Aerobic high-intensity intervals improve VO2max more than moderate training

Exercise volume and aerobic fitness in young adults: the Midwest Exercise Trial-2

To examine the effect of exercise volume at a fixed intensity on changes in aerobic fitness. Ninety-two overweight/obese individuals (BMI 25-40 kg m(2)), age 18-30 years, 50 % women, completed a 10 mo, 5 d wk(-1) supervised exercise intervention at 2 levels of exercise energy expenditure (400 or 600 kcal session(-1)) at 70-80 % heart rate (HR) max. Exercise consisted primarily of walking/jogging on motor-driven treadmills. The duration and intensity of all exercise sessions were verified by a downloadable HR monitor set to collect HR in 1-min epochs. All participants were instructed to continue their typical patterns of non-exercise physical activity and dietary intake over the duration of the 10 mo intervention. Maximal aerobic capacity (indirect calorimetry) was assessed on a motor-driven treadmill using a modified Balke protocol at baseline, mid-point (5 mo), and following completion of the 10 mo intervention. VO2 max (L min(-1)) increased significantly in both the 400 (11.3 %) and 600 kcal session(-1) groups (14 %) compared to control (-2.0 %; p < 0.001); however, the differences between exercise groups were not significant. Similar results were noted for change in relative VO2 max (mL kg(-1) min(-1)); however, the magnitude of change was greater than for absolute VO2 max (L min(-1)) (400 group = 18.3 %; 600 group = 20.2 %) due to loss of body weight over the 10-mo intervention in both exercise groups. Our results indicate that exercise volume was not associated with change in aerobic fitness in a sample of previously sedentary, overweight and obese young adults.

Effect of jumping interval training on neuromuscular and physiological parameters: a randomized controlled study

This study analyzed the effect of 4 weeks of jumping interval training (JIT), included in endurance training, on neuromuscular and physiological parameters. Eighteen recreational runners, randomized in control and experimental groups, performed 40 min of running at 70% of velocity at peak oxygen uptake, for 3 times per week. Additionally, the experimental group performed the JIT twice per week, which consisted of 4 to 6 bouts of continuous vertical jumps (30 s) with 5-min intervals. Three days before and after the training period, the countermovement (CMJ) and continuous jump (CJ30), isokinetic and isometric evaluation of knee extensors/flexors, progressive maximal exercise, and submaximal constant-load exercise were performed. The JIT provoked improvement in neuromuscular performance, indicated by (i) increased jump height (4.7%; effect size (ES) = 0.99) and power output (≈3.7%; ES ≈ 0.82) of CMJ and rate of torque development of knee extensors in isometric contraction (29.5%; ES = 1.02); (ii) anaerobic power and capacity, represented by the mean of jump height (7.4%; ES = 0.8), and peak power output (PPO) (5.6%; ES = 0.73) of the first jumps of CJ30 and the mean of jump height (10.2%, ES = 1.04) and PPO (9.5%, ES = 1.1), considering all jumps of CJ30; and (iii) aerobic power and capacity, represented by peak oxygen uptake (9.1%, ES = 1.28), velocity at peak oxygen uptake (2.7%, ES = 1.11), and velocity corresponding to the onset of blood lactate accumulation (9.7%, ES = 1.23). These results suggest that the JIT included in traditional endurance training induces moderate to large effects on neuromuscular and physiological parameters.

Inflammatory, lipid, and body composition responses to interval training or moderate aerobic training

PURPOSE

The goal of this study was to compare the effect of work- and duration-matched interval training (HIIT) versus moderate aerobic endurance training (ET) on acute and chronic inflammation, along with changes in the lipid profile, to determine which may be more beneficial for improving cardiovascular health.

METHODS

Twelve sedentary males (maximal oxygen consumption = 41.6 ± 5.4 mL kg(-1) min(-1)) completed 8 weeks of aerobic interval training or moderate aerobic training, with variables including C-reactive protein (CRP) for chronic inflammation, interleukin-6 (IL-6) response for the acute inflammatory response, plasma concentrations of high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TRG), and low-density lipoprotein, and body composition measured before and after the training period.

RESULTS

HIIT decreased plasma TRG from 92 ± 32 to 61 ± 12 mg dL(-1), which was significantly different from ET, while ET improved the TC:HDL ratio from 4.67 ± 0.85 to 4.07 ± 0.96 and reduced the percentage of android fat from 36.78 ± 9.60 to 34.18 ± 11.39 %. Neither training protocol resulted in an acute IL-6 response on the first nor the last day of exercise, a change in chronic levels of CRP, or a significant increase in HDL, despite previous research finding these changes.

CONCLUSIONS

It seems that in order to maximize the health outcomes from physical activity, both HIIT and ET should be included. The acute inflammatory response and reductions in chronic inflammation resulting from exercise training may not be as common as the literature suggests.

Effects of high-intensity aerobic exercise on psychotic symptoms and neurocognition in outpatients with schizophrenia: study protocol for a randomized controlled trial

Background

The focus in recent years on physical inactivity and metabolic disturbances in individuals with schizophrenia raises the question of potential effects of physical activity. Physical activity has shown beneficial effects on cognition in healthy older individuals as well as on symptom severity in depression. However, opinions diverge regarding whether aerobic high-intensity interval training reduces cognition and key symptoms in schizophrenia. The main objective for the trial is to investigate the potential effects of aerobic high-intensity interval training on neurocognitive function and mental symptoms in outpatients with schizophrenia.

Methods/Design

The trial is designed as a randomized controlled, observer-blinded clinical trial. Patients are randomized to 1 of 2 treatment arms with 12-week duration: aerobic high-intensity interval training or computer gaming skills training. All participants also receive treatment as usual. Primary outcome measure is neurocognitive function. Secondary outcome measures will be positive and negative symptoms, wellbeing, tobacco-smoking patterns and physiological/metabolic parameters. Patient recruitment takes place in catchment area-based outpatient clinics.

Trial registration

ClinicalTrials.gov NCT02205684. Registered 29 July 2014.

Effects of High Intensity Interval Training on Pregnant Rats, and the Placenta, Heart and Liver of Their Fetuses

OBJECTIVE

To investigate the effects of high intensity interval training (HIIT) on the maternal heart, fetuses and placentas of pregnant rats.

METHODS

Female Sprague-Dawley rats were randomly assigned to HIIT or sedentary control groups. The HIIT group was trained for 6 weeks with 10 bouts of high intensity uphill running on a treadmill for four minutes (at 85-90% of maximal oxygen consumption) for five days/week. After three weeks of HIIT, rats were mated. After six weeks (gestational day 20 in pregnant rats), echocardiography was performed to evaluate maternal cardiac function. Real-time PCR was performed for the quantification of gene expression, and oxidative stress and total antioxidant capacity was assessed in the tissue samples.

RESULTS

Maternal heart weight and systolic function were not affected by HIIT or pregnancy. In the maternal heart, expression of 11 of 22 genes related to cardiac remodeling was influenced by pregnancy but none by HIIT. Litter size, fetal weight and placental weight were not affected by HIIT. Total antioxidant capacity, malondialdehyde content, peroxidase and superoxide dismutase activity measured in the placenta, fetal heart and liver were not influenced by HIIT. HIIT reduced the expression of eNOS (p = 0.03), hypoxia-inducible factor 1α (p = 0.04) and glutathione peroxidase 4.2 (p = 0.02) in the fetal liver and increased the expression of vascular endothelial growth factor-β (p = 0.014), superoxide dismutase 1 (p = 0.001) and tissue inhibitor of metallopeptidase 3 (p = 0.049) in the fetal heart.

