High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis

High-intensity interval training exercise decreases brain CB1 receptor levels in male and female adult rats

The numerous health benefits of exercise are well-documented, including its efficacy in treating substance use disorders (SUDs). Several exercise regimens have been proposed; however, the most effective regimen for patients with addiction has yet to be elucidated. High-intensity interval training (HIIT) exhibits considerable potential compared to aerobic and resistance exercise. Dopamine signaling is recognized as a key neurobiological mechanism contributing to HIIT's therapeutic potential for SUDs; however, the role of the endocannabinoid system in this context is not well understood. The present study investigated the effects of HIIT exercise on endocannabinoid signaling by measuring cannabinoid receptor 1 (CB1R) binding in the brains of male and female rats using [3H]SR141716A autoradiography. Male and female rats were separated into sedentary and HIIT exercise groups. For six weeks, exercise was completed daily on a treadmill for 30 min (10 3-min intervals) progressively increasing speed to 0.8 mph (21.5 m/min). The HIIT program significantly reduced CB1R binding in both sexes across multiple brain regions, including the striatum, thalamus, and distinct areas of the cortex. Sex differences were observed wherein males exhibited greater CB1R binding than females across brain regions, including the cerebellum, striatum, and parts of the cortex. Males experienced an increase in mean cerebellum CB1R binding due to HIIT, whereas females showed no effect in this region. The results suggest HIIT exercise can modulate endocannabinoid signalling by way of decreased CB1R binding. These findings further support the intensity dependence of endocannabinoid modulation and highlight potential pathways for exercise-induced neurobiological and behavioural change.

Acute Effect of High-Intensity Interval Exercise on Blood Pressure in Females Living with Type 2 Diabetes and Hypertension

BACKGROUND

The acute effects of high-intensity interval training (HIIT) on blood pressure (BP) may depend on the exercise protocol performed.

PURPOSE

To compare the acute effect of high- and low-volume HIIT on post-exercise and ambulatory BP in untrained older females diagnosed with both type 2 diabetes and hypertension.

METHODS

Fifteen females (69 (65-74) yr) completed a crossover study with three experimental conditions: 1) REST (35 min in sitting position); 2) HIIT10 (10 × 1 min at 90% heart rate max (HRmax)), and 3) HIIT4 (4 × 4 min at 90% HRmax). After each experimental condition, BP was measured under controlled (4 h) and in subsequent free-living conditions (20 h).

RESULTS

In the controlled post-condition 4-h period, no significant interaction (time-condition) was observed for all BP parameters ( P ≥ 0.082). Similarly, during the subsequent 20-h free-living ambulatory monitoring (diurnal and nocturnal), no differences between conditions were detected ( P ≥ 0.094). A significant reduction in nighttime pulse pressure was observed in both HIIT4 and HIIT10 compared with REST (46 (44-50), 45 (42-53) vs 50 (45-57) mm Hg, respectively; P ≤ 0.018) with no differences between HIIT conditions ( P = 0.316). Changes in nocturnal systolic BP approached but did not reach statistical significance ( P = 0.068).

CONCLUSIONS

This study suggests that in untrained older females living with type 2 diabetes and hypertension, the HIIT10 and HIIT4 protocols have very limited to no acute effect on post-exercise and ambulatory BP. The fact that the vast majority of participants had well-controlled office and ambulatory BP values as well as low cardiorespiratory fitness could explain these findings.

Narrative Review of High-Intensity Interval Training: Positive Impacts on Cardiovascular Health and Disease Prevention

BACKGROUND

High-intensity interval training (HIIT) has gained recognition for its positive impacts on cardiovascular (CV) health, metabolic outcomes, mental health, and quality of life (QoL). This narrative review aims to comprehensively evaluate the efficacy of HIIT in enhancing CV health and preventing CV disease (CVD).

METHODS

A comprehensive search of PubMed identified 257 articles, of which 39 studies met predefined inclusion and exclusion criteria for quality assessment. Key metrics evaluated included blood pressure, vascular function, lipid profiles, body composition, and CRF.

RESULTS

HIIT significantly improved vascular function, evidenced by reductions in systolic and diastolic blood pressure and enhanced flow-mediated dilation. Improvements in cardiac function were observed through increased cardiac output and heart rate variability. Additionally, HIIT positively influenced lipid profiles, decreasing low-density lipoprotein and triglycerides while increasing high-density lipoprotein. Significant reductions in body fat and improvements in VO2peak were noted, contributing to enhanced CRF. HIIT also positively impacted mental health and QoL, reducing anxiety and depressive symptoms. Importantly, HIIT was safely and effectively applied to high-risk populations-individuals with obesity, metabolic syndrome, CVD, and cancer survivors-with a low incidence of adverse effects.

CONCLUSIONS

This review highlights HIIT as an effective and safe exercise modality for improving CV health, metabolic indicators, mental health, and QoL. Future research should focus on developing tailored HIIT protocols to optimize adherence and efficacy across diverse populations, considering variations in age, sex, health status, and underlying medical conditions.

Intra-apheresis Cycling to Improve the Clinical Efficacy of Peripheral Blood Stem Cell Donations

Peripheral blood stem cell (PBSC) donation is the primary procedure used to collect haemopoietic stem cells (HSCs) for transplantation in individuals with haematological malignancies. More than 90,000 HSC transplants take place globally each year, and there is an increasing need to guarantee HSC mobilisation, improve tolerability to apheresis, and optimise immune reconstitution. Currently, mobilisation of HSCs depends upon pharmacological agents, with donors inactive during their subsequent apheresis. A successful yield of HSCs is not always achieved, and greater efficiency of collection procedures would improve the donors' safety and experience, along with the overall functioning of apheresis departments. The mobilisation of immune cells during bouts of exercise has been increasingly studied over the past 40 years. Exercise enriches peripheral blood with HSCs and immune cells such as cytolytic natural killer cells, and these may impact upon collection efficiency and patient outcomes following transplantation. Using exercise in conjunction with routine pharmaceutical agents may meet these needs. This article describes the impact of exercise on the quantity and engraftment potential of HSCs. Given that PBSC collections take on average 3-4 h per day per donor, and often consecutive days to complete, particular attention is paid to adopting interval exercise in this setting. Moreover, practical and safety considerations for allogeneic and autologous donors are discussed. 'Intra-apheresis cycling' is proposed as a feasible adjunctive strategy to evoke clinically significant improvements in the quality of the immune graft. Further research is needed to validate this concept in conjunction with routine mobilisation agents.

Impact of resistance and high-intensity interval training on body composition, physical function, and temporal dynamics of adaptation in older women with impaired cardiometabolic health: a randomized clinical trial

PURPOSE

Physical inactivity is associated with reduced physical fitness (PF) in older women with impaired cardiometabolic health. Although exercise has been shown to improve PF, interindividual variability in response and adaptation changes over time remain unclear. This study evaluated the effects of eight weeks of resistance training (RT) and high-intensity interval training (HIIT) on body composition, isometric strength, and the 6-minute walk test (6MWT) in older women with impaired cardiometabolic health. Additionally, the study explored the reduction of non-responders (NRs) and adaptation changes over time.

