiveness of aerobic, resistance, and combined training on car-diovascular disease risk factors: A randomized controlled trial. PLoS ONE. 2019; 14: e0210292.

[32] Martin P, Erika Z, Keith A, Peter Š. The Effects of a 4-Week Combined Aerobic and Resistance Training and Volley-ball Training on Fitness Variables and Body Composition on STEAM Students. Applied Sciences. 2021; 11: 8397.

[33] Costa DC, Valente-dos-Santos J, Sousa-e-Silva P, Martinho DV, Duarte JP, Tavares OM, et al. Growth, body composition and bone mineral density among pubertal male athletes: intra-individual 12-month changes and comparisons between soccer players and swimmers. BMC Pediatrics. 2022; 22: 275.

[34] Massini DA, Macedo AG, Almeida TAF, Espada MC, Santos FJ, Castro EA, et al. Single- and Multi-Joint Maximum Weight Lifting Relationship to Free-Fat Mass in Different Exercises for Upper- and Lower-Limbs in Well-Trained Male Young Adults. International Journal of Environmental Research and Public Health. 2022; 19: 4020.

[35] Bouchard DR, Soucy L, Sénéchal M, Dionne IJ, Brochu M. Im-pact of resistance training with or without CR on physical ca-pacity in obese older women. Menopause. 2009; 16: 66–72.

[36] Villareal DT, Aguirre L, Gurney AB, Waters DL, Sinacore DR, Colombo E, et al. Aerobic or Resistance Exercise, or both, in Dieting Obese Older Adults. New England Journal of Medicine. 2017; 376: 1943–1955.

[37] Lu Z, Rong S, Zhang Y, Gao Y, Tian Y, Xiao L. Relationship be-tween weight status, obesity types and body composition among seven-year-old children in a community of Shandong. Chinese Journal of Child Health Care. 2022; 30: 20–24.

[38] Hagman E, Besor O, Hershkop K, Santoro N, Pierpont B, Mata M, et al. Relation of the degree of obesity in childhood to adipose tissue insulin resistance. Acta Diabetologica. 2019; 56: 219–226.

[39] Bódis K, Roden M. Energy metabolism of white adipose tissue and insulin resistance in humans. European Journal of Clinical Investigation. 2018; 48: e13017.

[40] Loh NY, Humphreys E, Karpe F, Tomlinson JW, Noordam R, Christodoulides C. Sex hormones, adiposity, and metabolic traits in men and women: a Mendelian randomisation study. European Journal of Endocrinology. 2022; 186: 407–416.

[41] Singh P, Covassin N, Marlatt K, Gadde KM, Heymsfield SB. Obesity, Body Composition, and Sex Hormones: Implications for Cardiovascular Risk. Comprehensive Physiology. 2021; 12: 2949–2993.

[42] Ghelani R, Lim C, Brain C, Fewtrell M, Butler G. Sudden sex hormone withdrawal and the effects on body composition in late pubertal adolescents with gender dysphoria. Journal of Pediatric Endocrinology and Metabolism. 2020; 33: 107–112.

[43] Groti Antonič K, Antonič B, Žuran I, Pfeifer M. Testosterone treatment longer than 1 year shows more effects on functional hypogonadism and related metabolic, vascular, diabetic and obesity parameters (results of the 2-year clinical trial). The Ag-ing Male. 2020; 23: 1442–1454.

[44] Ng Tang Fui M, Hoermann R, Zajac JD, Grossmann M. The ef-fects of testosterone on body composition in obese men are not sustained after cessation of testosterone treatment. Clinical En-docrinology. 2017; 87: 336–343.

[45] Di Nisio A, Sabovic I, De Toni L, Rocca MS, Dall’Acqua S, Azzena B, et al. Testosterone is sequestered in dysfunctional adi-pose tissue, modifying androgen-responsive genes. International Journal of Obesity. 2020; 44: 1617–1625.

[46] Machado FP, Rhoden EL, Pioner SR, Halmenschlager G, de Souza LVB, Lisot BC, et al. Weight Loss through Bariatric Surgery in Men Presents Beneficial Effects on Sexual Function, Symptoms of Testosterone Deficiency, and Hormonal Profile. Sexual Medicine. 2021; 9: 100400.

[47] Van de Velde F, Deventer K, Van Gansbeke W, Van Eenoo P, Van Renterghem P, Fiers T, et al. Metabolism of testosterone during weight loss in men with obesity. The Journal of Steroid Biochemistry and Molecular Biology. 2021; 209: 105851.

[48] Gates MA, Mekary RA, Chiu GR, Ding EL, Wittert GA, Araujo AB. Sex steroid hormone levels and body composition in men. The Journal of Clinical Endocrinology and Metabolism. 2013; 98: 2442–2450.

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