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AbstractObjectiveTo evaluate the effect of five years of supervised exercise training compared with recommendations for physical activity on mortality in older adults (70-77 years).DesignRandomised controlled trial.SettingGeneral population of older adults in Trondheim, Norway.Participants1567 of 6966 individuals born between 1936 and 1942.InterventionParticipants were randomised to two sessions weekly of high intensity interval training at about 90% of peak heart rate (HIIT, n=400), moderate intensity continuous training at about 70% of peak heart rate (MICT, n=387), or to follow the national guidelines for physical activity (n=780; control group); all for five years.Main outcome measureAll cause mortality. An exploratory hypothesis was that HIIT lowers mortality more than MICT.ResultsMean age of the 1567 participants (790 women) was 72.8 (SD 2.1) years. Overall, 87.5% of participants reported to have overall good health, with 80% reporting medium or high physical activity levels at baseline. All cause mortality did not differ between the control group and combined MICT and HIIT group. When MICT and HIIT were analysed separately, with the control group as reference (observed mortality of 4.7%), an absolute risk reduction of 1.7 percentage points was observed after HIIT (hazard ratio 0.63, 95% confidence interval 0.33 to 1.20) and an absolute increased risk of 1.2 percentage points after MICT (1.24, 0.73 to 2.10). When HIIT was compared with MICT as reference group an absolute risk reduction of 2.9 percentage points was observed (0.51, 0.25 to 1.02) for all cause mortality. Control participants chose to perform more of their physical activity as HIIT than the physical activity undertaken by participants in the MICT group. This meant that the controls achieved an exercise dose at an intensity between the MICT and HIIT groups.ConclusionThis study suggests that combined MICT and HIIT has no effect on all cause mortality compared with recommended physical activity levels. However, we observed a lower all cause mortality trend after HIIT compared with controls and MICT.Trial registrationClinicalTrials.gov NCT01666340.

Background With accumulating evidence suggesting that CVD has its origins in childhood obesity. The purpose of this study was to determine the effect of a real-world school-based high-intensity interval training intervention on body composition, cardiorespiratory fitness and cardiometabolic markers in obese boys aged 10 to 13 years. Methods Forty-five adolescent boys with obesity (age = 11.2 ± 0.7 years, BMI = 24.2 ± 1.0 kg/m 2 ), were randomized to high-intensity interval training group (HIIT, n  = 15), moderate-intensity continuous training group (MICT, n  = 15), or a control group (CON, n  = 15). The intervention groups performed three weekly exercise sessions over 12 weeks. HIIT group performed two sets of eight bouts of 15 s run at high-intensity [90 ~ 100% maximal aerobic speed (MAS)] separated by eight bouts of 15 s recovery run at low-intensity (50% MAS), MICT group performed 30 min run at moderate intensity (60 ~ 70% MAS) and CON group were instructed to continue their normal behaviors. All participants had indices of body composition, cardiorespiratory fitness (CRF) and cardiometabolic markers measured at baseline and post-intervention. Statistical differences between and within groups were determined by use of two-way analysis of variance (ANOVA) with repeated measures. Results Following the school-based training program, BMI and body fat mass decreased (BMI: − 1.8 kg/m 2 vs. – 1.2 kg/m 2 , P  < 0.01; FM: − 1.6 kg, P  < 0.05 vs. -3.7 kg, P  < 0.01) in HIIT and MICT group, but there was no significant difference between the two interventions; V ˙ O 2 peak both increased significantly in two intervention groups, and the increment of HIIT group was significantly greater than that of MICT (6.1 mL/kg/min vs. 3.8 mL/kg/min, P  < 0.01), Visceral adipose tissue was significant decrease in HIIT group (− 53 g vs. -17 g, P  < 0.01) whilst the MICT group experienced a significant decrease in body fat percentage (− 3.1 ± 1.0 kg, P  < 0.01), but there were no significant difference between the two interventions. Low-density lipoprotein cholesterol decreased only in HIIT group (− 17.2%, P  < 0.05). Significant decrease in the usual index of insulin resistance (HOMA-IR) occurred in HIIT and MICT groups (− 27.3 and − 28.6%, respectively; P  < 0.05). Conclusions Our results demonstrated that high-intensity interval training based on running can be used to improve the physical health of obese adolescents in school. Further investigations involving a larger cohort of participants, taken from different schools, is recommended. Trial registration title Effect of High Intensity Interval Training on Obese Children and Adolescents, time 16/12/2017, ID ChiCTR-IOR-17013992 , website http://www.chictr.org.cn