CONCLUSIONS

Maternal cardiac function and gene expression was not affected by HIIT. Although HIIT did not affect fetal growth, level of oxidative stress and total antioxidant capacity in the fetal tissues, some genes related to oxidative stress were altered in the fetal heart and liver indicating that protective mechanisms may be activated.

Impaired Aerobic Endurance and Muscular Strength in Substance Use Disorder Patients: Implications for Health and Premature Death

Although substance use disorder (SUD) patients are documented to have an inactive lifestyle, which is associated with cardiovascular disease, other lifestyle-related diseases and premature death, evidence regarding their aerobic endurance and muscular strength is limited. Therefore, the authors aimed to evaluate directly assessed maximal oxygen consumption, walking efficiency, as well as maximal strength in a group of SUD patients.A total of 44 SUD patients in residential treatment, 31 men (31 ± 8 years) and 13 women (34 ± 10 years), were included and completed the physical testing. The patients were compared with an age- and sex-matched reference group.Male and female SUD patients exhibited a maximal oxygen consumption of 44.6 ± 6.2 and 33.8 ± 6.6 mL· min kg, respectively. This was significantly lower than the reference group, 15% (P = 0.03) for men and 25% (P = 0.001) for women. In addition, the SUD patients had a 13% significantly reduced walking efficiency (P = 0.02), compared with healthy controls. The impairments in aerobic endurance were accompanied by significant reductions in maximal strength of 30% (P = 0.001) and 33% (P = 0.01) for men and women, respectively. In combination, these results imply that SUD patients have impaired endurance and muscular strength compared with what is typically observed in the population, and consequently suffer a higher risk of developing cardiovascular and other lifestyle-related diseases and early death. Effective physical exercise should be advocated as an essential part of the clinical practice of SUD treatment to improve the patient's health and consequently reduce the costs because of the high use of emergency departments, hospital, and medical care.

Separate Effects of Intensity and Amount of Exercise on Interindividual Cardiorespiratory Fitness Response

OBJECTIVE

To determine the separate effects of exercise intensity and amount on interindividual cardiorespiratory fitness (CRF) response.

PARTICIPANTS AND METHODS

Participants were 121 (75 females, 62%) sedentary, middle-aged (mean [SD] age, 53.2 [7.5] years), abdominally obese adults who completed at least 90% of 5 weekly exercise sessions prescribed over a 24-week intervention. Participants were randomly assigned to (1) low-amount, low-intensity exercise (LALI) (180 and 300 kcal per session for women and men, respectively, at 50% of CRF [VO 2peak]; n=39), (2) high-amount, low-intensity exercise (HALI) (360 and 600 kcal per session for women and men, respectively, at 50% of CRF; n=51), or high-amount, high-intensity exercise (HAHI) (360 and 600 kcal per session for women and men, respectively, at 75% of CRF; n=31). Cardiorespiratory fitness was measured using a treadmill test at 4, 8, 16, and 24 weeks. The study duration was September 1, 2009, through May 31, 2013.

RESULTS

Cardiorespiratory fitness increased within all 3 groups at 24 weeks (P<.001). At 24 weeks, 38.5% (15 of 39), 17.6% (9 of 51), and 0% (0 of 31) of the participants within the LALI, HALI, and HAHI groups, respectively, were CRF nonresponders. At a fixed exercise intensity, increasing exercise amount reduced the rate of nonresponse by 50% (P=.02). At a fixed amount of exercise, increasing the exercise intensity eliminated nonresponse (P=.001). Exposure to exercise decreased the number of CRF nonresponders between 4 and 8 weeks for LALI and by 16 weeks for HALI but plateaued thereafter. For HAHI, the number of CRF nonresponders decreased continually over the 24 weeks.

CONCLUSION

For a fixed amount of exercise, increasing exercise intensity consistent with consensus recommendations eliminated CRF nonresponse. Low-intensity exercise may not be sufficient to improve CRF for a substantial proportion of sedentary obese adults.

The effects of high-intensity interval training on glucose regulation and insulin resistance: a meta-analysis

The aim of this meta-analysis was to quantify the effects of high-intensity interval training (HIIT) on markers of glucose regulation and insulin resistance compared with control conditions (CON) or continuous training (CT). Databases were searched for HIIT interventions based upon the inclusion criteria: training ≥2 weeks, adult participants and outcome measurements that included insulin resistance, fasting glucose, HbA1c or fasting insulin. Dual interventions and participants with type 1 diabetes were excluded. Fifty studies were included. There was a reduction in insulin resistance following HIIT compared with both CON and CT (HIIT vs. CON: standardized mean difference [SMD] = -0.49, confidence intervals [CIs] -0.87 to -0.12, P = 0.009; CT: SMD = -0.35, -0.68 to -0.02, P = 0.036). Compared with CON, HbA1c decreased by 0.19% (-0.36 to -0.03, P = 0.021) and body weight decreased by 1.3 kg (-1.9 to -0.7, P < 0.001). There were no statistically significant differences between groups in other outcomes overall. However, participants at risk of or with type 2 diabetes experienced reductions in fasting glucose (-0.92 mmol L(-1), -1.22 to -0.62, P < 0.001) compared with CON. HIIT appears effective at improving metabolic health, particularly in those at risk of or with type 2 diabetes. Larger randomized controlled trials of longer duration than those included in this meta-analysis are required to confirm these results.

Short-term HIIT and Fat max training increase aerobic and metabolic fitness in men with class II and III obesity

OBJECTIVE

To compare the effects of two different 2-week-long training modalities [continuous at the intensity eliciting the maximal fat oxidation (Fatmax) versus high-intensity interval training (HIIT)] in men with class II and III obesity.

METHODS

Nineteen men with obesity (BMI ≥ 35 kg · m(-2)) were assigned to Fatmax group (GFatmax) or to HIIT group (GHIIT). Both groups performed eight cycling sessions matched for mechanical work. Aerobic fitness and fat oxidation rates (FORs) during exercise were assessed prior and following the training. Blood samples were drawn to determine hormones and plasma metabolites levels. Insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA2-IR).

RESULTS

Aerobic fitness and FORs during exercise were significantly increased in both groups after training (P ≤ 0.001). HOMA2-IR was significantly reduced only for GFatmax (P ≤ 0.001). Resting non-esterified fatty acids (NEFA) and insulin decreased significantly only in GFatmax (P ≤ 0.002).

CONCLUSIONS

Two weeks of HIIT and Fatmax training are effective for the improvement of aerobic fitness and FORs during exercise in these classes of obesity. The decreased levels of resting NEFA only in GFatmax may be involved in the decreased insulin resistance only in this group.

Effectiveness of High-Intensity Interval Training (HIT) and Continuous Endurance Training for VO2max Improvements: A Systematic Review and Meta-Analysis of Controlled Trials

BACKGROUND

Enhancing cardiovascular fitness can lead to substantial health benefits. High-intensity interval training (HIT) is an efficient way to develop cardiovascular fitness, yet comparisons between this type of training and traditional endurance training are equivocal.

OBJECTIVE

Our objective was to meta-analyse the effects of endurance training and HIT on the maximal oxygen consumption (VO2max) of healthy, young to middle-aged adults.

METHODS

Six electronic databases were searched (MEDLINE, PubMed, SPORTDiscus, Web of Science, CINAHL and Google Scholar) for original research articles. A search was conducted and search terms included 'high intensity', 'HIT', 'sprint interval training', 'endurance training', 'peak oxygen uptake', and 'VO2max'. Inclusion criteria were controlled trials, healthy adults aged 18-45 years, training duration ≥2 weeks, VO2max assessed pre- and post-training. Twenty-eight studies met the inclusion criteria and were included in the meta-analysis. This resulted in 723 participants with a mean ± standard deviation (SD) age and initial fitness of 25.1 ± 5 years and 40.8 ± 7.9 mL·kg(-1)·min(-1), respectively. We made probabilistic magnitude-based inferences for meta-analysed effects based on standardised thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject SDs for baseline VO2max.

