Extremely short duration high intensity interval training substantially improves insulin action in young healthy males

Physiological and Metabolic Responses to Low-Volume Sprint Interval Exercises: Influence of Sprint Duration and Repetitions

PURPOSE

This study aimed to determine physiological and metabolic responses to two different sprint interval exercises (SIE) matched for total sprint duration and sprint-rest ratio.

METHODS

After having measured peak oxygen uptake (V̇O 2peak ), 14 healthy males (27.1 ± 4.8 yr, 169.6 ± 6.0 cm, 64.5 ± 8.4 kg, V̇O 2peak : 47.2 ± 7.7 mL·kg -1 ·min -1 ) performed four 10-s sprints with 80-s recovery (SIE10) and two 20-s sprints with 160-s recovery (SIE20) on different occasions in a counterbalanced crossover manner. Pulmonary V̇O 2 and changes in tissue oxygenation index (∆TOI) at vastus lateralis (VL) and rectus femoris (RF) were measured during the SIE. Furthermore, T2-weighted magnetic resonance imaging was taken immediately before and after the SIE to determine the activation levels of VL, RF, vastus medialis, vastus intermedius, adductor magnus, biceps femoris long head, semitendinosus, and semimembranosus at 50% of right thigh length.

RESULTS

In SIE10, increases in V̇O 2 and ∆TOI at VL and RF plateaued after the second sprint, whereas session-averaged ∆TOI was greater in SIE20 than SIE10 in both muscles (VL: 20.9 ± 7.4 vs 14.2% ± 5.9%, RF: 22.8 ± 9.3 vs 12.9% ± 6.6%, P = 0.00). Although both SIE significantly increased T2 values in all eight muscles, those magnitudes were similar between the conditions (SIE10 vs SIE20: 5%-16% vs 8%-16%).

CONCLUSIONS

This study showed blunted responses of whole-body (V̇O 2 ) and peripheral (∆TOI) oxidative responses with successive sprints (sprint 1 < sprints 2-4) in SIE10, suggesting that increasing sprint repetitions does not necessarily induce greater oxidative metabolism or stimulus. Moreover, greater peripheral oxygen extraction (∆TOI) was achieved with SIE20, whereas %changes of T2 indicates that the thigh muscles were similarly activated between the SIE conditions.

Reduced-exertion high-intensity interval training (REHIT): a feasible approach for improving health and fitness?

In recent years, research investigating the dose-response to sprint interval training (SIT) has provided evidence that the number and duration of repetitions in a SIT session can be reduced whilst preserving the beneficial health-related adaptations. Together this research has led to the development of protocols involving minimal doses of SIT: regularly performing just two or three 20-30 s all-out sprints in a 10 min training session has been shown to elicit beneficial metabolic and cardiovascular adaptations. These SIT protocols, which we originally termed "reduced-exertion high-intensity interval training" (or REHIT), have the potential to remove many of the common barriers associated with other SIT protocols, as well as with HIT and aerobic exercise. Here, we critically review the evidence on the efficacy, feasibility and acceptability, and effectiveness of REHIT for improving health and fitness.

No Sex Differences in Perceptual Responses to High-Intensity Interval Training or Sprint Interval Training

ABSTRACT

Coe, LN and Astorino, TA. No sex differences in perceptual responses to high-intensity interval training or sprint interval training. J Strength Cond Res 36(6): 1025-1032, 2024-High-intensity interval training (HIIT) elicits similar and, in some cases, superior benefits vs. moderate-intensity continuous training (MICT). However, HIIT is typically more aversive than MICT because of the higher intensity and in turn, greater blood lactate accumulation (BLa). This study explored potential sex differences in perceptual responses to acute HIIT and sprint interval training. Fifteen men (age and V̇O2max = 29 ± 8 years and 39 ± 3 ml·kg-1·min-1) and 13 women (age and V̇O2max = 22 ± 2 years and 38 ± 5 ml·kg-1·min-1) who are healthy and recreationally active initially underwent testing of maximal oxygen uptake (V̇O2max) on a cycle ergometer. In randomized order on 3 separate occasions, they performed the 10 × 1-minute protocol at 85% of peak power output, 4 × 4-minute protocol at 85-95% maximal heart rate (%HRmax), or reduced exertion high intensity interval training consisting of 2 "all-out" 20-second sprints at a load equal to 5% body mass. Before and throughout each protocol, rating of perceived exertion (rating of perceived exertion [RPE] 6-20 scale), affective valence (+5 to -5 of the Feeling Scale), and BLa were assessed. Five minutes postexercise, enjoyment was measured using the Physical Activity Enjoyment scale survey. Results showed no difference in RPE (p = 0.17), affective valence (0.27), or enjoyment (p = 0.52) between men and women. Blood lactate accumulation increased in response to all protocols (p < 0.001), and men showed higher BLa than women (p = 0.03). Previous research suggests that interval exercise protocols are not interchangeable between men and women, yet our data reveal that men and women having similar V̇O2max exhibit no differences in perceptual responses to interval exercise.

GLUT4 localisation with the plasma membrane is unaffected by an increase in plasma free fatty acid availability

BACKGROUND

Insulin-stimulated glucose uptake into skeletal muscle occurs via translocation of GLUT4 from intracellular storage vesicles to the plasma membrane. Elevated free fatty acid (FFA) availability via a lipid infusion reduces glucose disposal, but this occurs in the absence of impaired proximal insulin signalling. Whether GLUT4 localisation to the plasma membrane is subsequently affected by elevated FFA availability is not known.

METHODS

Trained (n = 11) and sedentary (n = 10) individuals, matched for age, sex and body mass index, received either a 6 h lipid or glycerol infusion in the setting of a concurrent hyperinsulinaemic-euglycaemic clamp. Sequential muscle biopsies (0, 2 and 6 h) were analysed for GLUT4 membrane localisation and microvesicle size and distribution using immunofluorescence microscopy.

RESULTS

At baseline, trained individuals had more small GLUT4 spots at the plasma membrane, whereas sedentary individuals had larger GLUT4 spots. GLUT4 localisation with the plasma membrane increased at 2 h (P = 0.04) of the hyperinsulinemic-euglycemic clamp, and remained elevated until 6 h, with no differences between groups or infusion type. The number of GLUT4 spots was unchanged at 2 h of infusion. However, from 2 to 6 h there was a decrease in the number of small GLUT4 spots at the plasma membrane (P = 0.047), with no differences between groups or infusion type.

CONCLUSION

GLUT4 localisation with the plasma membrane increases during a hyperinsulinemic-euglycemic clamp, but this is not altered by elevated FFA availability. GLUT4 appears to disperse from small GLUT4 clusters located at the plasma membrane to support glucose uptake during a hyperinsulinaemic-euglycaemic clamp.

Effects of a 2-Week Kinect-Based Mixed-Reality Exercise Program on Prediabetes: A Pilot Trial during COVID-19

Background

Pre-diabetes can develop into type 2 diabetes mellitus, but can prevented by regular exercise. However, the outcomes when combining unsupervised Kinect-based mixed-reality (KMR) exercise with continuous glucose monitoring (CGM) remain unclear. Therefore, this single-arm pilot trial examined changes in blood glucose (BG) concentrations over 672 hours (4 weeks), including a 2-week period of KMR exercise and CGM in individuals with pre-diabetes.

Methods

This was a pre-and post-treatment case-control study with nine participants. General questionnaires were administered and body composition, fasting BG concentrations, and 2-hour oral glucose tolerance test (2-OGTT) results were measured pre-and post-treatment. Weekly average glucose concentrations, hyperglycemia rate, hypoglycemia rate, average glucose concentration over time, amount of physical activity, amount of food intake, and pre- and postprandial BG (immediately and 30, 60, 90, and 120 minutes after lunch) were measured over 4 weeks (pre-test, exercise, and post -test weeks). Glucose concentrations were measured before exercising, between sets, and 30 and 60 minutes after exercise during the 2 weeks of unsupervised exercise (3 days/week).

Results

In all participants, body mass index (27.16±2.92 kg/m2), fasting BG (108.00±7.19 mg/dL), 2-OGTT (162.56±18.12 mg/dL), hyperglycemia rate (P=0.040), and 90-minute postprandial BG (P=0.035) were significantly reduced during the 2 exercise weeks, and the 2-OGTT result (P=0.044) and diastolic blood pressure (DBP) (P=0.046) were significantly reduced at the post -test as compared with the pre-test.

Conclusion

This study found that 2 weeks of unsupervised KMR exercise reduced 2-OGTT, DBP, hyperglycemia rate, and 90-minute postprandial BG concentration. We believed this effect could be identified more clearly in studies involving a larger number of participants and longer durations of exercise.