The current study examined the adaptive response to both endurance (END) and sprint interval training (SIT) in a group of twenty-one recreationally active adults. All participants completed three weeks (four days/ week) of both END (30 minutes at ~65% VO2peak work rate (WR) and SIT (eight, 20-second intervals at ~170% VO2peak WR separated by 10 seconds of active rest) following a randomized crossover study design with a three-month washout period between training interventions. While a main effect of training was observed for VO2peak, lactate threshold, and submaximal heart rate (HR), considerable variability was observed in the individual responses to both END and SIT. No significant positive relationships were observed between END and SIT for individual changes in any variable. Non-responses were determined using two times the typical error (TE) of measurement for VO2peak (0.107 L/min), lactate threshold (15.7 W), and submaximal HR (10.7bpm). Non-responders in VO2peak, lactate threshold, and submaximal HR were observed following both END and SIT, however, the individual patterns of response differed following END and SIT. Interestingly, all individuals responded in at least one variable when exposed to both END and SIT. These results suggest that the individual response to exercise training is highly variable following different training protocols and that the incidence of non-response to exercise training may be reduced by changing the training stimulus for non-responders to three weeks of END or SIT.

Background Cardiovascular disease (CVD) remains the largest cause of death in breast cancer survivors. The aim of this study was to explore the impact of exercise intensity on aerobic fitness and autonomic cardiac regulation (heart rate variability (HRV)) and salivary biomarkers of the stress systems (HPA-axis, cortisol; sympathetic nervous system, α-amylase) and mucosal immunity (secretory(s)-IgA), markers of increased risk of CVD in breast cancer survivors. Methods Participants were randomly assigned to; 1) high intensity interval training (HIIT); 2) moderate-intensity, continuous aerobic training (CMIT); or 3) a wait-list control (CON) for a 12-week (36 session) stationary cycling intervention. Cardiorespiratory fitness (VO 2peak ), resting HRV and salivary biomarkers were measured at baseline 2–4 d pre-intervention and 2–4 d post the last exercise session. Results Seventeen participants were included in this study (62 ± 8 years, HIIT; n  = 6, CMIT; n  = 5, CON; n = 6). A significant improvement ( p  ≤ 0.05) was observed for VO 2peak in the HIIT group; 19.3% (B = 3.98, 95%CI = [1.89; 4.02]) and a non-significant increase in the CMIT group; 5.6% (B = 1.96, 95%CI = [− 0.11; 4.03]), compared with a 2.6% (B = − 0.64, 95%CI = [− 2.10; 0.82]) decrease in the CON group. Post intervention improvements in HRV markers of vagal activity (log (ln)LF/HF, LnRMSSD) and sympathetic nervous system (α-amylase waking response) occurred for individuals exhibiting outlying (> 95% CI) levels at baseline compared to general population. Conclusion High intensity interval training improved cardiovascular fitness in breast cancer survivors and improved cardiac regulation, and sympathetic nervous system (stress) responses in some individuals. High-intensity interval training was safe and effective for breast cancer survivors to participate in with promising results as a time efficient intensity to improve physical health and stress, reducing CVD risk. Trial registration This pilot study was retrospectively registered through the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620000684921 .

We investigated the effects of high-intensity interval (HIIT) and small-sided games (SSG) training programs on physiological and psychological responses in young soccer players. Twenty-four male soccer players (age 16.7 ± 0.9 years) were divided into two groups (HIIT and SSG) and completed a 6-week training programs consisting of two training sessions a week. HIIT consisted of intermittent runs lasting 15 s at the 110% maximum aerobic speed followed by a passive recovery lasting 15 s; SSG was instead structured in a 4 versus 4 players games on a playing field of 25 × 35 m. The muscular power of the lower body was assessed before and after each training session using the 5-jump test to leg length, and two incremental field tests (VAMEVAL test and modified agility t-test). Our results show that HIIT and SSG have similar beneficial effects on the variables connected to the soccer-specific performance and the endurance with little influence on neuromuscular performances. Psychological responses were assessed using the “physical activity enjoyment scale”, the Hooper index and the POMS variables. Results showed that SSG offers greater perceived enjoyment than what can be achieved with HIIT. In conclusion, SSG can be considered an effective, more motivating, and fun soccer-specific training that brings about physiological responses and neuromuscular adjustments in young soccer players.