RESULTS

The meta-analysed effect of endurance training on VO2max was a possibly large beneficial effect (4.9 mL·kg(-1)·min(-1); 95 % confidence limits ±1.4 mL·kg(-1)·min(-1)), when compared with no-exercise controls. A possibly moderate additional increase was observed for typically younger subjects (2.4 mL·kg(-1)·min(-1); ±2.1 mL·kg(-1)·min(-1)) and interventions of longer duration (2.2 mL·kg(-1)·min(-1); ±3.0 mL·kg(-1)·min(-1)), and a small additional improvement for subjects with lower baseline fitness (1.4 mL·kg(-1)·min(-1); ±2.0 mL·kg(-1)·min(-1)). When compared with no-exercise controls, there was likely a large beneficial effect of HIT (5.5 mL·kg(-1)·min(-1); ±1.2 mL·kg(-1)·min(-1)), with a likely moderate greater additional increase for subjects with lower baseline fitness (3.2 mL·kg(-1)·min(-1); ±1.9 mL·kg(-1)·min(-1)) and interventions of longer duration (3.0 mL·kg(-1)·min(-1); ±1.9 mL·kg(-1)·min(-1)), and a small lesser effect for typically longer HIT repetitions (-1.8 mL·kg(-1)·min(-1); ±2.7 mL·kg(-1)·min(-1)). The modifying effects of age (0.8 mL·kg(-1)·min(-1); ±2.1 mL·kg(-1)·min(-1)) and work/rest ratio (0.5 mL·kg(-1)·min(-1); ±1.6 mL·kg(-1)·min(-1)) were unclear. When compared with endurance training, there was a possibly small beneficial effect for HIT (1.2 mL·kg(-1)·min(-1); ±0.9 mL·kg(-1)·min(-1)) with small additional improvements for typically longer HIT repetitions (2.2 mL·kg(-1)·min(-1); ±2.1 mL·kg(-1)·min(-1)), older subjects (1.8 mL·kg(-1)·min(-1); ±1.7 mL·kg(-1)·min(-1)), interventions of longer duration (1.7 mL·kg(-1)·min(-1); ±1.7 mL·kg(-1)·min(-1)), greater work/rest ratio (1.6 mL·kg(-1)·min(-1); ±1.5 mL·kg(-1)·min(-1)) and lower baseline fitness (0.8 mL·kg(-1)·min(-1); ±1.3 mL·kg(-1)·min(-1)).

CONCLUSION

Endurance training and HIT both elicit large improvements in the VO2max of healthy, young to middle-aged adults, with the gains in VO2max being greater following HIT when compared with endurance training.

Haematological rather than skeletal muscle adaptations contribute to the increase in peak oxygen uptake induced by moderate endurance training

It remains unclear whether improvements in peak oxygen uptake (V̇(O2peak)) following endurance training (ET) are primarily determined by central and/or peripheral adaptations. Herein, we tested the hypothesis that the improvement in V̇(O2peak) following 6 weeks of ET is mainly determined by haematological rather than skeletal muscle adaptations. Sixteen untrained healthy male volunteers (age = 25 ± 4 years, V̇(O2peak) = 3.5 ± 0.5 l min(-1)) underwent supervised ET (6 weeks, 3-4 sessions per week). V̇(O2peak), peak cardiac output (Q̇(peak)), haemoglobin mass (Hb(mass)) and blood volumes were assessed prior to and following ET. Skeletal muscle biopsies were analysed for mitochondrial volume density (Mito(VD)), capillarity, fibre types and respiratory capacity (OXPHOS). After the post-ET assessment, red blood cell volume (RBCV) was re-established at the pre-ET level by phlebotomy and V̇(O2peak) and Q̇(peak) were measured again. We speculated that the contribution of skeletal muscle adaptations to the ET-induced increase in V̇(O2peak) would be revealed when controlling for haematological adaptations. V̇(O2peak) and Q̇(peak) were increased (P < 0.05) following ET (9 ± 8 and 7 ± 6%, respectively) and decreased (P < 0.05) after phlebotomy (-7 ± 7 and -10 ± 7%). RBCV, plasma volume and Hb(mass) all increased (P < 0.05) after ET (8 ± 4, 4 ± 6 and 6 ± 5%). As for skeletal muscle adaptations, capillary-to-fibre ratio and total Mito(VD) increased (P < 0.05) following ET (18 ± 16 and 43 ± 30%), but OXPHOS remained unaltered. Through stepwise multiple regression analysis, Q̇(peak), RBCV and Hb(mass) were found to be independent predictors of V̇(O2peak). In conclusion, the improvement in V̇(O2peak) following 6 weeks of ET is primarily attributed to increases in Q̇(peak) and oxygen-carrying capacity of blood in untrained healthy young subjects.

Effects of High-Intensity Interval Exercise versus Moderate Continuous Exercise on Glucose Homeostasis and Hormone Response in Patients with Type 1 Diabetes Mellitus Using Novel Ultra-Long-Acting Insulin

Introduction

We investigated blood glucose (BG) and hormone response to aerobic high-intensity interval exercise (HIIE) and moderate continuous exercise (CON) matched for mean load and duration in type 1 diabetes mellitus (T1DM).

Material and Methods

Seven trained male subjects with T1DM performed a maximal incremental exercise test and HIIE and CON at 3 different mean intensities below (A) and above (B) the first lactate turn point and below the second lactate turn point (C) on a cycle ergometer. Subjects were adjusted to ultra-long-acting insulin Degludec (Tresiba/ Novo Nordisk, Denmark). Before exercise, standardized meals were administered, and short-acting insulin dose was reduced by 25% (A), 50% (B), and 75% (C) dependent on mean exercise intensity. During exercise, BG, adrenaline, noradrenaline, dopamine, cortisol, glucagon, and insulin-like growth factor-1, blood lactate, heart rate, and gas exchange variables were measured. For 24 h after exercise, interstitial glucose was measured by continuous glucose monitoring system.

Results

BG decrease during HIIE was significantly smaller for B (p = 0.024) and tended to be smaller for A and C compared to CON. No differences were found for post-exercise interstitial glucose, acute hormone response, and carbohydrate utilization between HIIE and CON for A, B, and C. In HIIE, blood lactate for A (p = 0.006) and B (p = 0.004) and respiratory exchange ratio for A (p = 0.003) and B (p = 0.003) were significantly higher compared to CON but not for C.

Conclusion

Hypoglycemia did not occur during or after HIIE and CON when using ultra-long-acting insulin and applying our methodological approach for exercise prescription. HIIE led to a smaller BG decrease compared to CON, although both exercises modes were matched for mean load and duration, even despite markedly higher peak workloads applied in HIIE. Therefore, HIIE and CON could be safely performed in T1DM.