Frontiers and hotspots of high-intensity interval exercise in children and adolescents: text mining and knowledge domain visualization

Background: During the past two decades, research on high-intensity interval exercise (HIIE) in children and adolescents has steadily accumulated, especially on the subthemes of improving cardiometabolic and cardiovascular health. However, there is still little scientific understanding of using scientometric analysis to establish knowledge maps. Exploring the relationship between known and new emerging ideas and their potential value has theoretical and practical implications in the context of a researcher's limited ability to read, analyze, and synthesize all published works. Objective: First, this study aims to provide extensive information on HIIE research in children and adolescents, including authors, institutions, countries, journals, and references. Second, the objective is to use co-occurrence, burst, and co-citation analyses based on hybrid node types to reveal hotspots and forecast frontiers for HIIE research in children and adolescents. Methods: Using the bibliographic data of the Web of Science Core Collection (WoSCC) as the data source, publications, authors, and journals were analyzed with the help of bibliometric methods and visualization tools such as CiteSpace, VOSviewer, Pajek, and Bibliometrix R package. Authorial, institutional, and national collaboration networks were plotted, along with research hotspots and research frontiers based on keyword bursts and document co-citations. Results: This study found that executive function, high-intensity interval training, heart rate variability, and insulin resistance are emerging research topics; high-intensity training, mental health, exercise intensity, and cardiometabolic risk factors are continual frontier research areas in the subthemes. Conclusion: Our study has three novel contributions. First, it explicitly and directly reflects the research history and current situation of the HIIE intervention strategy in children and adolescents. This approach makes it clear and easy to trace the origin and development of this strategy in specific groups of children and adolescents. Second, it analyzes the research hotspots of HIIE in the field and predicts the research frontiers and development trends, which will help researchers get a deeper understanding of HIIE and pediatric health research. Third, the findings will enable researchers to pinpoint the most influential scholars, institutions, journals, and references in the field, increasing the possibility of future collaborations between authors, institutions, and countries.

Effects of Time-Efficient Occupational Exercise on Cardiorespiratory Fitness in Firefighters

OBJECTIVE

For a cohort of operational firefighters, we assessed the effects of workplace-based high-intensity interval training (HIIT) on cardiorespiratory fitness.

METHODS

Fifteen firefighters performed HIIT or moderate-intensity continuous training for 4 weeks. Outcomes were peak oxygen uptake, time trial performance, and affective (pleasure/displeasure) responses to exercise.

RESULTS

There was an increase in peak oxygen uptake for both conditions, although this did not reach statistical significance ( P = 0.06, η2 = 0.26) and time trial performance improved for both groups (2%, P < 0.01, η2 = 0.51). Affective responses were more favorable for HIIT, but both conditions avoided excessive sensations of displeasure.

CONCLUSION

Results suggest that workplace-based HIIT improved fitness and performance to a similar magnitude to moderate-intensity continuous training while avoiding overly negative affective responses and could improve occupational health of firefighters, despite reduced time commitment.

Exploring interindividual differences in fasting and postprandial insulin sensitivity adaptations in response to sprint interval exercise training

Previous studies have concluded that wide variance in changes in insulin sensitivity markers following exercise training demonstrates heterogeneity in individual trainability. However, these studies frequently don't account for technical, biological, and random within-subject measurement error. We used the standard deviation of individual responses (SDIR) to determine whether interindividual variability in trainability exists for fasting and postprandial insulin sensitivity outcomes following low-volume sprint interval training (SIT). We pooled data from 63 untrained participants who completed 6 weeks of SIT (n = 49; VO2max: 35 (7) mL⋅kg-1⋅min-1) or acted as no-intervention controls (n = 14; VO2max: 34 (6) mL⋅kg-1⋅min-1). Fasting and oral glucose tolerance test (OGTT)-derived measures of insulin sensitivity were measured pre- and post-intervention. SDIR values were positive and exceeded a small effect size threshold for changes in fasting glucose (SDIR = 0.27 [95%CI 0.07,0.38] mmol⋅L-1), 2-h OGTT glucose (SDIR = 0.89 [0.22,1.23] mmol⋅L-1), glucose area-under-the-curve (SDIR = 66.4 [-81.5,124.3] mmol⋅L-1⋅120min-1) and The Cederholm Index (SDIR = 7.2 [-16.0,19.0] mg⋅l2⋅mmol-1⋅mU-1⋅min-1), suggesting meaningful individual responses to SIT, whilst SDIR values were negative for fasting insulin, fasting insulin resistance and insulin AUC. For all variables, the 95% CIs were wide and/or crossed zero, highlighting uncertainty about the existence of true interindividual differences in exercise trainability. Only 2-22% of participants could be classified as responders or non-responders with more than 95% certainty. Our findings demonstrate it cannot be assumed that variation in changes in insulin sensitivity following SIT is attributable to inherent differences in trainability, and reiterate the importance of accounting for technical, biological, and random error when examining heterogeneity in health-related training adaptations.Highlights This study tested whether true interindividual variability exists for changes in insulin sensitivity and glyceamic control following 6-weeks of low volume sprint interval training (SIT).The high level of technical, biological, and random error associated with repeated measurements of insulin sensitivity and glycaemic control, means we can neither confidently conclude that there is evidence of true interindividual differences in the trainability of these outcomes following SIT, nor confidently identify responders or non-responders for such parameters.Researchers contrasting responders vs. non-responders for a given parameter, either to understand mechanisms of adaptation and/or develop physiological/genetic/epigenetic predictors of response, need to be aware that identification of responders and non-responders with sufficient certainty may not be achievable for parameters with a high level of technical, biological, and random error.

Acute and adaptive cardiovascular and metabolic effects of passive heat therapy or high-intensity interval training in patients with severe lower-limb osteoarthritis

Exercise is painful and difficult to perform for patients with severe lower-limb osteoarthritis; consequently, reduced physical activity contributes to increased cardiometabolic disease risk. The aim of this study was to characterize the acute and adaptive cardiovascular and metabolic effects of two low or no impact therapies in patients with severe lower-limb osteoarthritis: passive heat therapy (Heat) and high-intensity interval training (HIIT) utilizing primarily the unaffected limbs, compared to a control intervention of home-based exercise (Home). Participants completed up to 12 weeks of either Heat (20-30 min immersed in 40°C water followed by ~15-min light resistance exercise), HIIT (6-8 × 60-s intervals on a cross-trainer or arm ergometer at ~90-100% peak V ̇ $$ \dot{V} $$ O₂ ) or Home (~15-min light resistance exercise); all 3 sessions/week. Reductions in systolic (12 & 10 mm Hg), diastolic (7 & 4 mm Hg), and mean arterial (8 & 6 mm Hg) blood pressure (BP) were observed following one bout of Heat or HIIT exposure, lasting for the duration of the 20-min monitoring period. Across the interventions (i.e., 12 weeks), resting systolic BP and diastolic BP decreased with Heat (-9 & -4 mm Hg; p < 0.001) and HIIT (-7 & -3 mm Hg; p ≤ 0.011), but not Home (0 & 0 mm Hg; p ≥ 0.785). The systolic and diastolic BP responses to an acute exposure of Heat or HIIT in the first intervention session were moderately correlated with adaptive responses across the intervention (r ≥ 0.54, p ≤ 0.005). Neither intervention improved indices of glycemic control (p = 0.310). In summary, both Heat and HIIT induced potent immediate and adaptive hypotensive effects, and the acute response was moderately predictive of the long-term response.

The role of exercise and hypoxia on glucose transport and regulation

Muscle glucose transport activity increases with an acute bout of exercise, a process that is accomplished by the translocation of glucose transporters to the plasma membrane. This process remains intact in the skeletal muscle of individuals with insulin resistance and type 2 diabetes mellitus (T2DM). Exercise training is, therefore, an important cornerstone in the management of individuals with T2DM. However, the acute systemic glucose responses to carbohydrate ingestion are often augmented during the early recovery period from exercise, despite increased glucose uptake into skeletal muscle. Accordingly, the first aim of this review is to summarize the knowledge associated with insulin action and glucose uptake in skeletal muscle and apply these to explain the disparate responses between systemic and localized glucose responses post-exercise. Herein, the importance of muscle glycogen depletion and the key glucoregulatory hormones will be discussed. Glucose uptake can also be stimulated independently by hypoxia; therefore, hypoxic training presents as an emerging method for enhancing the effects of exercise on glucose regulation. Thus, the second aim of this review is to discuss the potential for systemic hypoxia to enhance the effects of exercise on glucose regulation.

Acute physiological outcomes of high-intensity functional training: a scoping review

Background

Systematic reviews and meta-analyses related to high-intensity functional training (HIFT) have been conducted. However, due to a restricted pool of available research, these investigations are often limited in scope. As such, a scoping review investigating the present literature surrounding the acute physiological response to HIFT-based exercise was chosen as a more appropriate structured review.

Methodology

A scoping review was conducted following Arksey and O'Malley's framework. Three large scale databases were searched to reveal any article pertaining to HIFT and related exercise terminology.