METHODS

This randomized clinical trial involved 36 older women (64 ± 8.4 years; BMI: 31.8 ± 5.5) with impaired cardiometabolic health, divided into RT-G (n = 12; 62 ± 7 years; BMI: 32.2 ± 4.1), HIIT-G (n = 12; 66 ± 10 years; BMI: 31.2 ± 4.1), and CG (n = 12; 64 ± 9 years; BMI: 31.8 ± 6) groups. RT-G performed elastic band exercises, and HIIT-G performed cycle ergometer intervals. BMI, body fat, lean mass, isometric strength, and 6MWT were measured at baseline and at four and eight weeks. The Student's t-test was applied for normally distributed variables and the Mann-Whitney U test for non-normal variables. Intra- and inter-group differences were analyzed using a two-way repeated measures ANOVA, considering group, time, and their interaction. Post-hoc comparisons were conducted using the Bonferroni test. Individual responses (IR) were calculated using the equation proposed by Hopkins: SDIR = √(SDExp2 - SDCon2). The prevalence of responders (Rs) and non-responders (NRs) was expressed as a percentage, and percentage changes from baseline to weeks four and eight were used to evaluate adaptations dynamics.

RESULTS

By week eight, isometric strength in RT-G significantly improved from 21.3 ± 4.4 to 24.37 ± 3.99 kg (p = 0.027; 95% CI: 1.8, 4.3 kg; Cohen's d = 0.731) and 6MWT distance in HIIT-G increased from 441.0 ± 48.9 to 480.0 ± 53.0 m. (p = 0.002; 95% CI: 22, 55 m; Cohen's d = 0.757). Both protocols reduced NRs for body fat, lean mass, and 6MWT. Responders showed greater adaptations in the first four weeks, stabilizing by week eight.

CONCLUSION

RT and HIIT improved PF in older women with impaired cardiometabolic health, reducing NRs in terms of body composition and 6MWT over eight weeks, with similar adaptation changes over time among the responders. These findings highlight the importance of individualized exercise interventions to maximize health benefits.

TRIAL REGISTRATION

This study was part of a trial registered at ClinicalTrials.gov (ID: NCT06201273). Date: 22/12/2023.

Determinants of Physical Activity 10 Months Following a Supervised Exercise Program in People With Type 2 Diabetes

AIMS

Supervised exercise provides numerous health benefits for people with type 2 diabetes mellitus (T2D); however, long-term adherence is poor. We aimed to identify (1) factors associated with total physical activity (PA) participation 10 months following supervised exercise and (2) barriers to and enablers of self-directed exercise.

METHODS

Fifty-seven adults with type 2 diabetes mellitus (age: 60.4 [8.6] y, 23% women, glycated hemoglobin [HbA1c]: 8.7% [1.9%], PA: 68.1 [142.3] min·wk-1) were allocated to low-volume combined aerobic and resistance high-intensity interval training (78 min·wk-1) or combined moderate intensity continuous training (210 min·wk-1). Participants completed 8 weeks of supervised training, then 10 months of self-directed exercise (12 mo total). Sociodemographic, medical, psychological, and health determinants of total PA at 12 months were identified using correlation and multiple regression analyses. Barriers and enablers were derived from individual participant interviews.

RESULTS

At 12 months, average weighted total PA was 209.4 (174.3) minutes per week. Only allocation to combined aerobic and resistance high-intensity interval training was an independent predictor of total PA at 12 months (β = 0.477, P = .027). Enablers of self-directed exercise included flexible exercise schedule and social support. Barriers were limited access to specialized equipment and competing time demands.

CONCLUSIONS

This study highlights factors to consider when designing long-term exercise support for people with type 2 diabetes mellitus.

Effects of high-intensity interval training on physical morphology, cardiopulmonary function, and metabolic indicators in older adults: a systematic review and meta-analysis

Background

Despite the growing attention towards the efficacy of high-intensity interval training (HIIT) on older adult health, a consensus regarding the pleiotropic effects of HIIT in this population is yet to be reached. Previous studies have predominantly focused on specific outcomes or particular groups, lacking comprehensive analysis.

Objective

We aimed to conduct a systematic evaluation of the impact of HIIT on body composition, cardiopulmonary function, and metabolic parameters in older adults.

Methods

The databases searched included PubMed, Web of Science, Cochrane Library, Scopus, WanFang, and other relevant sources from the inception of the database until July 2023. Randomized controlled trials (RCTs) on the effects of HIIT on body shape, cardiopulmonary function, and metabolic parameters in the older adult were searched.

Results

A total of 87 RCTs meeting the criteria were included, involving 4,213 older adult people. Meta-analysis results showed that HIIT significantly improved body fat percentage (BF%) [MD: -1.63%, p = 0.005], maximal oxygen uptake (VO2max) [MD: 2.46 mL min-1 kg-1, p < 0.00001], maximal heart rate (HRmax) [MD: 2.83 beats min-1, p = 0.02], and high-density lipoprotein (HDL) levels [MD: 0.04 mmol L-1, p = 0.002]. However, for systolic blood pressure (SBP) [MD: 0.49 mmHg, p = 0.60], resting heart rate (HRrest) [MD: -0.95 BPM -1, p = 0.24], triglycerides (TG) [tendency for MD: -0.02 mmol L-1, p = 0.61], low-density lipoprotein (LDL) [MD: -0.04 mmol L-1, p = 0.27] had no significant effect. Sensitivity analysis found that HIIT significantly improved waist circumference (WC) [MD: -1.89 cm, p = 0.17], diastolic blood pressure (DBP) [MD: -0.63 mmHg, p = 0.23], respiratory exchange rate (RER) [MD: 0.01, p = 0.20], total cholesterol (TC) [MD: 0.10 mmol L-1, p = 0.14], and fasting plasma glucose (FPG) [MD:-0.20 mmol L-1, p = 0.08], but the results lacked robustness. There was no significant improvement in DBP [MD: -0.63 mmHg, p = 0.23] and body mass index (BMI) [MD: -0.36 kg m-2, p = 0.06].

Conclusions

HIIT has shown certain potential and advantages in improving the physical health of the older adult, especially in cardiopulmonary function. However, more high-quality studies are needed to confirm the effects of HIIT on the physical health of the older adult in the future. It also provides a reference for the clinical practice and family health management of HIIT in the older adult and the development of HIIT guidelines.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/myprospero, identifier CRD42023460252.

Application of Exercise Snacks across Youth, Adult and Clinical Populations: A Scoping Review

BACKGROUND

Interest in 'exercise snacks' has increased, yet a comprehensive and holistic review of this novel concept is lacking. We aimed to map global research on 'exercise snacks', across youth, adult and clinical populations through a scoping review.

METHODS

A systematic search was conducted in six databases. Grey literature searches were also conducted. Studies whereby participants were prescribed a structured bout of intense exercise dispersed across the day, or the exercise was explicitly defined as a form of 'snacks', in any setting were included. We used the Consensus on Exercise Reporting Template (CERT) to assess the completeness of exercise descriptions. Data were recorded into spreadsheets, then descriptively analyzed and summarized in graphic form.

RESULTS

The 45 publications meeting our inclusion criteria represented 33 original studies. These 33 studies enrolled a total of 1118 participants, with a median sample size of 24. Studies were categorized as either acute (n = 12) or chronic (n = 21) trials with both trial types performed across a wide range of participant ages (range 8.7 to 78 years) but mostly conducted on healthy adults and older adults. The majority of studies (20/33) defined the concept as 'exercise snacks', with study context being predominantly the laboratory or home. A wide variety of exercise modes (e.g., cycling, stair climbing, body weight exercises) and comparator conditions (e.g., moderate intensity continuous exercise, prolonged sitting, non-exercise controls) were used. 'Exercise snack' intensity was prescribed more frequently than it was reported, and, of the available data, mean intensity was estimated at 76.9% of maximal heart rate and 5.2 Arbitrary Units (AU) on the Ratings of Perceived Exertion (RPE) CR10 scale. Study outcome measures were predominantly cardiovascular, metabolic, muscular, and psychological, with studies mostly adhering to the CERT, though there was underreporting of detail for the exercise provider, motivation strategies, adverse events and intervention fidelity.