Trial Registration

ClinicalTrials.gov NCT02075567 http://www.clinicaltrials.gov/ct2/show/NCT02075567

High Intensity Interval Training Improves Glycaemic Control and Pancreatic β Cell Function of Type 2 Diabetes Patients

Physical activity improves the regulation of glucose homeostasis in both type 2 diabetes (T2D) patients and healthy individuals, but the effect on pancreatic β cell function is unknown. We investigated glycaemic control, pancreatic function and total fat mass before and after 8 weeks of low volume high intensity interval training (HIIT) on cycle ergometer in T2D patients and matched healthy control individuals. Study design/method: Elderly (56 yrs±2), non-active T2D patients (n = 10) and matched (52 yrs±2) healthy controls (CON) (n = 13) exercised 3 times (10×60 sec. HIIT) a week over an 8 week period on a cycle ergometer. Participants underwent a 2-hour oral glucose tolerance test (OGTT). On a separate day, resting blood pressure measurement was conducted followed by an incremental maximal oxygen uptake (V˙O_2max) cycle ergometer test. Finally, a whole body dual X-ray absorptiometry (DXA) was performed. After 8 weeks of training, the same measurements were performed. Results: in the T2D-group, glycaemic control as determined by average fasting venous glucose concentration (p = 0.01), end point 2-hour OGTT (p = 0.04) and glycosylated haemoglobin (p = 0.04) were significantly reduced. Pancreatic homeostasis as determined by homeostatic model assessment of insulin resistance (HOMA-IR) and HOMA β cell function (HOMA-%β) were both significantly ameliorated (p = 0.03 and p = 0.03, respectively). Whole body insulin sensitivity as determined by the disposition index (DI) was significantly increased (p = 0.03). During OGTT, the glucose continuum was significantly reduced at -15 (p = 0.03), 30 (p = 0.03) and 120 min (p = 0.03) and at -10 (p = 0.003) and 0 min (p = 0.003) with an additional improvement (p = 0.03) of its 1^st phase (30 min) area under curve (AUC). Significant abdominal fat mass losses were seen in both groups (T2D: p = 0.004 and CON: p = 0.02) corresponding to a percentage change of -17.84%±5.02 and -9.66%±3.07, respectively. Conclusion: these results demonstrate that HIIT improves overall glycaemic control and pancreatic β cell function in T2D patients. Additionally, both groups experienced abdominal fat mass losses. These findings demonstrate that HIIT is a health beneficial exercise strategy in T2D patients.

Does aerobic exercise and the FITT principle fit into stroke recovery?

Sedentary lifestyle after stroke is common which results in poor cardiovascular health. Aerobic exercise has the potential to reduce cardiovascular risk factors and improve functional capacity and quality of life in people after stroke. However, aerobic exercise is a therapeutic intervention that is underutilized by healthcare professionals after stroke. The purpose of this review paper is to provide information on exercise prescription using the FITT principle (frequency, intensity, time, type) for people after stroke and to guide healthcare professionals to incorporate aerobic exercise into the plan of care. This article discusses the current literature outlining the evidence base for incorporating aerobic exercise into stroke rehabilitation. Recently, high-intensity interval training has been used with people following stroke. Information is provided regarding the early but promising results for reaching higher target heart rates.

Effect of 3-week high-intensity interval training on VO2max, total haemoglobin mass, plasma and blood volume in well-trained athletes

PURPOSE

This study examined the haematological adaptations to high-intensity interval training (HIT), i.e. total haemoglobin mass (tHb-mass), blood volume (BV), and plasma volume (PV), and its effects on VO2max in well-trained athletes.

METHODS

Twenty-seven male and eight female well-trained (VO2max 63.7 ± 7.7 ml/min/kg) athletes were randomly assigned to the HIT (HITG, N = 19) or the control group (CG, N = 16). Over a 3-week period, the HITG performed 11 HIT sessions, consisting of four 4-min interval bouts at an exercise intensity of 90-95 % of the individual maximal heart rate (HRmax), separated by 4-min active recovery periods. Before and 5 ± 2 days after the intervention, tHb-mass, BV and PV were determined by the CO-rebreathing method. VO2max was assessed in a laboratory treadmill test.

RESULTS

tHb-mass (from 753 ± 124 to 760 ± 121 g), BV (from 5.6 ± 0.8 to 5.6 ± 0.9 l) and PV (from 3.2 ± 0.5 to 3.2 ± 0.5 l) remained unchanged after HIT and did not show an interaction (group × time). Within the HITG, VO2max improved from baseline by +3.5 % (p = 0.011), but remained unchanged in the CG. No interaction (group × time) was seen for VO2max. The HITG showed a significant reduction in HRmax compared to the baseline measurement (-2.3 %, p ≤ 0.001), but HRmax remained unchanged in the CG. There was a significant interaction (group × time) for HRmax (p = 0.006). Also, oxygen pulse significantly increased only in HITG from 22.9 ± 4.4 to 23.9 ± 4.2 ml/beat, with no interaction (p = 0.150).

CONCLUSIONS

Eleven HIT sessions added to usual training did neither improve VO2max nor haematological parameters compared to the CG.

How exercise may amend metabolic disturbances in diabetic cardiomyopathy

SIGNIFICANCE

Over-nutrition and sedentary lifestyle has led to a worldwide increase in obesity, insulin resistance, and type 2 diabetes (T2D) associated with an increased risk of development of cardiovascular disorders. Diabetic cardiomyopathy, independent of hypertension or coronary disease, is induced by a range of systemic changes and may through multiple processes result in functional and structural cardiac derangements. The pathogenesis of this cardiomyopathy is complex and multifactorial, and it will eventually lead to reduced cardiac working capacity and increased susceptibility to ischemic injury.

RECENT ADVANCES

Metabolic disturbances such as altered lipid handling and substrate utilization, decreased mechanical efficiency, mitochondrial dysfunction, disturbances in nonoxidative glucose pathways, and increased oxidative stress are hallmarks of diabetic cardiomyopathy. Interestingly, several of these disturbances are found to precede the development of cardiac dysfunction.

CRITICAL ISSUES

Exercise training is effective in the prevention and treatment of obesity and T2D. In addition to its beneficial influence on diabetes/obesity-related systemic changes, it may also amend many of the metabolic disturbances characterizing the diabetic myocardium. These changes are due to both indirect effects, exercise-mediated systemic changes, and direct effects originating from the high contractile activity of the heart during physical training.

FUTURE DIRECTIONS

Revealing the molecular mechanisms behind the beneficial effects of exercise training is of considerable scientific value to generate evidence-based therapy and in the development of new treatment strategies.

The effects of high intensity interval training in women with rheumatic disease: a pilot study

PURPOSE

Rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) are inflammatory diseases which involve increased risk of cardiovascular disease (CVD). High intensity interval training (HIIT) is known to be effective in improving cardiovascular health. The aim of this study was to investigate whether 10 weeks of HIIT at 85-95% of HRmax would improve important risk factors of CVD in rheumatic patients, and if these patients would tolerate exercise intensities above today's recommendations.

METHODS

Seven women with RA and eleven with adult-JIA, 20-50 years, were recruited to this cross-over study. Participants performed HIIT, consisting of 4 × 4 min intervals at 85-95% of HRmax twice a week for 10 weeks on spinning bikes. Maximal oxygen uptake (VO2max), heart rate recovery, blood pressure, body composition, and blood variables were measured before and after the exercise and control period. Disease activity was determined and questionnaire data were collected.

RESULTS

HIIT resulted in 12.2% increase in VO2max and 2.9% improvement in heart rate recovery (p < 0.05). BMI, body fat, and waist circumference decreased 1.2, 1.0, and 1.6%, respectively, whereas muscle mass increased 0.6% (p < 0.05). A trend toward decreased CRP was detected after HIIT (p = 0.08). No changes were detected in disease activity or pain.

CONCLUSION

Despite rigorous high intensity exercise, no increase was detected in disease activity or pain, indicating that HIIT was well tolerated by these patients. Furthermore, HIIT had positive effects on several CVD risk factors. In light of this pilot study, HIIT seems like a promising non-pharmacological treatment strategy for patients with RA and adult-JIA.