Results

A total of 2,241 articles were found during the initial search. Following this, titles, then abstracts, and full-texts were reviewed to determine inclusion eligibility. A total of 60 articles which investigated a combined total of 35 unique HIFT workouts were included within this review.

Conclusions

A variety of physiological parameters and HIFT workouts have been examined. Markers of intensity (e.g., blood lactate concentrations, heart rate) have been most consistently assessed across all studies, and these support the idea that HIFT workouts are typically performed at high-intensity. In contrast, the inclusion of most other measures (e.g., hormonal, markers of inflammation and damage, energy expenditure, performance) has been inconsistent and has thus, limited the possibility for making generalized conclusions. Differences in study methodologies have further impacted conclusions, as different studies have varied in sample population characteristics, workouts assessed, and time points. Though it may be impossible to comprehensively research all possible HIFT workouts, consistent adoption of population definitions and workload quantification may overcome this challenge and assist with future comparisons.

The effect of Tabata-style functional high-intensity interval training on cardiometabolic health and physical activity in female university students

Introduction: The increasing prevalence of metabolic syndrome and physical inactivity enhances exposure to cardiometabolic risk factors in university students. High-intensity interval training (HIIT) improved cardiometabolic health in clinical adults but the evidence in the university setting is limited. Furthermore, few studies examined the effect of low-volume HIIT on habitual physical activity (PA). Therefore, the primary aim of this study was to evaluate the efficacy of 12-week Tabata-style functional HIIT for improving multiple cardiometabolic health outcomes and habitual PA. We also investigated whether changes in habitual PA over the intervention period had an impact on exercise-induced health outcomes. Methods: 122 female freshmen were randomized into the Tabata group (n = 60) and the control (n = 62). The Tabata training protocol involved 8 × 20 s maximal repeated functional exercises followed by 10 s rest with a frequency of 3 times per week for 12 weeks. Body composition, maximal oxygen uptake (VO_2max), blood pressure (BP), blood lipids, fasting glucose and insulin, C-reactive protein and PA were objectively measured using standardized methods. Dietary intake was measured using a valid food frequency questionnaire. All variables were measured pre- and post-intervention. Results: Mixed linear modelling results showed that there were large intervention effects on VO_2max (p < 0.001, d = 2.53, 95% CI: 2.03 to 3.00 for relative VO_2max; p < 0.001, d = 2.24, 95% CI: 1.76 to 2.68 for absolute VO_2max), resting heart rate (p < 0.001, d = -1.82, 95% CI: -2.23 to -1.37), systolic BP (p < 0.001, d = -1.24, 95% CI: -1.63 to -0.84), moderate-to-vigorous intensity physical activity (MVPA) (p < 0.001, d = 2.31, 95% CI: 1.83 to 2.77), total PA (p < 0.001, d = 1.98, 95% CI: 1.53 to 2.41); moderate effects on %BF (p < 0.001, d = -1.15, 95% CI: -1.53 to -0.75), FM (p < 0.001, d = -1.08, 95% CI: -1.46 to -0.69), high-density lipoprotein (HDL) (p < 0.001, d = 1.04, 95% CI: 0.65 to 1.42), total cholesterol (p = 0.001, d = -0.64, 95% CI: -1.00 to -0.26); small effects on BMI (p = 0.011, d = -0.48, 95% CI: -0.84 to 0.11), WC (p = 0.043, d = -0.37, 95% CI: -0.74 to -0.01), low-density lipoprotein (p = 0.003, d = -0.57, 95% CI: -0.93 to -0.19), HOMA-IR (p = 0.026, d = -0.42, 95% CI: -0.78 to -0.05) and fasting insulin (p = 0.035, d = -0.40, 95% CI: -0.76 to -0.03). Regression analysis showed that only the percentage change of HDL was associated with the change of MVPA (b = 0.326, p = 0.015) and TPA (b = 0.480, p = 0.001). Conclusion: From the findings of the study we can conclude that 12-week low-volume Tabata-style functional HIIT was highly effective for university female students to improve cardiorespiratory fitness, body fat, some cardiometabolic health outcomes and habitual PA.

Skeletal muscle mechanisms contributing to improved glycemic control following intense interval exercise and training

High-intensity and sprint interval training (HIIT and SIT, respectively) enhance insulin sensitivity and glycemic control in both healthy adults and those with cardiometabolic diseases. The beneficial effects of intense interval training on glycemic control include both improvements seen in the hours to days following a single session of HIIT/SIT and those which accrue with chronic training. Skeletal muscle is the largest site of insulin-stimulated glucose uptake and plays an integral role in the beneficial effects of exercise on glycemic control. Here we summarize the skeletal muscle responses that contribute to improved glycemic control during and following a single session of interval exercise and evaluate the relationship between skeletal muscle remodelling and improved insulin sensitivity following HIIT/SIT training interventions. Recent evidence suggests that targeting skeletal muscle mechanisms via nutritional interventions around exercise, particularly with carbohydrate manipulation, can enhance the acute glycemic benefits of HIIT. There is also some evidence of sex-based differences in the glycemic benefits of intense interval exercise, with blunted responses observed after training in females relative to males. Differences in skeletal muscle metabolism between males and females may contribute to sex differences in insulin sensitivity following HIIT/SIT, but well-controlled studies evaluating purported muscle mechanisms alongside measurement of insulin sensitivity are needed. Given the greater representation of males in muscle physiology literature, there is also a need for more research involving female-only cohorts to enhance our basic understanding of how intense interval training influences muscle insulin sensitivity in females across the lifespan.

Concurrent Exercise Training: Long-Term Changes in Body Composition and Motives for Continued Participation in Women with Obesity

The purpose of this project was to examine the effect of a concurrent exercise program (sprint interval training and resistance exercise) on body composition in women with obesity and factors associated with continued exercise participation following the program. Twenty women (37.1 ± 7.4 y, height = 1.63 ± 0.09 m, weight = 98.22 ± 0.22 kg, BMI = 34.2 ± 2.50 kg/m2) participated in a 10-week exercise intervention consisting of a sprint interval treadmill protocol and resistance training three times a week totaling 30 sessions. Body composition was measured by dual-energy X-ray absorptiometry (iDXA) at pretest, 12 weeks, and six months post-intervention. Semi-structured interviews assessed participants’ perception of the program at both 12 weeks and six months. Participants significantly reduced fat mass (p < 0.001), gynoid fat mass (p < 0.010), android fat mass (p = 0.003), and visceral fat mass (p = 0.003) at 12 weeks post-test. At six months, participants maintained their reductions in fat mass (p = 0.015), visceral fat (p = 0.040) and gynoid fat mass (p = 0.032). There were no significant main time effects in lean mass (p = 0.099) or caloric intake (p = 0.053) at 12 weeks or six months. Themes that emerged from the semi-structured interviews at 12 weeks reflected enjoyment in the training, increases in competence and knowledge, as well as apprehension of continuing training on their own. At six months, themes that emerged reflected overcoming barriers, competence regarding high-intensity training, and a lack of competence to engage in resistance training. Sprint interval training coupled with resistance training is a feasible exercise protocol for women with obesity and results in reduced fat mass over six months. Improving women’s competence for training is imperative for continued participation.

Factors Associated with White Fat Browning: New Regulators of Lipid Metabolism

Mammalian adipose tissue can be divided into white and brown adipose tissue based on its colour, location, and cellular structure. Certain conditions, such as sympathetic nerve excitement, can induce the white adipose adipocytes into a new type of adipocytes, known as beige adipocytes. The process, leading to the conversion of white adipocytes into beige adipocytes, is called white fat browning. The dynamic balance between white and beige adipocytes is closely related to the body’s metabolic homeostasis. Studying the signal transduction pathways of the white fat browning might provide novel ideas for the treatment of obesity and alleviation of obesity-related glucose and lipid metabolism disorders. This article aimed to provide an overview of recent advances in understanding white fat browning and the role of BAT in lipid metabolism.

Bout duration in high-intensity interval exercise modifies hematologic, metabolic and antioxidant responses

Objective

This study compared hematologic, metabolic and antioxidant responses between three high-intensity interval exercise (HIIE) trials of different bout duration and a continuous exercise trial (CON), all with equal average intensity, total work, and duration.

Methods

Eleven healthy young males performed four trials involving 20 min of cycling, either continuously (49% of power at VO₂max, PPO), or intermittently with 48 10-s bouts (HIIE10), 16 30-s bouts (HIIE30) or 8 60-s bouts (HIIE60) at 100% PPO, with a 1:1.5 work-to-recovery ratio at 15% PPO. Venous blood was obtained before, immediately after, and 1 h post-exercise to evaluate hematologic, metabolic and antioxidant responses. Blood lactate concentration was measured in capillary blood during exercise, while urine lactate was measured before and 1 h post-exercise.