CONCLUSION

The 'exercise snack' concept is being increasingly used to cover an array of exercise models. The most common protocols to date utilize body weight exercises or stair climbing. We recommend 'exercise snacks' terminology is consistently used to describe protocols whereby short, purposeful structured exercise is dispersed throughout the day. Future studies should provide detailed descriptions of their 'exercise snacks' model, through exercise and adverse event reporting checklists.

High-Intensity Interval Training Enhances the Positive Effect of Pentoxifylline on Lipid Profile and Inflammatory Markers in an Endometriosis Animal Model

Background: The relationship between endometriosis and cardiovascular disease (CVD) is well established. However, the effects of various exercise training modalities and the anti-inflammatory effects of pentoxifylline (PTX) remain inadequately understood. This investigation is aimed at evaluating the effects of PTX, both independently and in conjunction with high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), on lipid and inflammatory markers including triglycerides (TGs), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and C-reactive protein (CRP) in a rat model of endometriosis. Materials and Methods: Sprague-Dawley's rats were divided into two primary groups: the healthy control group that received no intervention and the induced endometriosis group. Endometriosis was surgically induced in rats, and those with confirmed endometriotic lesions were further categorized into six groups: control, MICT, drug of PTX (D), MICT+D, HIIT, and HIIT+D. Two weeks after laparotomy, PTX consumption and exercise training were performed for 8 weeks. PTX was administered orally at 100 mg/kg/day. MICT and HIIT sessions were conducted 5 days per week, with MICT beginning at 55% of maximum capacity for 31 min in the first week and progressing to 70% of maximum capacity for 46 min by the eighth week. HIIT sessions consisted of 2 min of running followed by 1 min of passive rest at 85% of maximum capacity, starting with seven intervals in the first week and increasing to twelve by the end of the eighth week. The macroscopic size of endometriosis lesions was measured, and cardiovascular risk factors, including hs-CRP, TC, TG, HDL-C, and LDL-C, were assessed in serum samples. Results: The induction of endometriosis was associated with elevated cardiovascular risk factors, including hs-CRP, TC, and TG. HIIT+D significantly decreased lesion volume (p < 0.0001, 95%confidence interval (CI) = 57.239-94.718), hs-CRP (p = 0.049, CI = -54.083 to - 29.478), TC (p = 0.045, CI = -38.607 to - 25.392), and TG (p = 0.042, CI = 25.531-55.801). PTX significantly decreased lesion volume (p < 0.0001, CI =34.709-73.919) and TC (p = 0.016, CI = -45.153 to - 30.179). Conclusion: All interventions except MICT reduced lesion volume, whereas only HIIT+PTX and PTX, in the order of importance, improved some cardiovascular risk indices in the rat model of endometriosis.

Twelve-week interval training alters cytokines, adipokines and bone markers in women with obesity

This study aimed to investigate the effects of a 12-week high-intensity interval training on inflammatory cytokines, adipokines, and markers of bone turnover and examine whether high-intensity interval training-induced changes in inflammatory cytokines and adipokines were associated with changes in markers of bone turnover. Twenty-four women with obesity (mean [standard deviation]: age: 36.1 [3.38] years, height: 158.9 [11.9] cm, and body mass index: 31.9 [1.5] kg/m2) were randomly assigned to either control (n=10) or high-intensity interval training (n=14) groups. Body mass (- 2.7%), fat mass (- 15%), and percent body fat (- 6.2%) significantly decreased (p<0.05), while the predicted V̇O2max increased (29.6%; p<0.001) following the high-intensity interval training program. The training program resulted in increased adiponectin (7.6%) and osteocalcin (11.3%; p<0.05) and reduced tumor necrosis factor alpha (66.1%), interleukin-1α (18.6%), C-reactive protein (24.0%), leptin (21.5%), and carboxy-terminal telopeptide cross-linking type one collagen (14%; p<0.05). When high-intensity interval training and control groups were analyzed separately, training-induced changes in inflammatory cytokines and adipokines were not associated with changes in bone turnover markers (p>0.05), whereas significant associations were found when the data of the groups were analyzed together (p<0.05). In conclusion, a 12-week high-intensity interval exercise program improves the inflammatory state, adipokines, markers of bone turnover, cardiorespiratory fitness, and body composition in women with obesity.

Intensity and enjoyment of play-based HIIT in children and adolescents with obesity

High-intensity interval training (HIIT) has been suggested as an effective treatment approach of childhood obesity. The objective of the present study was to examine intensity, enjoyment, and perceived exertion of a 4x4-minute play-based HIIT program for children and adolescents with obesity. 83 participants (42.2% girls, 12.3±1.5 years, 57.8% boys, 12.0±1.6 years) completed a 12-week intervention comprising three weekly sessions. After nine sessions (weeks 2, 6, and 11), participants rated perceived exertion (RPE) with a Borg scale and enjoyment of activities using the Physical Activity Enjoyment Scale (PACES). Heart rate (HR) was recorded to assess time spent in high- and moderate-intensity. Participants spent more time in high-intensity during strength-based (P=0.004) and running-based (P=0.007) activities compared to ball games, and more time was spent in moderate-intensity during ball games compared to strength-based (P=0.033) and running-based (P=0.028) activities. Overall, boys spent more time in moderate-intensity than girls (P=0.007). Participants rated RPE lower for ball games than for strength-based (P<0.001) and running-based (P<0.001) activities. Boys rated running-based activities more enjoyable than girls (P=0.021). Exercise intensity and RPE vary by activity in HIIT for children and adolescents with obesity. Ball games led to less high-intensity time and were seen as less exhausting. No differences in RPE or enjoyment were found over time.

ActiLup: is it feasible? High-intensity interval training in systemic lupus erythematosus patients with fatigue: protocol for a prospective, monocentric proof-of-concept study

The symptoms of active systemic lupus erythematosus (SLE) potentially lead to inactivity, muscle loss and social isolation. In addition to medical treatment, the current EULAR recommendations describe the relevance of physical activity, exercise and training as a non-pharmacological management option in patients with SLE. A positive interaction between fatigue and the basic health-promoting effects of exercise is well established. Still unclear is what kind of training, setting, and intensity show optimal objective and subjective outcomes. The study will include 40 adult SLE patients with moderate to severe fatigue. The study lasts 28 weeks and is divided into a 12-week "real-world" monitoring phase before rehabilitation, a 4-week inpatient rehabilitation phase, and a 12-week maintenance activity and training phase after the rehabilitation. The parameters consisted of physical performance parameters, laboratory parameters, physician and patient-related questionnaires and activity data based on a fitness watch. During rehabilitation, patients receive individual high-intensity interval training (HIIT), basic endurance training and functional interval training. This proof-of-concept trial aims to investigate if high-intensity interval training is feasible and how VO2peak is increased. Additionally, the effect of the severity of fatigue measured by patient-related outcomes and the number of anti-NR2 antibodies is focussed. This study was approved by the Ethics Committee of the Medical Association of Rhineland-Palatinate and complies with the standards of the Declaration of Helsinki. All participants will sign a written informed consent. Trial registration number: DRKS00022933.

Effect of brief intense stair climbing on cardiorespiratory fitness and metabolic risk factors in inactive young men with obesity: A randomized controlled trial

BACKGROUND AND AIM

We investigated the effects of brief, intense stair climbing on cardiorespiratory fitness (CRF) and cardiometabolic risk factors in young Korean men with obesity.