Age-related decline in mitral peak diastolic velocities is unaffected in well-trained runners

OBJECTIVES

We examined whether diastolic left ventricular function in young and senior lifelong endurance runners was significantly different from that in sedentary age-matched controls, and whether lifelong endurance running appears to modify the age-related decline in diastolic left ventricular function.

DESIGN

The study comprised 17 senior athletes (age: 59-75 years, running distance: 30-70 km/week), 10 young athletes (age: 20-36 years, matched for running distance), and 11 senior and 12 young weight-matched sedentary controls. Peak early (E) and late (A) mitral inflow and early (e') and late (a') diastolic and systolic (s') annular longitudinal tissue Doppler velocities were measured by echocardiography during four stages (rest, supine bike exercise at 30% and 60% of maximal workload, and recovery).

RESULTS

The athletes had marked cardiac remodeling, while overall differences in mitral inflow and annular tissue Doppler velocities during rest and exercise were more associated with age than with training status. The senior participants had lower E/A at rest, overall lower E, e' and s', and greater E/e' compared to the young participants (all values of P < 0.05). The athletes had greater E/A (P = 0.004), but tissue Doppler velocities were not different from those of the controls.

CONCLUSIONS

Lifelong endurance running was not found to be associated with major attenuation of the age-related decline in diastolic function at rest or during exercise.

High-intensity interval training: Modulating interval duration in overweight/obese men

INTRODUCTION

High-intensity interval training (HIIT) is a time-efficient strategy shown to induce various cardiovascular and metabolic adaptations. Little is known about the optimal tolerable combination of intensity and volume necessary for adaptations, especially in clinical populations.

OBJECTIVES

In a randomized controlled pilot design, we evaluated the effects of two types of interval training protocols, varying in intensity and interval duration, on clinical outcomes in overweight/obese men.

METHODS

Twenty-five men [body mass index (BMI) > 25 kg · m(2)] completed baseline body composition measures: fat mass (FM), lean mass (LM) and percent body fat (%BF) and fasting blood glucose, lipids and insulin (IN). A graded exercise cycling test was completed for peak oxygen consumption (VO2peak) and power output (PO). Participants were randomly assigned to high-intensity short interval (1MIN-HIIT), high-intensity interval (2MIN-HIIT) or control groups. 1MIN-HIIT and 2MIN-HIIT completed 3 weeks of cycling interval training, 3 days/week, consisting of either 10 × 1 min bouts at 90% PO with 1 min rests (1MIN-HIIT) or 5 × 2 min bouts with 1 min rests at undulating intensities (80%-100%) (2MIN-HIIT).

RESULTS

There were no significant training effects on FM (Δ1.06 ± 1.25 kg) or %BF (Δ1.13% ± 1.88%), compared to CON. Increases in LM were not significant but increased by 1.7 kg and 2.1 kg for 1MIN and 2MIN-HIIT groups, respectively. Increases in VO2peak were also not significant for 1MIN (3.4 ml·kg(-1) · min(-1)) or 2MIN groups (2.7 ml · kg(-1) · min(-1)). IN sensitivity (HOMA-IR) improved for both training groups (Δ-2.78 ± 3.48 units; p < 0.05) compared to CON.

CONCLUSION

HIIT may be an effective short-term strategy to improve cardiorespiratory fitness and IN sensitivity in overweight males.

Effect of Change in VO2max on Daily Total Energy Expenditure in a Cohort of Norwegian Men: A Randomized Pilot Study

OBJECTIVE

To investigate how a change in VO2max induced through 6 weeks of high intensity aerobic interval training affects daily total energy expenditure (TEE), active energy expenditure (AEE) and mitochondrial function in people not previously exposed to structured high intensity aerobic interval training (AIT).

METHODS

Thirty healthy males (39±6 yrs) not exposed to structured exercise training were randomized to either 1x4 min AIT (1-AIT), 4x4 min AIT (4-AIT), both at 90-95% maximum heart rate (HRmax) or 47 min of MCT at 70% HRmax. TEE, AEE, number of steps, active time, sedentary time, VO2max and mitochondrial function in m. vastus lateralis were measured before and after intervention.

RESULTS

TEE increased 14% (p=0.014) and AEE increased 43% (p= 0.004) after MCT. There was no change in TEE or AEE after 1-AIT or 4-AIT, but 1-AIT had significantly lower TEE (p=0.033) and step-count (p=0.011) compared to MCT post intervention. VO2max increased 7% after 1-AIT (p= 0.004) and 9% after 4-AIT (p=0.004), with no change after MCT. No change was observed in maximal mitochondrial respiration (VMAX) or Citrate Synthase (CS) activity within or between interventions. Basal respiration (V0) increased after 1-AIT (p=0.029) and 4-AIT (p=0.022), with no significant change after MCT.

CONCLUSION

AIT interventions that increase VO2max, do not stimulate subjects to increase TEE or AEE. The intensity of exercise seems to play apart, as MCT increased TEE and AEE and AIT did not. Emphasis should be placed on the importance of maintaining everyday activities when introducing structured exercise training to untrained individuals.

Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients

Objectives

To analyze the effects of a long-term intensive lifestyle intervention including high-intensity interval training (HIIT) and Mediterranean diet (MedD) counseling on glycemic control parameters, insulin resistance and β-cell function in obese subjects.

Methods

The glycemic control parameters (fasting plasma glucose, glycated hemoglobin), insulin resistance, and β-cell function of 72 obese subjects (54 women; mean age = 53 ± 9 years) were assessed at baseline and upon completion of a 9-month intensive lifestyle intervention program conducted at the cardiovascular prevention and rehabilitation center of the Montreal Heart Institute, from 2009 to 2012. The program included 2–3 weekly supervised exercise training sessions (HIIT and resistance exercise), combined to MedD counseling.

Results

Fasting plasma glucose (FPG) (mmol/L) (before: 5.5 ± 0.9; after: 5.2 ± 0.6; P < 0.0001), fasting insulin (pmol/L) (before: 98 ± 57; after: 82 ± 43; P = 0.003), and insulin resistance, as assessed by the HOMA-IR score (before: 3.6 ± 2.5; after: 2.8 ± 1.6; P = 0.0008) significantly improved, but not HbA1c (%) (before: 5.72 ± 0.55; after: 5.69 ± 0.39; P = 0.448), nor β-cell function (HOMA-β, %) (before: 149 ± 78; after: 144 ± 75; P = 0.58).

Conclusion

Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects.

•

High-intensity interval training and Mediterranean diet improves glycemic parameters in obese subjects.

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Patients with insulin resistance benefit the most from this program.

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This is the first study to confirm these long-term benefits with such a program.

Physiological load associated with a Zumba(®) fitness workout: a comparison pilot study between classes and a DVD

The objectives were to compare the metabolic load elicited by Zumba(®) classes and DVD workouts and link the physiological responses to participants' psychological characteristics. Fifteen women (25.4 ± 4.3 years old; 164.9 ± 5.1 cm; 56.9 ± 5.8 kg; 23.9 ± 4.9% body fat) performed three Zumba(®) classes and three Zumba(®) DVD workouts using a repeated measure design. Energy expenditure was assessed by extrapolating oxygen cost from heart rate (HR) using regressions from a preliminary incremental running test. Differences between Zumba(®) classes and Zumba(®) DVD workouts were assessed by Student's T tests and repeated measures analysis of variance and correlations between physiological and psychological variables by the Pearson's coefficient. Results showed that Zumba(®) classes allowed greater energy expenditure compared to Zumba(®) DVD workouts (6.8 ± 0.9 vs 5.6 ± 0.9 kcal · min(-1), 95% confidence interval (CI) limits: 0.3-2.1, P = 0.016), with significant differences in the time spent with a HR above 85% of HR reserve (14.7 vs 1.7%, 95% CI: 5.6-20.4, P = 0.021). Furthermore, women with a greater autonomy score showed a smaller difference between DVD and class (r = 0.511, P = 0.048), while greater differences were shown in women with greater interpersonal skills (r = -0.563, P = 0.028). The results suggest that while both types of workouts are suitable to maintain fitness Zumba(®) classes allow greater energy expenditure.