Results

Post-exercise leukocyte count (mean ± SD; 9.7 ± 2.8 k μL^-1), uric acid concentration (0.35 ± 0.10 mmol L^-1), glucose concentration (6.56 ± 1.44 mmol L^-1), and plasma volume change (-13.5 ± 4.4%) were greater in HIIE60 compared to all other trials (p < 0.05). One-hour post-exercise, lymphocytes decreased below pre-exercise values in all HIIE trials, and uric acid increased in the HIIE60 trial (p < 0.05). Urine lactate concentration 1 h post-exercise increased compared to pre-exercise only in HIIE60 (19-fold, p < 0.001), and this was related with the higher blood lactate concentration during exercise in that trial.

Conclusions

These findings highlight the importance of bout duration, given that shorter bouts of HIIE (30 s or 10 s) induce lower blood cell perturbations, metabolic stress, and antioxidant responses compared to the commonly used 1-min bouts, despite equal total work, duration, and work-to-recovery ratio.

A Short-Term Eccentric HIIT Induced Greater Reduction in Cardio-Metabolic Risk Markers in Comparison With Concentric HIIT in Sedentary Overweight Men

Background: Steady-state eccentric exercise training improves cardiometabolic risk (CMR) despite lesser cardiovascular demands compared with load-matched concentric training. Whether a high-intensity interval eccentric training is also effective reducing CMR is unknown. Aim: To compare the effects of a short-term high-intensity interval eccentric training (ECC-HIIT) with high-intensity interval concentric training (CONC-HIIT) on CMR in sedentary overweight men. Methods: Twenty men (age: 27.9 ± 5.3y, body massindex: 29.1 ± 3.1 kg·m-2) were randomly assigned to ECC-HIIT (n = 10) or CONC-HIIT (n = 10) delivered as six sessions, including 4 x 5:2 min work-to-rest ratio, at 80% peak concentric power output. Heart rate (HR), rate of perceived exertion (RPE) and muscle soreness weremonitored during training sessions. Training effects on lipid profile, insulin sensitivity (HOMA-IR), body composition, thigh circumference, isometric knee extensors maximal strength, resting systolic and diastolic blood pressure (SBP and DBP) were determined. Results: Average training HR and RPE were -29%and -50%lower in ECC-HIIT in comparison with CONC-HIIT. Muscle soreness was initially greater after ECC-HIIT compared with CONC-HIIT. Significant changes in total and low-density lipoprotein cholesterol (-7.0 ± 8.7%; p = .02 and -6.3 ± 14.4%; p = .03), SBP (-9.8 ± 7.8%; p = .002), and maximal thigh circumference (+2.5 ± 3.1%; p = .02) were observed following ECC-HIIT. No changes in any CMR marker were observed after CONC-HIIT. Moderate-to-large training effect sizes were obtained in thigh circumference, SBP, total cholesterol and low-density lipoprotein cholesterol in response to ECC-HIIT. Conclusion: A two-week ECC-HIIT was well-tolerated and induced rapid onset improvements in cholesterol and blood pressure compared to conventional CONC-HIIT in sedentary overweight men.

The Effect of Traditional Aerobic Exercise and Sprint Interval Training on Insulin Resistance in Men With Prediabetes: A Randomised Controlled Trial

Introduction

Prediabetes is an intermediate stage with hyperglycaemia below the threshold of diabetes mellitus. Insulin resistance is a significant factor in its pathogenesis. Lifestyle modifications are suggested and found to be more beneficial in this stage. Moderate-intensity exercise for 30 to 45 minutes a day is routinely recommended but has low compliance, and lack of time is a significant deterrent. Sprint interval training (SIT) is an alternate exercise regimen with higher intensity and less time requirement. The present study compares the effect of a three-month intervention of traditional aerobic exercise and sprint interval training on insulin resistance in prediabetic men.

Methods

The study subjects were males aged 25 to 40 years with prediabetes as per the American Diabetes Association criteria of fasting and two-hour plasma glucose levels. The study is a parallel-group randomised trial with one arm (AE group) involved in the traditional aerobic exercise (brisk walking) for 30 minutes, five days a week. The other arm was the sprint interval training (SIT) group performing an ‘all-out’ run effort for one minute followed by a recovery rest period of one and a half minutes, completing one cycle of two and half minutes. Four such cycles were completed in each session. Thus, the exercise sessions were just 10 minutes daily, three days a week. The duration of the intervention was three months. One hundred and sixty participants were recruited after screening and randomly assigned in a 1:1 ratio to the two groups. The primary outcome measure was insulin resistance estimated by homeostasis model assessment -estimated insulin resistance (HOMA-IR). The secondary outcome measures were fasting plasma glucose and serum insulin, glycated haemoglobin, body mass index and waist-hip ratio.

Results

The mean age of the AE group was 30.7 ± 3.3 years, and the SIT group was 31 ± 3.4 years. Seventy-two men from the AE group and 74 from the SIT group completed the study. After the three-month AE and SIT exercise, the per-protocol analysis reflected a significant reduction in insulin resistance, i.e., HOMA-IR (3.6 ± 1.1 to 3 ± 1.2, p<0.0001) after traditional aerobic exercise. Similarly, the HOMA-IR was significantly reduced after sprint interval training (3.3 ± 1.2 to 2.5 ± 1, p<0.0001). The intention-to-treat analysis also found that the reductions in HOMA-IR after both exercise protocols were statistically significant. The change in insulin resistance compared for the SIT vs AE group was not statistically significant. Secondary outcome measures HbA1c, fasting glucose, fasting insulin, BMI, and waist-hip ratio showed significant improvement with AE and SIT. 

Conclusions

The sprint interval training similarly improved insulin resistance and other parameters compared to the traditional exercise group. SIT can be a time-efficient exercise protocol suggested as a part of lifestyle modification for men with prediabetes.

Effects of indulgent food snacking, with and without exercise training, on body weight, fat mass, and cardiometabolic risk markers in overweight and obese men

We hypothesized that exercise training would prevent gains in body weight and body fat, and worsening of cardiometabolic risk markers, during a 4-week period of indulgent food snacking in overweight/obese men. Twenty-eight physically inactive men (ages 19-47 yr) with body mass index (BMI) ≥25 kg/m2 consumed 48 donuts (2/day, 6 days/week; ~14,500 kcal total) for 4 weeks while maintaining habitual diet. Men were randomly assigned to control (n = 9), moderate-intensity continuous training (MICT; n = 9), or high-intensity interval training (HIIT; n = 10). Exercise training occurred 4 days/week, ~250 kcal/session. Controls did not increase body weight, body fat, or visceral abdominal fat. This was partially explained by a decrease in self-reported habitual energy (-239 kcal/day, p = 0.05) and carbohydrate (-47 g/day; p = 0.02) intake. Large inter-individual variability in changes in body weight, fat, and fat-free mass was evident in all groups. Fasting blood pressure, and blood concentrations of glucose, insulin, and lipids were unchanged in all groups. Glucose incremental area under the curve during an oral glucose tolerance test was reduced by 25.6% in control (p = 0.001) and 32.8% in MICT (p = 0.01) groups. Flow-mediated dilation (FMD) was not changed in any group. VO2max increased (p ≤ 0.001) in MICT (9.2%) and HIIT (12.1%) groups. We conclude that in physically inactive men with BMI ≥25 kg/m2 , consuming ~14,500 kcal as donuts over 4 weeks did not adversely affect body weight and body fat, or several markers of cardiometabolic risk. Consumption of the donuts may have prevented the expected improvement in FMD with HIIT.

Effects of Introducing Rest Intervals in Functional Fitness Training

Background: Functional Fitness Training (FFT) is a new exercise modality prioritizing functional multi-joint movements executed at high intensity as a circuit. Objective: To examine the impacts of introducing rest intervals in a FFT workout compared to “rounds for time” (RFT) FFT. Materials and Methods: Participants were 25 resistance-trained adults who completed two FFT workouts 1 week apart. The study design was crossover such that in a given session half the participants completed the standard and the other half the adapted FFT (FFTadapted). The workouts consisted of the same exercises (circuit of four rounds of exercises), but one (FFTadapted) included preset rest intervals (three sets of 1 min after each completed round). Before and after the workouts, countermovement jump ability and blood lactate were measured. Heart rate (HR) and ratings of perceived exertion (RPE) were measured post-exercise. Results: For both the standard and adapted protocols, mean HR was 90% age-predicted maximum. Final RPE was also similar for both workouts (~15–15.5) and indicated a “hard” work intensity. Both FFTs took the same time to complete (~13 min). Furthermore, no significant differences were observed in jump ability between FFTs. In contrast, lactate (15.11 ± 3.64 vs. 13.48 ± 3.64 mmol·L−1, p < 0.05), measured 3 min post-exercise, was significantly lower in FFTadapted. Conclusions: In FFTadapted, there was a significant reduction in RPE and blood lactate concentrations after exercise, while there were no significant differences in either HR or jumping ability, compared to a FFT workout in RFT methodology.