METHODS AND RESULTS

Twenty-four healthy men (age: 25.8 ± 2.4 years, BMI: 27.1 ± 2.5 kg/m2) were randomized into either the stair climbing exercise group (n = 12) or the control group (no exercise intervention, n = 12). The stair climbing exercise (5 days per week for 4 weeks) included a 3-min warm-up, followed by three 20-s bouts of vigorous stair climbing [≥80 % of age-predicted maximal heart rate (MHR)], with 2-min of recovery in between. Peak oxygen uptake (VO2peak) and body composition were measured by maximal treadmill test and bioelectrical impedance analysis, respectively. A fasting blood sample was obtained after a 10-h overnight fast to measure cardiometabolic markers. All participants completed the study and attended 97.1 % of all scheduled exercise sessions. There was significant group x time effect on CRF, such that the stair climbing exercise group had significant improvements in VO2peak (pre: 38.7 ± 5.2 versus post: 41.6 ± 5.7 ml/kg/min, P < 0.01) and exercise duration (pre: 10.4 ± 1.8 versus post: 12.1 ± 1.9 min, P < 0.01) during a maximal treadmill test, but with decreases in VO2peak and no change in the exercise duration the control group. Body weight, body fat and metabolic variables were unchanged after stair climbing exercise.

CONCLUSION

Brief, intense stair climbing with a total time commitment of 10 min per day is effective for improving VO2peak in young men with obesity.

CLINICAL TRIAL REGISTRATION

KCT0008139.

No sex differences in systemic metabolic responses to acute sprint interval training performed after an oral 75-g glucose load in adults with excess adiposity

BACKGROUND & AIMS

Research exploring sex-based variations in responses to acute sprint interval training (SIT) remains limited. This study aimed to examine the impact of biological sex on the systemic metabolic response to SIT. We hypothesized that acute metabolic responses to SIT would differ between males and females.

METHODS

Sedentary adults (15 males; 14 females) with excess adiposity (defined as body fat >30 %) were matched for age (32.8 ± 7.5 vs. 29.5 ± 6.5 years) and body fat mass (33.0 ± 2.9 vs. 33.2 ± 2.8 %). Following a 75-g glucose load, participants were randomly allocated to either a control (resting) or SIT trial (8 × 30 s of "all-out" cycling at a resistance of 0.075 % W kg-1 of muscle mass, interspersed with 1 min of recovery). Parameters assessed included respiratory quotient (RQ), resting energy expenditure (REE), substrate utilization rates (fat and carbohydrate), total energy output, and blood lactate and glucose levels. These were collected during fasting and at 60, 120, and 240 min post-glucose load, with the area under the curve (AUC) calculated for both trials.

RESULTS

An interaction was observed in time (P = 0.012) and trial (P < 0.001) for RQ; however, there was no significant interaction between sex × trial (P = 0.818). Males exhibited higher mean REE values than females in both conditions. Nevertheless, AUC analysis showed no significant interaction between sex and trial (P = 0.562). A significant trial × time relationship was found for fat and carbohydrate percentage contributions (P < 0.001). Post-SIT, AUCs for fat contribution (g min-1 and mg kg-1 min-1) to energy expenditure increased in both sexes compared with resting (P < 0.05), with differences noted among trials over time (P < 0.001). Blood lactate levels also increased similarly post-SIT in both sexes (P < 0.05), without a significant sex × trial interaction (AUC, P = 0.798).

CONCLUSIONS

These data demonstrate that exercise differed between the sexes and did not support the premise that acute metabolic responses to SIT would vary between males and females.

Exercise type and settings, quality of life, and mental health in coronary artery disease: a network meta-analysis

BACKGROUND AND AIMS

Individuals with coronary artery disease have poorer mental health, health-related quality of life (HR-QoL), and cognition compared with (age-matched) controls. Exercise training may attenuate these effects. The aim is to systematically review and meta-analyse the effects of different exercise types and settings on brain structure/function, cognition, HR-QoL, mental health (e.g. depression, anxiety), and sleep in patients with coronary artery disease.

METHODS

A systematic search was conducted and a network meta-analysis compared (i) exercise types, high-intensity interval training (HIIT), HIIT + resistance (HIIT + R), moderate-intensity training (MIT), MIT + R and stretching-toning-balance training, and (ii) exercise settings, in-person and home-based.

RESULTS

A total of 42 randomized controlled trials with a parallel group design were identified, of which 36 were included in the meta-analysis. Few studies included cognition (n = 2), sleep (n = 2), and none brain structure/function (n = 0). Most studies examined HR-QoL (n = 30), depression (n = 15), and anxiety (n = 9), in which outcomes were meta-analysed. HIIT + R, HIIT, and MIT were associated with improved HR-QoL vs. no exercise (i.e. usual care) [standardized mean difference, SMD: 1.53 (95% confidence interval 0.83; 2.24), 0.44 (0.15; 0.73), and 0.44 (0.20; 0.67), respectively]. In-person exercise was associated with larger and significant improvements [HR-QoL SMD: 0.51 (0.28; 0.74), depressive SMD: -0.55 (-1.03; -0.07), and anxiety symptoms SMD: -1.16 (-2.05; -0.26)] compared with no exercise, whereas home-based programmes were not significantly associated with improvements in these outcomes. Findings were robust in secondary (i.e. intervention duration and volume) and sensitivity analyses excluding high risk of bias studies.

CONCLUSIONS

Exercise training, especially in-person sessions, was associated with improved HR-QoL, depression and anxiety, independently of exercise type. However, this study raises concern about the effectiveness of home-based programmes in improving these outcomes.Study protocol was registered in PROSPERO (ID: CRD42023402569).

Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR)

Aging, a universal and inevitable process, is characterized by a progressive accumulation of physiological alterations and functional decline over time, leading to increased vulnerability to diseases and ultimately mortality as age advances. Lifestyle factors, notably physical activity (PA) and exercise, significantly modulate aging phenotypes. Physical activity and exercise can prevent or ameliorate lifestyle-related diseases, extend health span, enhance physical function, and reduce the burden of non-communicable chronic diseases including cardiometabolic disease, cancer, musculoskeletal and neurological conditions, and chronic respiratory diseases as well as premature mortality. Physical activity influences the cellular and molecular drivers of biological aging, slowing aging rates-a foundational aspect of geroscience. Thus, PA serves both as preventive medicine and therapeutic agent in pathological states. Sub-optimal PA levels correlate with increased disease prevalence in aging populations. Structured exercise prescriptions should therefore be customized and monitored like any other medical treatment, considering the dose-response relationships and specific adaptations necessary for intended outcomes. Current guidelines recommend a multifaceted exercise regimen that includes aerobic, resistance, balance, and flexibility training through structured and incidental (integrated lifestyle) activities. Tailored exercise programs have proven effective in helping older adults maintain their functional capacities, extending their health span, and enhancing their quality of life. Particularly important are anabolic exercises, such as Progressive resistance training (PRT), which are indispensable for maintaining or improving functional capacity in older adults, particularly those with frailty, sarcopenia or osteoporosis, or those hospitalized or in residential aged care. Multicomponent exercise interventions that include cognitive tasks significantly enhance the hallmarks of frailty (low body mass, strength, mobility, PA level, and energy) and cognitive function, thus preventing falls and optimizing functional capacity during aging. Importantly, PA/exercise displays dose-response characteristics and varies between individuals, necessitating personalized modalities tailored to specific medical conditions. Precision in exercise prescriptions remains a significant area of further research, given the global impact of aging and broad effects of PA. Economic analyses underscore the cost benefits of exercise programs, justifying broader integration into health care for older adults. However, despite these benefits, exercise is far from fully integrated into medical practice for older people. Many healthcare professionals, including geriatricians, need more training to incorporate exercise directly into patient care, whether in settings including hospitals, outpatient clinics, or residential care. Education about the use of exercise as isolated or adjunctive treatment for geriatric syndromes and chronic diseases would do much to ease the problems of polypharmacy and widespread prescription of potentially inappropriate medications. This intersection of prescriptive practices and PA/exercise offers a promising approach to enhance the well-being of older adults. An integrated strategy that combines exercise prescriptions with pharmacotherapy would optimize the vitality and functional independence of older people whilst minimizing adverse drug reactions. This consensus provides the rationale for the integration of PA into health promotion, disease prevention, and management strategies for older adults. Guidelines are included for specific modalities and dosages of exercise with proven efficacy in randomized controlled trials. Descriptions of the beneficial physiological changes, attenuation of aging phenotypes, and role of exercise in chronic disease and disability management in older adults are provided. The use of exercise in cardiometabolic disease, cancer, musculoskeletal conditions, frailty, sarcopenia, and neuropsychological health is emphasized. Recommendations to bridge existing knowledge and implementation gaps and fully integrate PA into the mainstream of geriatric care are provided. Particular attention is paid to the need for personalized medicine as it applies to exercise and geroscience, given the inter-individual variability in adaptation to exercise demonstrated in older adult cohorts. Overall, this consensus provides a foundation for applying and extending the current knowledge base of exercise as medicine for an aging population to optimize health span and quality of life.