Endurance training inhibits insulin clearance and IDE expression in Swiss mice

INTRODUCTION

Endurance training improves peripheral insulin sensitivity in the liver and the skeletal muscle, but the mechanism for this effect is poorly understood. Recently, it was proposed that insulin clearance plays a major role in both glucose homeostasis and insulin sensitivity. Therefore, our goal was to determine the mechanism by which endurance training improves insulin sensitivity and how it regulates insulin clearance in mice.

METHODS

Mice were treadmill-trained for 4 weeks at 70-80% of maximal oxygen consumption (VO2 max) for 60 min, 5 days a week. The glucose tolerance and the insulin resistance were determined using an IPGTT and an IPITT, respectively, and the insulin decay rate was calculated from the insulin clearance. Protein expression and phosphorylation in the liver and the skeletal muscle were ascertained by Western blot.

RESULTS

Trained mice exhibited an increased VO2 max, time to exhaustion, glucose tolerance and insulin sensitivity. They had smaller fat pads and lower plasma concentrations of insulin and glucose. Endurance training inhibited insulin clearance and reduced expression of IDE in the liver, while also inhibiting insulin secretion by pancreatic islets. There was increased phosphorylation of both the canonical (IR-AKT) and the non-canonical (CaMKII-AMPK-ACC) insulin pathways in the liver of trained mice, whereas only the CaMKII-AMPK pathway was increased in the skeletal muscle.

CONCLUSION

Endurance training improved glucose homeostasis not only by increasing peripheral insulin sensitivity but also by decreasing insulin clearance and reducing IDE expression in the liver.

High intensity interval and endurance training have opposing effects on markers of heart failure and cardiac remodeling in hypertensive rats

There has been re-emerging interest and significant work dedicated to investigating the metabolic effects of high intensity interval training (HIIT) in recent years. HIIT is considered to be a time efficient alternative to classic endurance training (ET) that elicits similar metabolic responses in skeletal muscle. However, there is a lack of information on the impact of HIIT on cardiac muscle in disease. Therefore, we determined the efficacy of ET and HIIT to alter cardiac muscle characteristics involved in the development of diastolic dysfunction, such as ventricular hypertrophy, fibrosis and angiogenesis, in a well-established rodent model of hypertension-induced heart failure before the development of overt heart failure. ET decreased left ventricle fibrosis by ~40% (P < 0.05), and promoted a 20% (P<0.05) increase in the left ventricular capillary/fibre ratio, an increase in endothelial nitric oxide synthase protein (P<0.05), and a decrease in hypoxia inducible factor 1 alpha protein content (P<0.05). In contrast, HIIT did not decrease existing fibrosis, and HIIT animals displayed a 20% increase in left ventricular mass (P<0.05) and a 20% decrease in cross sectional area (P<0.05). HIIT also increased brain natriuretic peptide by 50% (P<0.05), in the absence of concomitant angiogenesis, strongly suggesting pathological cardiac remodeling. The current data support the longstanding belief in the effectiveness of ET in hypertension. However, HIIT promoted a pathological adaptation in the left ventricle in the presence of hypertension, highlighting the need for further research on the widespread effects of HIIT in the presence of disease.

Time-to-Fatigue During Incline Treadmill Running: Implications for Individualized Training Prescription

Uphill running has been touted as a key interval training tactic for distance runners despite few scientifically derived recommendations for individualized training prescription. To date, a majority of uphill training research has focused on shorter, faster training bouts; however, longer, slower bouts based on an individual's velocity at maximum oxygen consumption (Vmax) may prove more effective. One potential longer bout length may be associated with the time Vmax can be maintained (Tmax), an approach proven effective in level-grade interval training. Therefore, the purpose of this investigation included examining the Tmax, heart rate, and test-retest reliability of incline treadmill running (INC) on a 10% grade at 65, 70, 75, 80, and 85%Vmax compared with level-grade running at Vmax. Twelve moderately trained distance runners (age, 26.4 ± 4.8; body mass, 64.3 ± 12.9 kg; height, 171.2 ± 9.3 cm; and V̇O2max, 56.6 ± 7.6 ml·min⁻¹·kg⁻¹) completed 2 Tmax INC trials at each submaximal Vmax and a level-grade Tmax at Vmax. The dependent variables were Tmax, heart rate plateau (HR(Plateau)), and half-time to heart rate plateau (½HR(Plateau)) of each condition. Statistical significance was set to p ≤ 0.05. Student's t-test revealed no significant differences in Tmax, HR(Plateau), and ½HR(Plateau) between trials 1 and 2 at any INC condition. One-way analysis of variance revealed significant differences in (a) Tmax during INC at 75, 80, and 85%Vmax and level-grade at Vmax and (b) ½HR(Plateau) during INC at 80 and 85%Vmax and all other conditions. In conclusion, Tmax and heart rate dynamics during INC proved reliable, and simple regression analysis revealed ∼68%Vmax during INC yields the same level-grade Tmax at Vmax.

Different ankle muscle coordination patterns and co-activation during quiet stance between young adults and seniors do not change after a bout of high intensity training

Background

Available evidence suggests that young adults and seniors use different strategies to adjust for increasing body sway during quiet standing. Altered antagonist muscle co-activation and different ankle muscle coordination patterns may account for this finding. Consequently, we aimed at addressing whether aging leads to changes in neuromuscular coordination patterns as well as co-activation during quiet stance. We additionally investigated whether a bout of high intensity interval training additionally alters these patterns.

Methods

Twenty healthy seniors (age: 70 ± 4 y) and twenty young adults (age: 27 ± 3 y) were enrolled in the present study. In between the testing procedures, four consecutive high-intensity intervals of 4 min duration at a target exercise intensity of 90 to 95% HR_max were completed on a treadmill. The total center of pressure (COP) path length displacement served as standing balance performance outcome. In order to assess ankle muscle coordination patterns, amplitude ratios (AR) were calculated for each muscle (e.g. tibialis anterior (TA) [%] = (TA × 100)/(gastrocnemius medialis (GM) + soleus (SOL) + peroneus longus (PL) + TA). The co-activation was calculated for the SOL and TA muscles computing the co-activation index (CAI = 2 × TA/TA + SOL).

Results

Seniors showed an inverted ankle muscle coordination pattern during single limb stance with eyes open (SLEO), compared to young adults (rest: GM, S: 15 ± 8% vs Y: 24 ± 9%; p = 0.03; SOL, S: 27 ± 14% vs Y: 37 ± 18%; p = 0.009; TA, S: 31 ± 13% vs Y: 13 ± 7%; p = 0.003). These patterns did not change after a high-intensity training session. A moderate correlation between amplitude ratios of the TA-contribution and postural sway was observed for seniors during SLEO (r = 0.61). Ankle co-activation was twofold elevated in seniors compared to young adults during SLEO (p < 0.001). These findings were also not affected by high intensity training.