High-Intensity Interval Training for Knee Osteoarthritis: A Pilot Study

OBJECTIVE

To assess the feasibility and changes in outcomes of a 12-week high-intensity interval training (HIIT) program in individuals with symptomatic knee osteoarthritis (OA).

METHODS

The single-arm trial included 29 participants (mean ± SD age 63 ± 7 years; 66% women; 66% obese). Measures of participant flow, adherence, and tolerability were collected. Pain, function, and balance were assessed at baseline, 6 weeks, and 12 weeks using the Western Ontario and McMaster Universities Osteoarthritis Index, 20-m fast-paced walk test, 30-second chair-stand test, stair-climb test, timed up and go test, and single leg stance. Cardiorespiratory fitness, strength, and body composition were evaluated using peak oxygen consumption (VO2 peak), isometric knee extensor/flexor strength, and dual-energy x-ray absorptiometry, respectively. HIIT was completed two times/week (cycling or treadmill) and consisted of 10 repetitions of 1-minute bouts at 90% VO2 peak, with 1-minute rest periods. Separate multivariable-adjusted linear mixed models were fit for each outcome with fixed effects of time, age, sex, body mass index, and random effects of baseline values to estimate mean changes and 95% confidence intervals (CIs) between baseline and 12-week assessments.

RESULTS

Recruitment aligned with the anticipated enrollment rate, adherence was 70%, and no adverse events were reported. At 12 weeks, improvements were observed for most outcomes, with notable mean changes for the 20-m fast-paced walk (-1.13 [95% CI -1.61 to -0.64] seconds), 30-second chair-stand (2.6 [1.8-3.4] stands), and VO2 peak (0.14 [0.03-0.24] liters/minute).

CONCLUSION

In this 12-week pilot study, HIIT improved multiple aspects of health in individuals with knee OA; larger studies are needed.

Exercise Training Protocols to Improve Obesity, Glucose Homeostasis, and Subclinical Inflammation

The global pandemics of obesity and sedentarism are associated with poor quality of life and increased risks for development of inflammatory chronic diseases, including type 2 diabetes, cardiovascular diseases, and cancer. Physical activity is considered as an antidote to counteract the development of chronic sterile inflammatory diseases. Thus, we review the most promising exercise training protocols for promoting weight loss, improving glucose homeostasis, and reducing inflammation. We discuss the advantages and disadvantages of moderate-intensity continuous aerobic training, high-intensity aerobic training, and combined (aerobic + resistance) training. Our aim with this chapter is to provide evidence and guidance for choosing the most appropriate protocols of exercise training according to the goals of the patient.

Exercise induces favorable metabolic changes in white adipose tissue preventing high-fat diet obesity

Diet and/or exercise are cost effective interventions to treat obesity. However, it is unclear if the type of exercise undertaken can prevent the onset of obesity and if it can act through different effects on fat depots. In this study we did not allow obesity to develop so we commenced the high-fat diet (HFD) and exercise programs concurrently and investigated the effect of endurance exercise (END) and high-intensity interval training (HIIT) on changes in cellular adipogenesis, thermogenesis, fibrosis, and inflammatory markers in three different fat depots, on a HFD and a chow diet. This was to assess the effectiveness of exercise to prevent the onset of obesity-induced changes. Mice fed with chow or HFD (45% kcal fat) were trained and performed either END or HIIT for 10 weeks (3 x 40 min sessions/week). In HFD mice, both exercise programs significantly prevented the increase in body weight (END: 17%, HIIT: 20%), total body fat mass (END: 46%, HIIT: 50%), increased lean mass as a proportion of body weight (Lean mass/BW) by 14%, and improved insulin sensitivity by 22%. Further evidence of the preventative effect of exercise was seen significantly decreased markers for adipogenesis, inflammation, and extracellular matrix accumulation in both subcutaneous adipose tissue (SAT) and epididymal adipose tissue (EPI). In chow, no such marked effects were seen with both the exercise programs on all the three fat depots. This study establishes the beneficial effect of both HIIT and END exercise in preventing metabolic deterioration, collagen deposition, and inflammatory responses in fat depots, resulting in an improved whole body insulin resistance in HFD mice.

The effect of endurance training on non-alcoholic fatty liver disease in mice

Chronic endurance exercise is a therapeutic strategy in the treatment of non-alcoholic fatty liver disease (NAFLD). Metabolic, cardiorespiratory, and endocrine pathways targeted by chronic endurance exercise have been identified; however, the specific cellular and molecular pathways modified by exercise in the steatotic liver remain unresolved. In this study, we show hepatic gene expression, and the structure, characteristics, and clinical differences between sedentary and exercised mice, by an endurance exercise model with wheels with a controlled velocity that allows for the quantification of a human-relevant endurance "dosage," after exposure to regular and high-fat diet. Chronic exercise modified the transcription of hepatic genes related to liver nuclear receptors, cell growth, fibrosis, inflammation, and oxidative stress, and decreased the amount of lipid accumulation in the liver. Moreover, the combination of endurance training with the change in diet differentially modified the genetic expression of the biomarkers relative to the separate interventions. Even though exercise by itself showed counteract NAFLD development, the combined intervention was sufficient to convert the structure and clinical aspects of the liver from steatotic to healthy. Given our findings, the combination of endurance exercise and change in diet should be considered a therapeutic option for NASH.

Functional Translation of Exercise Responses from Exercise Testing to Exercise Training: The Test of a Model

Exercise prescription based on exercise test results is complicated by the need to downregulate the absolute training intensity to account for cardiovascular drift in order to achieve a desired internal training load. We tested a recently developed generalized model to perform this downregulation using metabolic equivalents (METs) during exercise testing and training. A total of 20 healthy volunteers performed an exercise test to define the METs at 60, 70, and 80% of the heart rate (HR) reserve and then performed randomly ordered 30 min training bouts at absolute intensities predicted by the model to achieve these levels of training intensity. The training HR at 60 and 70% HR reserve, but not 80%, was significantly less than predicted from the exercise test, although the differences were small. None of the ratings of perceived exertion (RPE) values during training were significantly different than predicted. There was a strong overall correlation between predicted and observed HR (r = 0.88) and RPE (r = 0.52), with 92% of HR values within ±10 bpm and 74% of RPE values within ±1 au. We conclude that the generalized functional translation model is generally adequate to allow the generation of early absolute training loads that lead to desired internal training loads.

Short-Term, Equipment-Free High Intensity Interval Training Elicits Significant Improvements in Cardiorespiratory Fitness Irrespective of Supervision in Early Adulthood

Introduction: Serious health implications from having low levels of cardiorespiratory fitness (CRF) and being overweight in young adulthood are carried forward into later life. High-intensity interval training (HIIT) is a time-effective, potent stimulus for improving CRF and indices of cardiometabolic health. To date, few studies have investigated the use of equipment-free HIIT or the impact of supervision for improving CRF via HIIT. Methods: Thirty healthy young adults (18-30 y) were randomised to 4 weeks (12 sessions) equipment-free, bodyweight based supervised laboratory HIIT (L-HIIT), unsupervised home HIIT (H-HIIT) or no-intervention (CON). Utilised exercises were star jumps, squats and standing sprints. Measurements of CRF (anaerobic threshold (AT) and VO₂peak), blood pressure (BP), body mass index (BMI), blood glucose and plasma insulin by oral glucose tolerance test (OGTT), and muscle architecture were performed at baseline and after the intervention. Results: When compared to the control group, both HIIT protocols improved CRF (AT: L-HIIT mean difference compared to the control group (MD) +2.1 (95% CI: 0.34-4.03) ml/kg/min; p = 0.02; H-HIIT MD +3.01 (1.17-4.85) ml/kg/min; p = 0.002), VO₂peak: L-HIIT (MD +2.94 (0.64-5.25) ml/kg/min; p = 0.01; H-HIIT MD +2.55 (0.34-4.76) ml/kg/min; p = 0.03), BMI (L-HIIT MD -0.43 (-0.86 to 0.00) kg/m²; p = 0.05; H-HIIT: MD -0.51 (-0.95 to -0.07) kg/m²; p = 0.03) and m. vastus lateralis pennation angle (L-HIIT MD 0.2 (0.13-0.27)°; p < 0.001; H-HIIT MD 0.17 (0.09 to 0.24)°; p < 0.001). There was no significant change in BP, blood glucose or plasma insulin in any of the groups. Conclusions: Four weeks time-efficient, equipment-free, bodyweight-based HIIT is able to elicit improvements in CRF irrespective of supervision status. Unsupervised HIIT may be a useful tool for counteracting the rise of sedentary behaviours and consequent cardiometabolic disorders in young adults.