Effects of intermittent dieting with break periods on body composition and metabolic adaptation: a systematic review and meta-analysis

CONTEXT

Intermittent dieting incorporated with break periods (INT-B) has recently been promoted as an alternative dietary approach for optimal weight management.

OBJECTIVE

This study assessed the effectiveness of INT-B compared with that of conventional continuous energy restriction (CER) for improving body composition and attenuating metabolic adaptation.

DATA SOURCES

A systematic search was conducted on 6 databases using all available records until July 2023.

DATA EXTRACTION

The extracted data included the lead author, year of publication, population characteristics, intervention protocols, duration, and adherence.

DATA ANALYSIS

Random-effects meta-analyses were conducted for within-group and between-group comparisons of anthropometric and metabolic outcomes. Subgroup moderator analysis was performed for the types of INT-B, intervention duration, and population characteristics.

RESULTS

Of the 1469 records, 12 randomized trials (with 881 participants) were included. Within-group analyses demonstrated significant improvements in body mass, fat mass, body mass index, body fat percentage, and waist circumference following both INT-B and CER, with no significant group differences. However, resting metabolic rate (RMR) was significantly reduced following CER only. The compensatory reduction in RMR was significantly smaller following INT-B compared with CER, suggesting a lesser degree of metabolic adaptation. INT-B had a more significant effect on RMR retention in individuals with overweight/obesity compared with resistance-trained individuals.

CONCLUSION

This review provides up-to-date evidence for INT-B as a viable dietary strategy to improve body composition and attenuate metabolic adaptation.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42023448959.

Exercise snacks and physical fitness in sedentary populations

Physical inactivity remains a pressing global public health concern. Prolonged periods of sedentary behavior have been linked to heightened risks of non-communicable diseases such as cardiovascular diseases and type 2 diabetes, while engaging in any form of physical activity can elicit favorable effects on health. Nevertheless, epidemiological research indicates that people often struggle to meet recommended physical activity guidelines, citing time constraints, lack of exercise equipment, and environmental limitations as common barriers. Exercise snacks represents a time-efficient approach with the potential to improve physical activity levels in sedentary populations, cultivate exercise routines, and enhance the perception of the health benefits associated with physical activity. We review the existing literature on exercise snacks, and examine the effects of exercise snacks on physical function and exercise capacity, while also delving into the potential underlying mechanisms. The objective is to establish a solid theoretical foundation for the application of exercise snacks as a viable strategy for promoting physical activity and enhancing overall health, particularly in vulnerable populations who are unable to exercise routinely.

The long-lasting impact of high-intensity training via collaborative care in patients with schizophrenia: A 5-year follow-up study

Although exercise is medicine for outpatients with schizophrenia, it is unclear if one-year adherence-supported exercise leads to a "tipping point", at which the exercise becomes a routine manifested as life-long training in the patient group.

METHODS

Forty-eight outpatients (28 men/20 women: 35 ± 11 (mean ± SD) years) with schizophrenia (ICD-10: F20-29) were randomised to: 1) collaborative care group (TG), performing aerobic interval (AIT; 4 × 4-min treadmill walking/running at ∼90 % peak heart rate) and leg press maximal strength training (MST; 4 × 4 repetitions at ∼90 % maximal strength [1RM]) 2d·wk.-1 for 1-year, supported by transportation and training supervision; or 2) control group (CG). Peak oxygen uptake (V̇O2peak) and walking work efficiency were measured directly along with scaled 1RM/power, anthropometry, blood pressure, and blood samples at inclusion, 1-year, and 5-years post-intervention.

RESULTS

The TG increased V̇O2peak (11 %, p < .01), scaled 1RM (40 %, p < .001), and power (26 %, p < .001) compared to CG after 1-year. At follow-up, no intergroup differences in these factors were observed (all p > .05). Both groups improved walking work efficiency (TG: 11 %; CG: 18 %; both p < .05) after 1-year (no intergroup difference, p > .05), but not at follow-up (both p > .05). At follow-up, HDL (high-density lipoprotein)-cholesterol (-15 %, p < .01) and glucose (26 %, p < .01) decreased/increased(respectively) more in the TG than CG. No other intergroup differences were observed in anthropometry or blood samples.

CONCLUSION

1-year adherence-supported high-intensity training improves V̇O2peak, 1RM, and power in outpatients with schizophrenia. However, the improvements in these factors key to longevity are not maintained after 5 years. These findings highlight the importance of long-lasting cost-efficient adherence support, ultimately affecting the population's prognosis.

The Effect of High-Intensity Interval Training (HIIT) on Brain-Derived Neurotrophic Factor Levels (BNDF): A Systematic Review

BACKGROUND/OBJECTIVES

High-intensity interval training (HIIT) alternates short periods of intense exercise with recovery, effectively enhancing cardiorespiratory fitness, endurance, and strength in various populations. Concurrently, brain-derived neurotrophic factor (BDNF) supports neuronal resilience and activity-dependent plasticity, which are vital for learning and memory. This study aims to systematically review changes in BDNF levels in response to HIIT, with three primary objectives: evaluating the benefits of HIIT for BDNF modulation, assessing methodological quality and the risk of bias in reviewed studies, and identifying patterns in BDNF response based on HIIT protocols and population characteristics.

METHODS

Comprehensive database searches were conducted in PubMed and SPORTDiscus to identify relevant studies published up to April 2024. Given the diversity in study designs and outcomes, a narrative synthesis was performed rather than a meta-analysis. Bias was evaluated using visualization tools such as RobVis, and the review was conducted by a single researcher, which may limit its comprehensiveness.

RESULTS

Twelve studies met the inclusion criteria, with most indicating significant increases in BDNF levels post-HIIT, suggesting HIIT's potential to enhance neuroplasticity and cognitive functions. However, variations in BDNF responses were observed across different HIIT protocols and study populations. Some studies reported decreases or no change in BDNF levels, reflecting the complex regulation of BDNF influenced by factors such as exercise intensity, duration, and individual variability.

CONCLUSIONS

HIIT shows promise as an intervention for increasing BDNF levels, with potential benefits for brain health and cognitive function. These findings underscore the need for further research to confirm the optimal conditions under which HIIT can effectively enhance neurological outcomes. Future studies should explore standardized HIIT protocols and the long-term impact of HIIT on BDNF and neuroplasticity.