Women with PCOS have substantially greater symptoms of depression and anxiety, and a lower health-related quality of life (HRQoL) compared to women without PCOS. The aim of this study was to determine if high-intensity interval training (HIIT) could provide greater improvements in mental health outcomes than standard moderate-intensity continuous training (MICT). Twenty-nine overweight women with PCOS aged 18–45 years were randomly assigned to 12 weeks of either MICT (60–75% HR peak , N = 15) or HIIT (> 90% HR peak , N = 14). Outcome measures included symptoms of depression, anxiety and stress (DASS-21), general HRQoL (SF-36) and PCOS specific HRQoL (PCOSQ) collected at baseline and post-intervention. Reductions in depression (Δ − 1.7, P = 0.005), anxiety (Δ − 3.4, P < 0.001) and stress (Δ − 2.4, P = 0.003) scores were observed in the HIIT group, while MICT only resulted in a reduction in stress scores (Δ − 2.9, P = 0.001). Reductions in anxiety scores were significantly higher in the HIIT group compared to the MICT group (β = − 2.24, P = 0.020). Both HIIT and MICT significantly improved multiple domain scores from the SF-36 and PCOSQ. This study highlights the potential of HIIT for improving mental health and HRQoL in overweight women with PCOS. HIIT may be a viable strategy to reduce symptoms of depression and anxiety in women with PCOS, however, large-scale studies are required to confirm these findings. Trial registration number : ACTRN12615000242527.

ObjectivesPatients with rheumatoid arthritis (RA) have substantially elevated risk for cardiovascular diseases, and low cardiorespiratory fitness (VO2max) is a major mediator. The aim of this assessor-blinded, two-armed multicentre randomised controlled trial was to evaluate the effects of high-intensity interval training (HIIT) and strength exercise on cardiovascular health, physical fitness and overall health in patients with RA.MethodsIn total, 87 patients (86% female; aged 20–60 years) were randomly assigned to an intervention group (IG) or a control group (CG). The IG performed HIIT and strength exercise for 12 weeks. The CG was instructed to be physically active on a moderately intensive level, ≥150 min/week. Primary outcome was change in VO2max. Secondary outcomes were changes in anthropometry measures, muscle strength, overall health (Visual Analogue Scale (VAS)-Global), Patient Global Impression of Change (PGIC), pain and disease activity (Disease Activity Score in 28 joints (DAS28)).ResultsThere was a significant mean group difference of change on VO2max (3.71 mL/kg/min; 95% CI 2.16, 5.25) in favour of the IG. Significant mean group differences of change were also seen for O2-pulse (1.38; 95% CI 0.85 to 1.91), waist circumference (−2.6; 95% CI −5.09 to –0.18), 1-minute sit-to-stand (5.0; 95% CI 3.35 to 6.72), handgrip strength (28.5; 95% CI 3.80 to 52.8), overall health (−14.7; 95% CI –23.8 to –5.50) and PGIC (p<0.0001) in favour of the IG. No significant mean group differences of change were found for pain (−4.0; 95% CI −13.07 to 5.06), DAS28 (−0.25; 95% CI −0.60 to 0.10) and erythrocyte sedimentation rate (−0.64; 95% CI −3.23 to 1.90).ConclusionSupervised HIIT and strength exercise improved cardiovascular health, physical fitness and overall health without a deterioration in pain and disease activity and should be considered in patients with well-controlled RA.Trial registration numberNCT05768165.