Promoting Exercise and Healthy Diet Among Primary Care Patients: Feasibility, Preliminary Outcomes, and Lessons Learned From a Pilot Trial With High Intensity Interval Exercise

Physical activity and healthy diet are recognized as effective approaches for disease prevention. Controlled laboratory clinical trials support these approaches, yet minimal data exists supporting implementation of exercise as medicine within a healthcare setting.

Objectives: To understand perception and barriers to exercise and nutrition from patients and physicians from a family medicine clinic (FMC) to inform the implementation of a laboratory-based exercise and nutrition lifestyle intervention (Phase I), and to determine the feasibility, adherence, and preliminary outcomes of implementing this lifestyle intervention into a FMC (Phase II).

Methods: In phase I 10 patients and 5 physicians were interviewed regarding perceptions of exercise and nutrition practices. In phase II patients at risk for cardiovascular disease were enrolled into a lifestyle intervention (n = 16), within a FMC, manipulating diet and exercise. Cardiorespiratory fitness (CRF), body composition, and metabolic blood markers were completed at baseline, after the 12-week intervention, and at 24 weeks. Feasibility was defined by patients who completed the intervention and number of sessions vs. total available.

Results: Prescribing high-intensity interval training and a meal replacement for 12 weeks in patients with at least one risk factor for cardiovascular disease, was shown to have moderate feasibility with 62.5% (n = 10) for patients completing the 12 week intervention, and poor feasibility for assessing effects 12 weeks after cessation of the intervention, with 50% (n = 5) participants returning. Tracking exercise electronically via FitBit had moderate fidelity (n = 9), with hardcopy logs yielding poor compliance (n = 6). This pilot study demonstrated preliminary effectiveness of this home-based approach for improving cardiorespiratory fitness with an average 4.31 ± 5.67 ml·kg·min⁻¹ increase in peak oxygen consumption. Blood triglycerides and insulin were improved in 70% and 60% of the patients, respectively.

Conclusions: Despite moderate feasibility, a home-based exercise and nutrition has the potential to be used as an effective approach for managing and mitigating cardiovascular disease risk factors. There were key lessons learned which will help to develop and adapt a larger scale lifestyle intervention into a clinical setting.

Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/study/NCT02482922, identifier NCT02482922.

Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective

Engaging in regular exercise results in a range of physiological adaptations offering benefits for exercise capacity and health, independent of age, gender or the presence of chronic diseases. Accumulating evidence shows that lack of time is a major impediment to exercise, causing physical inactivity worldwide. This issue has resulted in momentum for interval training models known to elicit higher enjoyment and induce adaptations similar to or greater than moderate-intensity continuous training, despite a lower total exercise volume. Although there is no universal definition, high-intensity interval exercise is characterized by repeated short bursts of intense activity, performed with a "near maximal" or "all-out" effort corresponding to ≥90% of maximal oxygen uptake or >75% of maximal power, with periods of rest or low-intensity exercise. Research has indicated that high-intensity interval training induces numerous physiological adaptations that improve exercise capacity (maximal oxygen uptake, aerobic endurance, anaerobic capacity etc.) and metabolic health in both clinical and healthy (athletes, active and inactive individuals without any apparent disease or disorder) populations. In this paper, a brief history of high-intensity interval training is presented, based on the novel findings of some selected studies on exercise capacity and health, starting from the early 1920s to date. Further, an overview of the mechanisms underlying the physiological adaptations in response to high-intensity interval training is provided.

Short-Term High-Intensity Interval Exercise Promotes Motor Cortex Plasticity and Executive Function in Sedentary Females

Previous research has demonstrated that regular exercise modulates motor cortical plasticity and cognitive function, but the influence of short-term high-intensity interval training (HIIT) remains unclear. In the present study, the effect of short-term HIIT on neuroplasticity and executive function was assessed in 32 sedentary females. Half of the participants undertook 2 weeks of HIIT. Paired-pulse transcranial magnetic stimulation (ppTMS) was used to measure motor cortical plasticity via short intracortical inhibition (SICI) and intracortical facilitation (ICF). We further adapted the Stroop task using functional near-infrared spectroscopy (fNIRS) to evaluate executive function in the participants. The results indicated that, compared with the control group, the HIIT group exhibited decreased ICF. In the Stroop task, the HIIT group displayed greater activation in the left dorsolateral prefrontal cortex (DLPFC) and left orbitofrontal cortex (OFC) even though no significant difference in task performance was observed. These findings indicate that short-term HIIT may modulate motor cortical plasticity and executive function at the neural level.

Interval training versus moderate-intensity continuous training for cardiorespiratory fitness improvements in middle-aged and older adults: a systematic review and meta-analysis

Interval training has been promoted as a superior, time-efficient exercise strategy for enhancing cardiorespiratory fitness in the ageing population. This study assessed the effectiveness of interval training compared with that of moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness in middle-aged and older adults. Six databases were systematically searched for studies with exercise interventions (minimum 2-week duration). Meta-analyses were conducted for within-group and between-group comparisons of maximal oxygen uptake (VO_2max). Sub-group analysis was performed using the nature of interval training (high-intensity interval training [HIIT] and sprint interval training [SIT]). Of 3,257 studies, 14 were included (429 participants). Within-group analyses demonstrated significant VO_2max improvements (mL/kg/min) following interval training (mean difference: MD = 2.26; 95% confidence interval [CI] = 1.50-3.02) and MICT (MD = 1.34; 95% CI = 0.45-2.23]. When comparing the modes of training, the gain in VO_2max was significantly greater following interval training (MD = 1.10; CI = 0.55-1.64). Sub-group analysis showed that HIIT (MD = 1.04; CI = 0.21-1.88) and SIT (MD = 1.18; CI = 0.60-1.76) resulted in superior VO_2max gain than MICT. This study provides evidence synthesis for interval training as a viable exercise strategy to improve cardiorespiratory function in healthy ageing.

The impact of high intensity interval training on liver fat content in overweight or obese adults: A meta-analysis

Liver fat is a marker of the metabolic derangements associated with obesity for which exercise training is a potential therapy. We therefore performed a systematic meta-analysis to investigate the effect of high intensity interval training (HIIT) on liver fat content in overweight or obese adults with metabolic disorders. PubMed, Scopus, Web of Science and the Cochrane were searched up to October 2020 for HIIT vs. Control (CON) or HIIT vs. moderate intensity interval training (MICT) studies on liver fat content in overweight and obese individuals with metabolic disorders. Standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were calculated. Ten studies involving 333 participants were included in the meta-analysis. Based on studies that directly compared HIIT and CON (6 studies), HIIT was beneficial for promoting a reduction in liver fat [-0.51 (95% CI: -0.85 to -0.17), p = 0.003]. However, there were no significant evidence for an effect of HIIT on liver fat [-0.07 (95% CI: -0.33 to 0.19), p = 0.59], when compared with MICT (7 studies). These results suggest that a HIIT could induce improvements in liver fat of overweight and obese adults with metabolic disorders despite no weight loss.

Eight sessions of endurance training decrease fasting glucose and improve glucose tolerance in middle-aged overweight males

Exercise improves metabolic regulation and reduces the risk of developing type 2 diabetes and other metabolic diseases. The recommendations for exercise are rather general and the health benefits of controlled training studies are important to make better recommendations. In the present study, we report that eight endurance training sessions over 3 weeks reduced fasting glucose, and improved glucose tolerance and plasma lipids in sedentary middle-aged males (44-64 years) with overweight or obesity (BMI: 27-38). The decrease in fasting glucose was substantial (from 5.3 ± 0.3 to 4.8 ± 0.2 mM; p < .001). The training sessions consisted of 60-min indoor-cycling at ∼83% of peak heart rate divided in four blocks of 15 min cycling, with 2-min rest between blocks. Maximal oxygen uptake did not increase (38.8 ± 1.8 vs. 39.0 ± 1.6 ml kg^-1 min^-1). In conclusion, 3-weekly sessions of moderate-/high-intensity endurance training can be recommended for untrained males with overweight or obesity to improve glucose homeostasis.

Effects of Different Exercise Training Protocols on Gene Expression of Rac1 and PAK1 in Healthy Rat Fast- and Slow-Type Muscles

Purpose

Rac1 and its downstream target PAK1 are novel regulators of insulin and exercise-induced glucose uptake in skeletal muscle. However, it is not yet understood how different training intensities affect the expression of these proteins. Therefore, we studied the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on Rac1 and PAK1 expression in fast-type (gastrocnemius, GC) and slow-type (soleus, SOL) muscles in rats after HIIT and MICT swimming exercises.

Methods

The mRNA expression was determined using qPCR and protein expression levels with reverse-phase protein microarray (RPPA).