Optimizing concurrent training programs: A review on factors that enhance muscle strength

The purpose of this study is to explore the factors that should be considered when designing concurrent training programs to minimize the "interference effect." This study provides a comprehensive summary of various perspectives from existing studies on factors such as the ability level of the target group, the frequency and intensity of concurrent training, the order and interval time of resistance and endurance training, nutritional arrangements during training, and gender differences in concurrent training. The results of this study suggest that the emergence of the "interference effect" in concurrent training is influenced by several factors, with a particular emphasis on the adaptation status of muscle fitness when compared to resistance training alone. However, it is important to note that the current understanding of this theory remains somewhat ambiguous. The ability level of participants plays a crucial role in training adaptation and the specificity of post-training skeletal muscle molecular responses. Therefore, the participant's capacity level is likely a key determinant of the extent of the interference effect in concurrent training. In addition to training-related factors such as frequency, duration, intensity, volume, training sequence, recovery time, and nutritional intake, non-training-related variables, including the methodology used to assess various metrics, also significantly impact the design of concurrent training programs. These factors collectively influence the overall outcomes and provide insight into the extent of the "interference effect" in concurrent training. Understanding these aspects is essential for comprehending the phenomenon of the "interference effect" in concurrent training.

Effects of high-intensity interval and moderate-intensity continuous training on ambulatory blood pressure and cardiovascular outcomes in older adults with hypertension (HEXA Study): study protocol for a randomised trial

INTRODUCTION

Approximately two-thirds of Brazilian older adults have hypertension. Aerobic training is the first-line non-pharmacological therapy for hypertension. However, the effects of different aerobic training approaches on ambulatory blood pressure in older adults are uncertain. Here, we present the study protocol for the HEXA Study, which aims to investigate the effects of high-intensity interval (HIIT) and moderate-intensity continuous training (MICT) on 24-hour ambulatory blood pressure and cardiovascular outcomes in older adults with hypertension.

METHODS AND ANALYSIS

This is a single-centre, randomised, three-arm, parallel superiority trial with a 1:1:1 ratio. The trial is conducted with blinded outcome assessors and statistical analysts. 66 inactive older adults with hypertension aged 60-80 years without a history of major adverse cardiovascular events will be randomly assigned to one of the following groups: (1) HIIT (3 months; 3× week); (2) MICT (3 months; 3× week); (3) health education programme (control; 3 months; 1× week). Exercise training sessions involve rating of perceived exertion-based outdoor moderate walking, brisk walking and/or jogging. The primary outcome is 24-hour ambulatory blood pressure. Secondary cardiovascular outcomes are resting blood pressure, cardiorespiratory fitness, pulse wave velocity, carotid intima-media thickness, heart rate variability and cardiac function/structure. All outcomes are measured at baseline and after a 3-month period. In addition, feelings of pleasure/displeasure, adherence and safety are reported.

ETHICS AND DISSEMINATION

All procedures were approved by the Research Ethics Committee of the Onofre Lopes University Hospital (protocol, CAAE 07191019.8.0000.5292) and are executed in compliance with the Declaration of Helsinki. Additionally, the procedures adhered to Resolution 466/2012 issued by the Brazilian National Health Council for research involving human subjects.

TRIAL REGISTRATION NUMBER

Brazilian Registry of Clinical Trials (ID: RBR-4ntszb).

The MDM2 SNP309 differentially impacts cardiorespiratory fitness in young healthy women and men

PURPOSE

Maximal oxygen consumption (VO2max), the predominant index of cardiorespiratory fitness (CRF), is a predictor of whole-body function and longevity in humans. The central cardiac function and the skeletal muscle's capacity to use oxygen are key determinants of VO2max. Murine Double Minute 2 (MDM2), mainly known as an oncogene, could regulate myocardial hypertrophy, skeletal muscle angiogenesis, and oxidative phosphorylation. A prevalent single nucleotide polymorphism in the MDM2 promoter (SNP309) substitutes a T for a G, supporting a greater transcriptional activity. We aim to assess whether SNP309 impacts intrinsic CRF.

METHODS

82 young healthy nonathletic male and female adults aged 23 ± 2 years performed cardiorespiratory exercise testing to determine their VO2max (mL kg-1 min-1). The genomic DNAs isolated from saliva were genotyped using Taqman-based qPCR.

RESULTS

A one-way ANOVA showed that SNP309 influenced relative VO2max in the whole cohort (p = 0.044) and in men (p = 0.009), remaining non-significant in women (p = 0.133). VO2max was higher in TT homozygotes than in GT heterozygotes (whole cohort, 47 ± 12 vs. 42 ± 6 mL kg-1 min-1, p = 0.030; men, 53 ± 8 vs. 45 ± 6 mL kg-1 min-1, p = 0.011). A contingency analysis revealed a positive association between SNP309 in men in which the TT genotype was more frequent in the high VO2max group (p = 0.006). When considering G as the dominant allele, men bearing a G allele had lower relative VO2max than TT homozygotes (47 ± 7 vs. 53 ± 8, GG/GT vs. TT, p = 0.010). Conversely, women bearing a G allele had a higher relative VO2max than TT homozygotes (39 ± 5 vs. 34 ± 7, GG/GT vs. TT, p = 0.047).

CONCLUSION

SNP309 impacts VO2max in a sex-dependent manner in our cohort.

Long-Term High-Intensity Interval Training Intervention Improves Emotional Conflict Control in Association With Right Ventrolateral Prefrontal Activation in Males With Methamphetamine Use Disorder: A Randomized Controlled Trial

Acute high-intensity interval training (HIIT) has cognitive benefits in individuals with methamphetamine use disorder (MUD), yet it remains largely unknown the benefits of long-term HIIT on emotional conflict control and its neural mechanism in individuals with MUD. The current study conducted a 36-week low-volume HIIT intervention to investigate the effects of HIIT on emotional conflict control in males with MUD and their prefrontal cortex (PFC) activation. This study was a sub-study of the Study for Rehabilitation Training Model Construction and Training Effect of High Intensity Compound Exercise Prescription. Forty males with MUD (31.50 ± 4.33 years) were randomly assigned to the HIIT group and control group. The HIIT group received a 36-week low-volume HIIT intervention, while the control group maintained daily physical exercise. The emotional conflict task (emotional face-word Stroop task) with functional near-infrared spectroscopy (fNIRS) recording and subjective craving test were performed before and after the intervention. The results showed that the HIIT intervention reduced the emotional conflict and increased cortical activations of right dorsolateral PFC (dlPFC) and right ventrolateral PFC (vlPFC). More importantly, the HIIT-induced decreased emotional conflict was associated significantly with increased right vlPFC activation. In addition, subjective craving was also reduced after HIIT intervention. While the control group showed significant changes in neither brain activation nor the craving. These findings suggest that long-term low-volume HIIT can improve PFC activation, promote emotional conflict control, and reduce subjective craving in males with MUD. HIIT seems to be an effective method of withdrawal rehabilitation for males with MUD.

Effects of high-intensity interval training on selected indicators of physical fitness among male team-sport athletes: A systematic review and meta-analysis

BACKGROUND

Superior physical fitness and performance are essential in male team sports. Among a myriad of training methodologies, high-intensity interval training (HIIT) has gained popularity owing to its unparalleled efficiency and effectiveness. Previous studies have established that HIIT is a proven and effective approach for enhancing various physiological performance outcomes, particularly oxygen consumption capacity, in individual sports. Despite potential differences in training practices between male and female athletes, HIIT is recognized as an anaerobic training approach for team-sport athletes. This systematic review aimed to comprehensively and innovatively analyze the existing literature to examine the effectiveness of HIIT on oxygen consumption performance among male team-sport athletes.