Conclusion

Increased ankle co-activation in the anterior-posterior plane and inverted ankle muscle coordination pattern merely occurred during single-leg stance. Seniors with decreased postural control showed higher TA contributions during SLEO. These neuromuscular changes are not affected by acute intermittent high intensity aerobic exercise.

Effect of game format on heart rate, activity profile, and player involvement in elite and recreational youth players

The purpose of this study was to evaluate activity profile, aerobic load, and player involvement in two game formats of recreational and elite youth football for two age groups. A total of 152 youth players participated, with 45 U10 players playing 5v5 and 8v8 games, and 41 U13 players playing 8v8 and 11v11 (20 min) games. Activity profile, heart rate (HR), and technical actions were measured during all games using 10 Hz GPS, video filming, and HR monitors. For U10, no difference was found in total distance covered (1754 ± 237 vs 1771 ± 314 m, P = 0.650, d = 0.06), whereas mean HR (174 ± 10 vs 168 ± 12 bpm, P = 0.001, d = 0.59) and number of technical actions (65.1 ± 24.0 vs 36.9 ± 20.4, P    0.001, d = 1.27) were higher in 5v5 than in 8v8. For U13, lower total distance covered (1821 ± 325 vs 2038 ± 328 m, P < 0.001, d = 0.66) and higher number of technical actions (36.2 ± 14.9 vs 26.9 ± 14.1, P < 0.001, d = 0.64) were observed in 8v8 than in 11v11, with no difference in mean HR (170 ± 10 vs 171 ± 10 bpm, P = 0.679, d = 0.10). In conclusion, HR is high in youth football matches irrespective of the level of play and the game format. Playing with fewer players on smaller pitches results in minor changes to the physical loading but elevates the technical involvement of youth players both at elite level and recreational level.

Cardiorespiratory fitness in groups with different physical activity levels

The aim of the study was to determine how different categorizations of self-reported and objectively measured physical activity (PA) reflect variations in cardiorespiratory fitness (VO2max ). A total of 759 individuals (366 women) with a mean age of 48.5 years (SD 14.4) wore an accelerometer (ActiGraph GT1M) for seven consecutive days and answered the short International Physical Activity Questionnaire (IPAQ). VO2max was directly measured during a continuous graded exercise treadmill test until exhaustion. Men and women categorized as highly active by IPAQ had 9% and 13% higher VO2max , respectively, than those reporting a low PA level (P < 0.05). Men and women meeting the PA recommendation of 150 min/week of daily moderate intensity PA, measured by accelerometer, had 13% and 9% higher VO2max , respectively, than participants not meeting this recommendation (P < 0.01). No significant differences in average sedentary time, analyzed in total min/day and in bouts of 10 and 30 min, were found between participants with high or low cardiorespiratory fitness. However, women spent less time than men in bouts of sedentary behaviors. Self-reported PA by IPAQ and objectively measured PA by accelerometer were both useful instruments for detecting differences in VO2max .

High-intensity interval training with vibration as rest intervals attenuates fiber atrophy and prevents decreases in anaerobic performance

Aerobic high-intensity interval training (HIT) improves cardiovascular capacity but may reduce the finite work capacity above critical power (W′) and lead to atrophy of myosin heavy chain (MyHC)-2 fibers. Since whole-body vibration may enhance indices of anaerobic performance, we examined whether side-alternating whole-body vibration as a replacement for the active rest intervals during a 4x4 min HIT prevents decreases in anaerobic performance and capacity without compromising gains in aerobic function. Thirty-three young recreationally active men were randomly assigned to conduct either conventional 4x4 min HIT, HIT with 3 min of WBV at 18 Hz (HIT+VIB18) or 30 Hz (HIT+VIB30) in lieu of conventional rest intervals, or WBV at 30 Hz (VIB30). Pre and post training, critical power (CP), W′, cellular muscle characteristics, as well as cardiovascular and neuromuscular variables were determined. W′ (−14.3%, P = 0.013), maximal voluntary torque (−8.6%, P = 0.001), rate of force development (−10.5%, P = 0.018), maximal jumping power (−6.3%, P = 0.007) and cross-sectional areas of MyHC-2A fibers (−6.4%, P = 0.044) were reduced only after conventional HIT. CP, V̇O2peak, peak cardiac output, and overall capillary-to-fiber ratio were increased after HIT, HIT+VIB18, and HIT+VIB30 without differences between groups. HIT-specific reductions in anaerobic performance and capacity were prevented by replacing active rest intervals with side-alternating whole-body vibration, notably without compromising aerobic adaptations. Therefore, competitive cyclists (and potentially other endurance-oriented athletes) may benefit from replacing the active rest intervals during aerobic HIT with side-alternating whole-body vibration.

A randomised controlled study of the long-term effects of exercise training on mortality in elderly people: study protocol for the Generation 100 study

INTRODUCTION

Epidemiological studies suggest that exercise has a tremendous preventative effect on morbidity and premature death, but these findings need to be confirmed by randomised trials. Generation 100 is a randomised, controlled study where the primary aim is to evaluate the effects of 5 years of exercise training on mortality in an elderly population.

METHODS AND ANALYSIS

All men and women born in the years 1936-1942 (n=6966), who were residents of Trondheim, Norway, were invited to participate. Between August 2012 and June 2013, a total of 1567 individuals (790 women) were included and randomised to either 5 years of two weekly sessions of high-intensity training (10 min warm-up followed by 4×4 min intervals at ∼90% of peak heart rate) or, moderate-intensity training (50 min of continuous work at ∼70% of peak heart rate), or to a control group that followed physical activity advice according to national recommendations. Clinical examinations, physical tests and questionnaires will be administered to all participants at baseline, and after 1, 3 and 5 years. Participants will also be followed up by linking to health registries until year 2035.

ETHICS AND DISSEMINATION

The study has been conducted according to the SPIRIT statement. All participants signed a written consent form, and the study has been approved by the Regional Committee for Medical Research Ethics, Norway. Projects such as this are warranted in the literature, and we expect that data from this study will result in numerous papers published in world-leading clinical journals; we will also present the results at international and national conferences.

TRIAL REGISTRATION NUMBER

Clinicaltrials.gov NCT01666340.

Effects of low-volume high-intensity interval training (HIT) on fitness in adults: a meta-analysis of controlled and non-controlled trials

Background

Low-volume high-intensity interval training (HIT) appears to be an efficient and practical way to develop physical fitness.

Objective

Our objective was to estimate meta-analysed mean effects of HIT on aerobic power (maximum oxygen consumption [VO_2max] in an incremental test) and sprint fitness (peak and mean power in a 30-s Wingate test).

Data Sources

Five databases (PubMed, MEDLINE, Scopus, BIOSIS and Web of Science) were searched for original research articles published up to January 2014. Search terms included ‘high intensity’, ‘HIT’, ‘sprint’, ‘fitness’ and ‘VO_2max’.

Study Selection

Inclusion criteria were fitness assessed pre- and post-training; training period ≥2 weeks; repetition duration 30–60 s; work/rest ratio <1.0; exercise intensity described as maximal or near maximal; adult subjects aged >18 years.

Data Extraction

The final data set consisted of 55 estimates from 32 trials for VO_2max, 23 estimates from 16 trials for peak sprint power, and 19 estimates from 12 trials for mean sprint power. Effects on fitness were analysed as percentages via log transformation. Standard errors calculated from exact p values (where reported) or imputed from errors of measurement provided appropriate weightings. Fixed effects in the meta-regression model included type of study (controlled, uncontrolled), subject characteristics (sex, training status, baseline fitness) and training parameters (number of training sessions, repetition duration, work/rest ratio). Probabilistic magnitude-based inferences for meta-analysed effects were based on standardized thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject standard deviations (SDs) for baseline fitness.