Results

HIIT significantly decreased Rac1 mRNA expression in GC compared to MICT (p = 0.003) and to the control group (CON) (p = 0.001). At the protein level Rac1 was increased in GC in both training groups, but only the difference between HIIT and CON was significant (p = 0.02). HIIT caused significant decrease of PAK1 mRNA expression in GC compared to MICT (p = 0.007) and to CON (p = 0.001). At the protein level, HIIT increased PAK1 expression in GC compared to MICT and CON (by ∼17%), but the difference was not statistically significant (p = 0.3, p = 0.2, respectively). There were no significant differences in the Rac1 or PAK1 expression in SOL between the groups.

Conclusion

Our results indicate that HIIT, but not MICT, decreases Rac1 and PAK1 mRNA expression and increases the protein expression of especially Rac1 but only in fast-type muscle. These exercise training findings may reveal new therapeutic targets to treat patients with metabolic diseases.

A Tool to Explore Discrete-Time Data: The Time Series Response Analyser

The analysis of time series data is common in nutrition and metabolism research for quantifying the physiological responses to various stimuli. The reduction of many data from a time series into a summary statistic(s) can help quantify and communicate the overall response in a more straightforward way and in line with a specific hypothesis. Nevertheless, many summary statistics have been selected by various researchers, and some approaches are still complex. The time-intensive nature of such calculations can be a burden for especially large data sets and may, therefore, introduce computational errors, which are difficult to recognize and correct. In this short commentary, the authors introduce a newly developed tool that automates many of the processes commonly used by researchers for discrete time series analysis, with particular emphasis on how the tool may be implemented within nutrition and exercise science research.

Efficacy of a Six-Week Dispersed Wingate-Cycle Training Protocol on Peak Aerobic Power, Leg Strength, Insulin Sensitivity, Blood Lipids and Quality of Life in Healthy Adults

The aim of this study was to evaluate the efficacy of a six-week dispersed Wingate Anaerobic test (WAnT) cycle exercise training protocol on peak aerobic power (VO_2peak), isokinetic leg strength, insulin sensitivity, lipid profile and quality of life, in healthy adults. Methods: We conducted a match-controlled cohort trial and participants were assigned to either the training (intervention, INT, N = 16) or non-training (control, CON, N = 17) group. INT performed 30-s WAnT bouts three times a day in the morning, afternoon and evening with each bout separated by ~4 h of rest, performed for 3 days a week for 6 weeks. Criterion measures of peak oxygen uptake (VO_2peak), leg strength, insulin markers such as homeostatic model assessment (HOMA) and quantitative insulin-sensitivity check index (QUICKI), blood lipids profile and health-related quality of life (HRQL) survey were assessed before and after 6 weeks in both groups. Results: Absolute VO_2peak increased by 8.3 ± 7.0% (p < 0.001) after INT vs. 0.9 ± 6.1% in CON (p = 0.41) group. Maximal voluntary contraction at 30°·s^-1 of the dominant lower-limb flexors in INT increased significantly post-training (p = 0.03). There were no changes in the INT individuals' other cardiorespiratory markers, HOMA, QUICKI, blood lipids, and HRQL measures (all p > 0.05) between pre- and post-training; but importantly, no differences were observed between INT and CON groups (all p > 0.05). Conclusions: The results indicate that 6 weeks of dispersed sprint cycle training increased cardiorespiratory fitness and dynamic leg strength but had minimal impact on insulin sensitivity, blood lipids and quality of life in the exercising individuals.

Why are South Asians prone to type 2 diabetes? A hypothesis based on underexplored pathways

South Asians have a high prevalence of type 2 diabetes, even at a lower BMI. This review sets out our perspective and hypothesis on the reasons for this. Emerging data from epidemiological studies indicate that South Asians may have a lower ability to secrete insulin, and thus may have less compensatory reserves when challenged with unhealthy lifestyles. Thus, insulin resistance may not be the primary driver of type 2 diabetes in this population. Furthermore, data also suggest that South Asians, on average, have lower muscle mass, and may have a specific propensity to ectopic hepatic fat accumulation and for intramyocellular fat deposition, which cause further disruption in insulin action. We hypothesise that the high diabetes susceptibility in South Asians is evolutionarily set through dual parallel and/or interacting mechanisms: reduced beta cell function and impaired insulin action owing to low lean mass, which is further accentuated by ectopic fat deposition in the liver and muscle. These areas warrant further research.

The Effect of Low-Volume High-Intensity Interval Training on Body Composition and Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis

BACKGROUND

Evidence for the efficacy of low-volume high-intensity interval training (HIIT) for the modulation of body composition is unclear.

OBJECTIVES

We examined the effect of low-volume HIIT versus a non-exercising control and moderate-intensity continuous training (MICT) on body composition and cardiorespiratory fitness in normal weight, overweight and obese adults. We evaluated the impact of low-volume HIIT (HIIT interventions where the total amount of exercise performed during training was ≤ 500 metabolic equivalent minutes per week [MET-min/week]) compared to a non-exercising control and MICT.

METHODS

A database search was conducted in PubMed (MEDLINE), EMBASE, CINAHL, Web of Science, SPORTDiscus and Scopus from the earliest record to June 2019 for studies (randomised controlled trials and non-randomised controlled trials) with exercise training interventions with a minimum 4-week duration. Meta-analyses were conducted for between-group (low-volume HIIT vs. non-exercising control and low-volume HIIT vs. MICT) comparisons for change in total body fat mass (kg), body fat percentage (%), lean body mass (kg) and cardiorespiratory fitness.

RESULTS

From 11,485 relevant records, 47 studies were included. No difference was found between low-volume HIIT and a non-exercising control on total body fat mass (kg) (effect size [ES]: - 0.129, 95% confidence interval [CI] - 0.468 to 0.210; p = 0.455), body fat (%) (ES: - 0.063, 95% CI - 0.383 to 0.257; p = 0.700) and lean body mass (kg) (ES: 0.050, 95% CI - 0.250 to 0.351; p = 0.744), or between low-volume HIIT and MICT on total body fat mass (kg) (ES: - 0.021, 95% CI - 0.272 to 0.231; p = 0.872), body fat (%) (ES: 0.005, 95% CI - 0.294 to 0.304; p = 0.974) and lean body mass (kg) (ES: 0.030, 95% CI - 0.167 to 0.266; p = 0.768). However, low-volume HIIT significantly improved cardiorespiratory fitness compared with a non-exercising control (p < 0.001) and MICT (p = 0.017).

CONCLUSION

These data suggest that low-volume HIIT is inefficient for the modulation of total body fat mass or total body fat percentage in comparison with a non-exercise control and MICT. A novel finding of our meta-analysis was that there appears to be no significant effect of low-volume HIIT on lean body mass when compared with a non-exercising control, and while most studies tended to favour improvement in lean body mass with low-volume HIIT versus MICT, this was not significant. However, despite its lower training volume, low-volume HIIT induces greater improvements in cardiorespiratory fitness than a non-exercising control and MICT in normal weight, overweight and obese adults. Low-volume HIIT, therefore, appears to be a time-efficient treatment for increasing fitness, but not for the improvement of body composition.

Quantifying the effects of four weeks of low-volume high-intensity sprint interval training on V̇O2max through assessment of hemodynamics

BACKGROUND

Sprint interval training is a popular workout modality. Studies have eluded to a positive effect on maximal oxygen uptake, however little is known about the mechanistic basis of this adaptation. Therefore, the purpose of this study was to determine the effects of a short-term high-intensity sprint interval training (SIT) intervention on V̇O2max through quantification of both the respiratory and hemodynamic responses.

METHODS

Thirty-six physically active participants undertook 4 weeks of either cycling-based SIT (8×20 s at 170% P-V̇O2max with 10 s recovery) or continuous exercise training (CET) (30 min at 70% P-V̇O2max) 3 times per week. V̇O2max, blood-based markers and hemodynamic responses were assessed pre and post the intervention period. V̇O2max was assessed using breath-by-breath open circuit spirometry, while hemodynamic responses were monitored using thoracic impedance cardiography.

RESULTS

V̇O2max exhibited a non-significant 4.1% increase (ES=0.24) for SIT with 7.0% P=0.007 (ES=0.40) increase for CET. Hemodynamic responses (maximal cardiac output, maximal stroke volume) displayed non-significant responses for CET and SIT while a-vO2dif-max increased from 15.8±4.8 to 18.3±2.9 mL/100 mL) (P=0.02) (ES=0.63) in SIT.

CONCLUSIONS

V̇O2max is a function of maximal cardiac output and a-vO2dif-max, so for a meaningful change to occur in cardiorespiratory fitness, there must be a concomitant increase in O2 delivery. This study demonstrates that a low volume SIT intervention evokes peripherally mediated responses (a-vO2dif) and anaerobic substrate utilization rather than O2 delivery components. Future works should address the time course of the responses and when assessing V̇O2max-based responses that due attention be given to the hemodynamic responses as means of quantification of the response.