Physical exercise is an effective measure to prevent sarcopenia. However, the effects of Nordic walking based on high-intensity interval training (HIIT NW) and conventional strength training (ST) on the parameters related to sarcopenia in postmenopausal women remain unclear. Therefore, this study aims to evaluate the effects of 12-week HIIT NW and ST on body composition and physical function performance in postmenopausal women. The participants were 71 women aged between 60 and 79 years old without sarcopenia. Participants were randomly assigned to the HIIT NW group (12-week Nordic walking training, 3 × /week), the ST group (12-week strength training, 3 × /week), and the control group. The body composition was determined by using Otupole InBody 720. Test the hand grip strength with a digital hand force gauge. The strength of the extensor and flexor muscles of the knee joint was measured using Biodex System 4 Pro™. This study also employed common methods for measuring functional performance and conducted two measurements of blood creatinine and creatine kinase. Compared with the control group, significant improvements were observed in parameters such as Time Up and Go (TUG) and knee joint flexor strength (KFS) in both the HIIT NW group and the ST group. In the ST group alone, significant enhancements were noted in parameters including walking speed (GS) and hand strength on the left side (HS-L). Following the intervention, the HIIT NW group exhibited a marked increase in limb lean mass, which led to a significant rise in the skeletal muscle index (SMI) (p < 0.001). However, the body fat mass (BFM) and body mass index (BMI) decreased significantly in the ST group (p < 0.001 and p = 0.005, respectively). No significant changes were observed in the control group. Both HIIT NW and ST interventions can effectively prevent sarcopenia in postmenopausal women. The former focuses on improving lower limb strength, while the latter focuses on improving upper limb strength. In the short term, the HIIT NW intervention model is more beneficial for postmenopausal women with normal weight, while the conventional ST intervention model is more conducive to the overweight population.

Background This study assessed the feasibility and acceptability of two common types of exercise training—high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT)—in adults with Crohn’s disease (CD). Methods In this mixed-methods pilot trial, participants with quiescent or mildly-active CD were randomly assigned 1:1:1 to HIIT, MICT or usual care control, and followed up for 6 months. The HIIT and MICT groups were offered three exercise sessions per week for the first 12 weeks. Feasibility outcomes included rates of recruitment, retention, outcome completion, and exercise attendance. Data were collected on cardiorespiratory fitness (e.g., peak oxygen uptake), disease activity, fatigue, quality of life, adverse events, and intervention acceptability (via interviews). Results Over 17 months, 53 patients were assessed for eligibility and 36 (68%) were randomised (47% male; mean age 36.9 [SD 11.2] years); 13 to HIIT, 12 to MICT, and 11 to control. The exercise session attendance rate was 62% for HIIT (288/465) and 75% for MICT (320/429), with 62% of HIIT participants (8/13) and 67% of MICT participants (8/12) completing at least 24 of 36 sessions. One participant was lost to follow-up. Outcome completion rates ranged from 89 to 97%. The mean increase in peak oxygen uptake, relative to control, was greater following HIIT than MICT (2.4 vs. 0.7 mL/kg/min). There were three non-serious exercise-related adverse events, and two exercise participants experienced disease relapse during follow-up. Conclusions The findings support the feasibility and acceptability of the exercise programmes and trial procedures. A definitive trial is warranted. Physical exercise remains a potentially useful adjunct therapy in CD. [ID: ISRCTN13021107].

Abstract Context We investigated whether 6 weeks of high-intensity interval training (HIT) induced improvements in cardiometabolic health markers similar to moderate-intensity continuous training (MICT) in people with type 1 diabetes (T1D), and whether HIT abolished acute reductions in plasma glucose levels observed after MICT sessions. Methods Two groups of sedentary individuals with T1D (n = 7 per group) completed 6 weeks of thrice weekly HIT or MICT. Pre- and post-training measurements were made of 24-hour interstitial glucose profiles, using continuous glucose monitors, and cardiometabolic health markers [peak oxygen consumption (V˙o2peak), blood lipid profile, and aortic pulse wave velocity (aPWV)]. Capillary blood glucose (BG) concentrations were assessed before and after exercise to investigate changes in BG levels during exercise in the fed state. Results Six weeks of HIT or MICT increased V˙o2peak by 14% and 15%, respectively (P < 0.001), and aPWV by 12% (P < 0.001), with no difference between groups. There was no difference in incidence or percentage of time spent in hypoglycemia after training in either group (P > 0.05). In the fed state, the mean change (±SEM) in capillary BG concentration during the HIT sessions was −0.2 ± 0.5 mmol/L, and −5.5 ± 0.4 mmol/L during MICT. Conclusions Six weeks of HIT improved V˙o2peak and aPWV to a similar extent as MICT. That BG levels remained stable during HIT in the fed state but consistently fell during MICT suggests HIT may be the preferred training mode for some people with T1D. High-intensity interval training improved aerobic capacity and abolished the decline in blood glucose levels observed during moderate-intensity continuous training sessions in people with T1D.