Resistance training → Insulin resistance (HOMA-IR)
Higher Resistance training decreases Insulin resistance (HOMA-IR).
Waters 2022 randomized 160 older adults with obesity and found that resistance training during matched diet-induced weight loss of about 9 to 10 percent raised the OGTT insulin sensitivity index 39 percent; combination training raised it 86 percent.
Randomized trial · Moderate · N=160
Supported by an experiment or a tightly identified design. Read the caveats.
Mechanism
Waters, Aguirre, Gurney, and colleagues randomized 160 sedentary adults aged 65 and older with obesity and mild-to-moderate frailty in Albuquerque. Forty people each went to control, aerobic plus diet, resistance plus diet, or both plus diet. Twenty-six weeks. The three exercise arms sat in the same weekly counseling and a 500 to 750 kcal daily deficit, aiming for about 10 percent weight loss. They trained three times a week for 60 to 90 minutes. Control got neither the diet nor the exercise. Insulin sensitivity was the Matsuda index from a 75-gram oral glucose tolerance test, done at least 48 hours after the last session. It is not HOMA-IR. Resistance plus diet raised the index by 1.0, a 39 percent rise from a baseline of 2.6. Aerobic plus diet raised it by 1.2, about 50 percent. Combination raised it by 1.9, 86 percent. Combination beat resistance-only. Resistance and aerobic did not differ from each other. Fasting glucose, two-hour glucose, and the glucose and insulin areas under the curve improved versus control in every exercise arm and did not differ among those arms. Thigh intermuscular fat and abdominal visceral fat fell more with combination than with resistance alone. Those drops tracked the rise in the sensitivity index. The authors treat less fat sitting in and around muscle as the path to better insulin action. Ho, Dhaliwal, Hills, and Pal randomized 64 overweight or obese adults to 12 weeks of moderate-intensity aerobic, resistance, or combination work, 30 minutes, five days a week, or a placebo-supplement control. They measured fasting glucose, insulin, and HOMA2-IR. They did not find a significant reduction in fasting glucose or insulin. Combination lost 1.6 percent of weight versus control. That is a shorter, lighter program and a fasting assay, not Waters' OGTT.
Caveats
Waters is a secondary analysis of LITOE (NCT01065636). Mean age 70. Older adults with obesity and frailty, not a general gym sample. Control did not diet. There is no weight-loss-only arm. The authors skipped it because diet without exercise had already been shown to cost bone and muscle. All three exercise arms lost about 9 percent of body weight. Combination beat resistance-only on the sensitivity index. The node on this atlas is labeled HOMA-IR; Waters used the Matsuda index from an OGTT. Ho is 12 weeks at moderate intensity. Sixteen people in the resistance arm. Fasting insulin and glucose did not move. Session attendance was 67 to 74 percent. This page is not a training prescription.
Effect
qualitative. Waters 2022: REX+diet Matsuda ISI +1.0 (39%), COMB +1.9 (86%), N=160, 6 months. Ho 2013: no significant drop in fasting glucose or insulin at 12 weeks.
Nodes
Named confounders
Cite this page
What Causes What. “Resistance training → Insulin resistance (HOMA-IR).” https://whatcauseswhat.org/edges/e-training-insulin (atlas updated 2026-09-02).
Papers
- Effect of Aerobic or Resistance Exercise, or Both, on Intermuscular and Visceral Fat and Physical and Metabolic Function in Older Adults With Obesity While Dieting.
DL Waters, L Aguirre, B Gurney, DR Sinacore, K Fowler, G Gregori, R Armamento-Villareal, C Qualls · 2022 · The journals of gerontology. Series A, Biological sciences and medical sciences
- The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial.
SS Ho, SS Dhaliwal, AP Hills, S Pal · 2013 · BMC public health