Comparison of Acute Cardiometabolic Responses in a 7-Minute Body Weight Circuit to 7-Minute HIIT Training Protocol

To investigate the acute cardiometabolic responses of a 7-minute bodyweight resistance exercise circuit (HICE) compared to a 7-minute high intensity interval training cycle protocol (HIIE).

METHODS

Twelve apparently healthy and active young adults were enrolled in a randomized crossover study (HICE vs HIIE). The 12 HICE exercises used a 30:5 second exercise to rest ratio, followed by a 3-minute cool-down and was replicated in the HIIE cycle protocol. Following each protocol, subjects were seated for the next hour. Measurements included blood pressure (BP) heart rate, blood glucose and triglycerides, taken prior to exercise, immediately after, 15, 30, 45, and 60-minutes post-exercise. Blood glucose and triglycerides were only taken, immediately after and at 60-minutes. General mixed linear modeling was used to analyze the data and Cohen's d was calculated for effect size. Post hoc analysis of individual time points used Bonferroni adjustment.

RESULTS

There was no significant difference in overall systolic BP between HIIE and HICE (p = 0.168). However, there was a significant difference in overall diastolic BP resulting a higher response in HIIE (p = 0.002). Immediately after exercise exhibited significant (p = 0.001) and trending, respectfully, higher values in diastolic BP for HIIE. The overall post-exercise heart rate was lower for HIIE vs HICE (p < 0.001). Blood glucose and Triglycerides had no overall difference between the two protocols (p = 0.104).

CONCLUSION

The HICE protocol had a similar cardiometabolic response post-exercise to HIIE but did have a reduction in diastolic BP post-exercise. However, post-exercise heart rate was higher.

Interval exercise induces milder respiratory responses compared to continuous exercise

The purpose of this study was to explore the respiratory response of acute interval and continuous exercise (CE) of low and high intensity. Fourteen recreational athletes (7 men and 7 women; VO₂max = 35.7 ± 6.1 mlkg^-1min^-1) performed a bout of continuous and a bout of interval exercise (IE) both consisted of 5-min cycling at low intensity [80% of the power output (W) of the predetermined gas exchange threshold (GET) (80%W_GET)] and 5-min cycling at high intensity {W_GET plus the work rate corresponding to 50% of the difference between peak power output (PPO) at oxygen uptake (VO₂max) test and the W_GET [W_GET + 0.50 Δ(PPO - W_GET)]}. CE compared to IE induced significant higher heart rate and ventilation as well as significant higher levels of mouth occlusion pressure for 0.1 s (P_0.1) (P < 0.05) during low and high intensities. Our results indicate that CE stimulates respiration more than IE when the exercise is performed at the same relative intensity.

Six Sessions of Sprint-Interval Training Did Not Improve Endurance and Neuromuscular Performance in Untrained Men

Previous research demonstrated that six sessions of cycling sprint-interval training (SIT) within a duration of only 2 weeks can increase endurance performance considerably. Primarily muscular mechanisms have been under investigation explaining such performance improvements. However, it has been shown in other exercise tasks that training-induced changes also occur at the level of the central nervous system. Therefore, we hypothesized to observe an enhanced neuromuscular performance in conjunction with an increase in endurance performance after 2 weeks of SIT. Therefore, we randomly assigned 19 healthy men (26 ± 5 years) to a control (n = 10) or a training group (n = 9), the latter performing a replication of the SIT protocol from Burgomaster et al. Before and after the training intervention, both groups performed a cycling endurance test until exhaustion. Neuromuscular function of the right vastus lateralis muscle was assessed before and after each endurance task by the means of maximal voluntary isometric contractions (MVCs). The variables of interest being MVC, voluntary activation was measured by peripheral nerve stimulations (VAPNS), by transcranial magnetic stimulation (VATMS), as well as potentiated resting twitches (Qtw,pot). We did not find any significant differences between the groups in the control variable time to exhaustion in the endurance task. In addition, we did not observe any time × group interaction effect in any of the neuromuscular parameters. However, we found a significant large-sized time effect in all neuromuscular variables (MVC, η p 2 = 0.181; VATMS, η p 2 = 0.250; VAPNS, η p 2 = 0.250; Qtw,pot, η p 2 = 0.304) as well as time to exhaustion η p 2 = 0.601). In contrast to other studies, we could not show that a short-term SIT is able to increase endurance performance. An unchanged endurance performance after training most likely explains the lack of differences in neuromuscular variables between groups. These findings demonstrate that replication studies are needed to verify results no matter how strong they seem to be. Differences over time for the variables of neuromuscular fatigue irrespective of group (MVC, + 9.3%; VATMS, + 0.2%; VAPNS, + 6.3%; Qtw,pot, + 6.3%) demonstrate test-retest effects that should be taken into consideration in future training studies and emphasize the inevitable necessity for controlled experiments.

The Impact of Sprint Interval Training Frequency on Blood Glucose Control and Physical Function of Older Adults

Exercise is a powerful tool for improving health in older adults, but the minimum frequency required is not known. This study sought to determine the effect of training frequency of sprint interval training (SIT) on health and physical function in older adults. Thirty-four (13 males and 21 females) older adults (age 65 ± 4 years) were recruited. Participants were allocated to a control group (CON n = 12) or a once- (n = 11) or twice- (n = 11) weekly sprint interval training (SIT) groups. The control group maintained daily activities; the SIT groups performed 8 weeks of once- or twice-weekly training sessions consisting of 6 s sprints. Metabolic health (oral glucose tolerance test), aerobic capacity (walk test) and physical function (get up and go test, sit to stand test) were determined before and after training. Following training, there were significant improvements in blood glucose control, physical function and aerobic capacity in both training groups compared to control, with changes larger than the smallest worthwhile change. There was a small to moderate effect for blood glucose (d = 0.43–0.80) and physical function (d = 0.43–0.69) and a trivial effect for aerobic capacity (d = 0.01) between the two training frequencies. Once a week training SIT is sufficient to produce health benefits. Therefore, the minimum time and frequency of exercise required is much lower than currently recommended.

High-Intensity Interval Training Restores Glycolipid Metabolism and Mitochondrial Function in Skeletal Muscle of Mice With Type 2 Diabetes

High-intensity interval training has been reported to lower fasting blood glucose and improve insulin resistance of type 2 diabetes without clear underlying mechanisms. The purpose of this study was to investigate the effect of high-intensity interval training on the glycolipid metabolism and mitochondrial dynamics in skeletal muscle of high-fat diet (HFD) and one-time 100 mg/kg streptozocin intraperitoneal injection-induced type 2 diabetes mellitus (T2DM) mice. Our results confirmed that high-intensity interval training reduced the body weight, fat mass, fasting blood glucose, and serum insulin of the T2DM mice. High-intensity interval training also improved glucose tolerance and insulin tolerance of the T2DM mice. Moreover, we found that high-intensity interval training also decreased lipid accumulation and increased glycogen synthesis in skeletal muscle of the T2DM mice. Ultrastructural analysis of the mitochondria showed that mitochondrial morphology and quantity were improved after 8 weeks of high-intensity interval training. Western blot analysis showed that the expression of mitochondrial biosynthesis related proteins and mitochondrial dynamics related proteins in high-intensity interval trained mice in skeletal muscle were enhanced. Taken together, these data suggest high-intensity interval training improved fasting blood glucose and glucose homeostasis possibly by ameliorating glycolipid metabolism and mitochondrial dynamics in skeletal muscle of the T2DM mice.

The effects of two weeks high-intensity interval training on fasting glucose, glucose tolerance and insulin resistance in adolescent boys: a pilot study

Background

Current evidence of metabolic health benefits of high-intensity interval training (HIIT) are limited to longer training periods or conducted in overweight youth. This study assessed 1) fasting and postprandial insulin and glucose before and after 2 weeks of HIIT in healthy adolescent boys, and 2) the relationship between pre intervention health outcomes and the effects of the HIIT intervention.

Methods

Seven healthy boys (age:14.3 ± 0.3 y, BMI: 21.6 ± 2.6, 3 participants classified as overweight) completed 6 sessions of HIIT over 2 weeks. Insulin resistance (IR) and blood glucose and insulin responses to a Mixed Meal Tolerance Test (MMTT) were assessed before (PRE), 20 h and 70 h after (POST) the final HIIT session.

Results

Two weeks of HIIT had no effect on fasting plasma glucose, insulin or IR at 20 h and 70 h POST HIIT, nor insulin and glucose response to MMTT (all P > 0.05). There was a strong negative correlation between PRE training IR and change in IR after HIIT (r = − 0.96, P < 0.05).

Conclusion

Two weeks of HIIT did not elicit improvements to fasting or postprandial glucose or insulin health outcomes in a group of adolescent boys. However the negative correlation between PRE IR and improvements after HIIT suggest that interventions of this type may be effective in adolescents with raised baseline IR.