METHODS

A comprehensive literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across the PubMed, SCOPUS, Web of Science, and SPORTDiscus databases until December 31, 2023. The inclusion criteria for this review encompassed research articles published in peer-reviewed journals that specifically focused on the impact of HIIT on the oxygen consumption performance of male players engaged in team sports. The study population exclusively consisted of male participants. The collected data included study characteristics, participant demographics, intervention details, and outcomes. Methodological quality assessment was performed using standardized criteria. The effect sizes (ESs) were calculated, and a meta-analysis was conducted using a random-effects model.

RESULTS

The literature search yielded 13 eligible studies encompassing 286 athletes aged 14-26 years. The meta-analysis showed statistically significant enhancements in maximal oxygen uptake (VO2max) in six studies (ES, 0.19-0.74; p < 0.005), Yo-Yo Intermittent Recovery Test (YYIRT) performance in six studies (ES, 0.20-2.07; p = 0.009), repeated-sprint ability total time (RSAtotal) in five studies (ES, 0.18-1.33; p < 0.001), and the best and average times for repeated-sprint ability (RSAbest and RSAmean, respectively) in four studies (ES, 0.47-1.50; p < 0.001). However, two studies did not report any significant differences in the outcomes of the Velocity in 30-15 Intermittent Fitness Test (VIFT) between the experimental and control groups (ES, -0.08 and -0.27; p = 0.87 and 0.443, respectively). Moreover, one study did not report any significant differences in the maximal aerobic speed (MAS) (ES, 0.41, p = 0.403).

CONCLUSIONS

HIIT significantly improved VO2max, YYIRT, and RSA; however, it did not appear to enhance VIFT and MAS performance, irrespective of age or competition level. These findings indicate that HIIT could serve as a valuable method for improving oxygen consumption performance (VO2max, YYIRT, and RSA) in male team-sport athletes, offering a time-efficient alternative to the traditional training methods. Further research is warranted to investigate its impact on performance outcomes in competitive settings and identify optimal HIIT protocols tailored to specific team sports.

High-intensity interval training for cardiometabolic health in adults with metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials

OBJECTIVE

To assess the effectiveness of high-intensity interval training (HIIT) compared with traditional moderate-intensity continuous training (MICT) and/or non-exercise control (CON) for modification of metabolic syndrome (MetS) components and other cardiometabolic health outcomes in individuals with MetS.

DESIGN

Systematic review and meta-analysis DATA SOURCES: Five databases were searched from inception to March 2024.

STUDY APPRAISAL AND SYNTHESIS

Meta-analyses of randomised controlled trials (RCTs) comparing HIIT with MICT/CON were performed for components of MetS (waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and fasting blood glucose (BG)) and clinically relevant cardiometabolic health parameters. Subgroup moderator analyses were conducted based on the intervention duration and HIIT volume.

RESULTS

Out of 4819 studies, 23 RCTs involving 1374 participants were included (mean age: 46.2-67.0 years, 55% male). HIIT significantly improved WC (weighted mean difference (WMD) -4.12 cm, 95% CI -4.71 to -3.53), SBP (WMD -6.05 mm Hg, 95% CI -8.11 to -4.00), DBP (WMD -3.68 mm Hg, 95% CI -5.70 to -1.65), HDL-C (WMD 0.12 mmol/L, 95% CI 0.04 to 0.20), TG (WMD -0.34 mmol/L, 95% CI -0.41 to -0.27) and BG (WMD -0.35 mmol/L, 95% CI -0.54 to -0.16) compared with CON (all p<0.01). HIIT approaches demonstrated comparable effects to MICT across all parameters. Subgroup analyses suggested that HIIT protocols with low volume (ie, <15 min of high-intensity exercise per session) were not inferior to higher volume protocols for improving MetS components.

CONCLUSION

This review supports HIIT as an efficacious exercise strategy for improving cardiometabolic health in individuals with MetS. Low-volume HIIT appears to be a viable alternative to traditional forms of aerobic exercise.

Impact of High-Intensity Interval Training (HIIT) on Patient Recovery After Myocardial Infarction and Stroke: A Fast Track to Fitness

Regular exercise leads to various adaptations and many pathophysiological changes that significantly benefit exercise stamina and overall health, both in the general population and in patients with chronic cardiovascular diseases. High-intensity interval training (HIIT) is a form of exercise training that consists of short repetitive bursts of intense workouts that push the body to more than 90 percent of its maximal oxygen consumption (VO2 max) and more than 75 percent of maximal power, with in between periods of low-intensity exercise for recovery, followed by a cool-down period. HIIT has unquestionably emerged as a powerful and effective intervention in rehabilitating patients, particularly those recovering from heart attacks and strokes. HIIT significantly enhances cardiovascular fitness by improving parameters such as VO2 max, endothelial function, and overall cardiac output. In addition to these cardiovascular benefits, HIIT also contributes to improved metabolic health, including better glycemic control and lipid profile regulation, which are often compromised in patients with cardiovascular conditions. Furthermore, HIIT has a positive impact on stroke patient's functional recovery and quality of life, allowing them to regain mobility, independence, and a sense of well-being more quickly. While concerns about the safety of high-intensity exercises in individuals with compromised heart function remain, current evidence suggests that when properly supervised, HIIT is both safe and well-tolerated in these populations. As healthcare continues to evolve, the incorporation of innovative and evidence-based approaches such as HIIT may redefine the future of cardiovascular rehabilitation, ultimately providing long-term health benefits for patients recovering from MI and stroke.

Cardiac autonomic modulation and exercise capacity in older adults with intellectual disability: A 6-month randomised control trial

BACKGROUND

Despite reported physical and functional improvements with aerobic and sprint interval training (SIT) protocols in individuals with intellectual disability (ID), it is not known if these interventions' effectivity would promote improvements in cardiac autonomic modulation. This study aimed to investigate if a 6-month SIT or a continuous aerobic programme could enhance physical performance and cardiac autonomic modulation at rest, during physical activity (PA) and after it in older adults with an ID.

METHODS

This is a randomised control trial. Participants with ID (age: 50.58 ± 7.25) were allocated to one of three groups [multicomponent aerobic training group (MATG), multicomponent interval sprint training group (MISTG) and control group (CG)]. The programmes lasted 24 weeks, with three sessions/week, 75-90 min per session. The HRV was analysed at rest and recovery, the delta of heart rate (HR) was analysed during 6MWT, and the HR t-off kinetics was analysed in recovery after 6MWT.

RESULTS

There were not found differences between groups, moments, or interaction for cardiac autonomic modulation at rest and recovery. During exercise, only MSITG showed a significant increase of HR between rest and the first 30 s of exercise (P < 0.05). Physical performance increased only in MSITG (P < 0.05), while CG showed a significant reduction (P < 0.01).

CONCLUSIONS

The MSITG improved the physical performance and the vagal withdrawal at the beginning of the submaximal exercise. These findings suggest that high-intensity exercise may positively impact baroreflex function, mitigating the decline in autonomic reflex response capacity associated with aging in individuals with ID.

Efficacy of Interval Training in Improving Body Composition and Adiposity in Apparently Healthy Adults: An Umbrella Review with Meta-Analysis

BACKGROUND

Although the efficacy of interval training for improving body composition has been summarized in an increasing number of systematic reviews in recent years, discrepancies in review findings and conclusions have been observed.

OBJECTIVE

This study aims to synthesize the available evidence on the efficacy of interval training compared with moderate-intensity continuous training (MICT) and nonexercise control (CON) in reducing body adiposity in apparently healthy adults.