Results

A mean low-volume HIT protocol (13 training sessions, 0.16 work/rest ratio) in a controlled trial produced a likely moderate improvement in the VO_2max of active non-athletic males (6.2 %; 90 % confidence limits ±3.1 %), when compared with control. There were possibly moderate improvements in the VO_2max of sedentary males (10.0 %; ±5.1 %) and active non-athletic females (3.6 %; ±4.3 %) and a likely small increase for sedentary females (7.3 %; ±4.8 %). The effect on the VO_2max of athletic males was unclear (2.7 %; ±4.6 %). A possibly moderate additional increase was likely for subjects with a 10 mL·kg⁻¹·min⁻¹ lower baseline VO_2max (3.8 %; ±2.5 %), whereas the modifying effects of sex and difference in exercise dose were unclear. The comparison of HIT with traditional endurance training was unclear (−1.6 %; ±4.3 %). Unexplained variation between studies was 2.0 % (SD). Meta-analysed effects of HIT on Wingate peak and mean power were unclear.

Conclusions

Low-volume HIT produces moderate improvements in the aerobic power of active non-athletic and sedentary subjects. More studies are needed to resolve the unclear modifying effects of sex and HIT dose on aerobic power and the unclear effects on sprint fitness.

Age related vascular endothelial function following lifelong sedentariness: positive impact of cardiovascular conditioning without further improvement following low frequency high intensity interval training

Aging is associated with diffuse impairments in vascular endothelial function and traditional aerobic exercise is known to ameliorate these changes. High intensity interval training (HIIT) is effective at improving vascular function in aging men with existing disease, but its effectiveness remains to be demonstrated in otherwise healthy sedentary aging. However, the frequency of commonly used HIIT protocols may be poorly tolerated in older cohorts. Therefore, the present study investigated the effectiveness of lower frequency HIIT (L_fHIIT) on vascular function in a cohort of lifelong sedentary (SED; n =22, age 62.7 ± 5.2 years) men compared with a positive control group of lifelong exercisers (LEX; n = 17, age 61.1 ± 5.4 years). The study consisted of three assessment phases; enrolment to the study (Phase A), following 6 weeks of conditioning exercise in SED (Phase B) and following 6 weeks of low frequency HIIT in both SED and LEX (L_fHIIT; Phase C). Conditioning exercise improved FMD in SED (3.4 ± 1.5% to 4.9 ± 1.1%; P <0.01) such that the difference between groups on enrolment (3.4 ± 1.5% vs. 5.3 ± 1.4%; P <0.01) was abrogated. This was maintained but not further improved following L_fHIIT in SED whilst FMD remained unaffected by L_fHIIT in LEX. In conclusion, L_fHIIT is effective at maintaining improvements in vascular function achieved during conditioning exercise in SED. L_fHIIT is a well‐tolerated and effective exercise mode for reducing cardiovascular risk and maintaining but does not improve vascular function beyond that achieved by conditioning exercise in aging men, irrespective of fitness level.

The effects of low frequency high intensity interval training (HIIT) on vascular endothelial function in lifelong sedentary men remains currently unknown. The present study examined the impact of low frequency HIIT following conditioning exercise on low determinants of vascular endothelial function and angiogenic biomarkers in aging men compared with a positive control group of similarly aged. The major findings of this study indicate that low frequency HIIT is a well‐tolerated and effective exercise mode for reducing cardiovascular risk and maintaining but not improving endothelial function beyond that achieved by conditioning exercise in aging men, irrespective of fitness level.

The feasibility and effectiveness of high-intensity boxing training versus moderate-intensity brisk walking in adults with abdominal obesity: a pilot study

Background

High-intensity interval training (HIIT) performed on exercise cycle or treadmill is considered safe and often more beneficial for fat loss and cardiometabolic health than moderate-intensity continuous training (MICT). The aim of this pilot study was to assess the feasibility and effectiveness of a 12-week boxing training (HIIT) intervention compared with an equivalent dose of brisk walking (MICT) in obese adults.

Methods

Men and women with abdominal obesity and body mass index >25 kg/m² were randomized to either a boxing group or a brisk walking (control) group for 12 weeks. Each group engaged in 4 training sessions per week, equated for total physical activity. Feasibility outcomes included recruitment rates, assessment of training intensities, adherence and adverse events. Effectiveness was assessed pre and post intervention via pertinent obesity-, cardiovascular-, and health-related quality of life (HRQoL) outcomes.

Results

Nineteen individuals expressed an interest and 63% (n = 12) consented. Recruitment was slower than anticipated (1.3 participants/week). The boxing group trained at a significantly higher intensity each week versus the brisk walking group (p < 0.05). Two participants in the boxing group experienced an adverse event; both continued to exercise with modifications to the exercise program. No other adverse events were noted. The boxing group attended more sessions (79% vs. 55%) and had a lower attrition rate (n = 0 vs. n = 2) than the walking group. Analysis of covariance revealed that the boxing group significantly improved body fat percentage (p = 0.047), systolic blood pressure (p = 0.026), augmentation index (AIx; p < 0.001), absolute VO_2max (p = 0.015), and Physical Functioning (p = 0.042) and Vitality (p = 0.024) domains of HRQoL over time. The walking group did not improve any clinical outcomes, and experienced a worsening of Vitality (p = 0.043).

Conclusions

Boxing training (HIIT) in adults with abdominal obesity is feasible and may elicit a better therapeutic effect on obesity, cardiovascular, and HRQoL outcomes than an equivalent dose of brisk walking (MICT). Robustly designed randomized controlled trials are required to confirm these findings and inform clinical guidelines and practice for obesity treatment.

Trial registration

Trial registration: ACTRN12615000007538

Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes

IN BRIEF Recent research has shown that high-intensity interval training (HIIT) can promote improvements in glucose control and cardiovascular health in individuals with type 2 diabetes. This article summarizes the evidence and highlights the ways in which HIIT might be safely implemented as an adjunct to more traditional exercise approaches.

Acute effects of interval versus continuous endurance training on pulse wave reflection in healthy young men

AIM

Our aim was to investigate the acute and 24-hour (h) effects of high-intensity interval training (HIIT) and moderate continuous training (MCT) on arterial pulse wave reflection, an established marker of arterial stiffness and cardiovascular risk.

METHODS

In a randomized cross-over design, 21 young healthy male participants performed a HIIT or a MCT on separate visits. Before and 5 (t5), 20 (t20), 35 (t35), and 50 (t50) minutes after the acute exercise bouts, the crude augmentation index (AIx) and the AIx at a set heart rate (AIx@75) were analysed by applanation tonometry. Starting 1 h post-exercise, both indices were captured over 24-h with an oscillometric monitoring device.

RESULTS

AIx did not change significantly after MCT but declined progressively after HIIT, reaching significantly lower values compared to MCT at t35 (P = 0.045) and t50 (P = 0.008). AIx@75 increased after both acute exercise types but was higher after HIIT at t5 (P < 0.001), t20 (P < 0.001) and t35 (P = 0.009) compared to MCT. The 24-h follow-up revealed a significant decline in AIx@75 after HIIT (P = 0.007) but not after MCT (P = 0.813).

CONCLUSIONS

Exercise intensity affects pulse wave reflection, with different time courses for AIx and AIx@75 post-exercise. Although initially higher after HIIT, AIx@75 declines in the 24-h recovery period indicating more favourable effects on pulse wave reflection compared to MCT. This may result in substantial positive chronic training effects on arterial stiffness in health and cardiovascular disease.