METHODS

An umbrella review with meta-analysis was performed. A systematic search was conducted in seven databases (MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science) up to October 2023. Systematic reviews with meta-analyses of randomized controlled trials (RCTs) comparing interval training and MICT/CON were included. Literature selection, data extraction, and methodological quality assessment (AMSTAR-2) were conducted independently by two reviewers. Meta-analyses were performed using a random-effects model. Subgroup analyses were conducted based on the type of interval training [high-intensity interval training (HIIT) and sprint interval training (SIT)], intervention duration, body mass index, exercise modality, and volume of HIIT protocols.

RESULTS

Sixteen systematic reviews, including 79 RCTs and 2474 unique participants, met the inclusion criteria. Most systematic reviews had a critically low (n = 6) or low (n = 6) AMSTAR-2 score. Interval training demonstrated significantly greater reductions in total body fat percent (BF%) compared with MICT [weighted mean difference (WMD) of - 0.77%; 95% confidence interval (CI) - 1.12 to - 0.32%] and CON (WMD of - 1.50%; 95% CI - 2.40 to - 0.58%). Significant reductions in fat mass, visceral adipose tissue, subcutaneous abdominal fat, and android abdominal fat were also observed following interval training compared to CON. Subgroup analyses indicated that both HIIT and SIT resulted in superior BF% loss than MICT. These benefits appeared to be more prominent in individuals with overweight/obesity and longer duration interventions (≥ 12 weeks), as well as in protocols using cycling as a modality and low-volume HIIT (i.e., < 15 min of high-intensity exercise per session).

CONCLUSIONS

This novel umbrella review with large-scale meta-analysis provides an updated synthesis of evidence with implications for physical activity guideline recommendations. The findings support interval training as a viable exercise strategy for reducing adiposity in the general population.

Effects of high-intensity interval training versus moderate-intensity continuous training on vascular function among individuals with overweight and obesity-a systematic review

BACKGROUND

The study aimed to investigate and systematically review the evidence relating to the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on vascular function such as arterial diameter, arterial stiffness, pulse wave velocity, blood flow, etc. in individuals with overweight and obesity.

METHODS

The entire content of PubMed (MEDLINE), Scopus, SPORT Discus® (via EBSCO host), CINAHL, and Web of Science were searched. Only experimental research studies conducted in adult participants aged ≥18 years, published in English before January 2023 were included.

RESULTS

A total of 5397 studies were reviewed for the title and abstract with 11 studies being included for data extraction. The review resulted in a total of 346 individuals with overweight and obesity with body mass index (BMI) ranging between 25-36 kg/m2. HIIT and MICT intensities resulted in 85%-95% and 60%-70% maximal heart rate (MHR) respectively. Seven out of 11 studies showed some concerns about the overall risk of bias. Six of 11 studies reported improving vascular function following HIIT than MICT.

CONCLUSION

HIIT is a more effective and time-efficient exercise for enhancing vascular functions in individuals with overweight and obesity, leading to improvements in flow-mediated dilation by 3.9% and arterial diameter by 4.8%, compared to MICT.

Correlation Analysis of Activity Levels and Risk Factors in Patients with Stroke: Variations in Cardiac Function According to the Longshi Scale

Objective

This study examined the link between physical activity levels, as measured by the Longshi Scale, and cardiac function and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in stroke patients, aiming to find correlations with stroke risk factors.

Methods

The study involved 123 apoplexy patients divided into four groups based on the Longshi Scale: bedridden (31), domestic (32), community (30), and health (30). Clinical data was collected, and hemodynamic assessments were performed using impedance cardiography.

Results

Cardiac output time index (CTI) and estimated ejection fraction (EF est) were significantly reduced in both the domestic and community groups compared to the health group (P < 0.05), while diastolic arterial blood pressure (DABP) and systemic vascular resistance index (SVRi) were increased. In the bedridden group, stroke volume (SV), cardiac output (CO), CTI, left cardiac work index (LCWi), and EF est were all lower compared to the health group (P < 0.05), with SVRI and NT-proBNP levels being higher. Additionally, the bedridden group exhibited lower SV, CO, DABP, LCWi, CTI, and EF est when compared to the domestic and community groups (P < 0.05), but higher end-diastolic filling rate (EDFR) and NT-proBNP levels. The Longshi Scale grading positively correlated with SV (r = 0.536, P < 0.01), and NT-proBNP, EF, and cognitive dysfunction were found to be associated with activity levels in stroke patients.

Conclusion

The Longshi Scale correlates with cardiac function indicators like NT-proBNP and EF, and can help identify stroke patients at risk of cardiac dysfunction. Moreover, cognitive dysfunction was identified as a significant factor influencing the range of activity in patients with stroke.

Technology supported High Intensity Training in chronic non-specific low back pain (the Techno-HIT trial): study protocol of a randomised controlled trial

Chronic low back pain (CLBP) is one of the most common chronic musculoskeletal disorders worldwide. Guidelines recommend exercise therapy (ET) in CLBP management, but more research is needed to investigate specific ET modalities and their underlying mechanisms. The primary goal of this study is to evaluate the short-term and long-term effectiveness of a time-contingent individualised high-intensity training (HIT) protocol on disability compared with a time-contingent moderate-intensity training (MIT) as used in usual care, in persons with severely disabling CLBP. Additionally, the effectiveness on central effects, the added value of prolonged training at home and technology support, and the cost-effectiveness are evaluated. In this randomised controlled trial, CLBP patients will be randomly divided into three groups of 56 participants. Group 1, 'TechnoHIT', receives HIT with technology-support in the home-phase. Group 2, 'HIT', receives HIT without technology support. Group 3, 'MIT', receives MIT, reflecting training intensity as used in usual care. The primary outcome is patient-reported disability, measured by the Modified Oswestry Disability Index. Secondary outcomes include quantitative sensory testing, psychosocial factors, broad physical fitness, quality of life, cost-effectiveness, adherence and usability of technology. Trial registration number NCT06491121.

Cardiomyocyte Adaptation to Exercise: K+ Channels, Contractility and Ischemic Injury

Cardiovascular disease is a leading cause of morbidity and mortality, and exercise-training (TRN) is known to reduce risk factors and protect the heart from ischemia and reperfusion injury. Though the cardioprotective effects of exercise are well-documented, underlying mechanisms are not well understood. This review highlights recent findings and focuses on cardiac factors with emphasis on K+ channel control of the action potential duration (APD), β-adrenergic and adenosine regulation of cardiomyocyte function, and mitochondrial Ca2+ regulation. TRN-induced prolongation and shortening of the APD at low and high activation rates, respectively, is discussed in the context of a reduced response of the sarcolemma delayed rectifier potassium channel (IK) and increased content and activation of the sarcolemma KATP channel. A proposed mechanism underlying the latter is presented, including the phosphatidylinositol-3kinase/protein kinase B pathway. TRN induced increases in cardiomyocyte contractility and the response to adrenergic agonists are discussed. The TRN-induced protection from reperfusion injury is highlighted by the increased content and activation of the sarcolemma KATP channel and the increased phosphorylated glycogen synthase kinase-3β, which aid in preventing mitochondrial Ca2+ overload and mitochondria-triggered apoptosis. Finally, a brief section is presented on the increased incidences of atrial fibrillation associated with age and in life-long exercisers.

Effects of volume-matched once-weekly and thrice-weekly high-intensity interval training (HIIT) on body adiposity in adults with central obesity: Study protocol for a randomized controlled trial

Objective

This study aims to examine the comparative effects of 75 min of volume-matched once-weekly and thrice-weekly high-intensity interval training (HIIT) on body adiposity in adults with central obesity.

Methods

This assessor-blinded, three-arm, randomized controlled trial will recruit 315 physically inactive adults with central obesity (aged ≥18 years, body mass index ≥23, waist circumference ≥90 cm for men and ≥80 cm for women). Participants will be randomly allocated to the once-weekly HIIT, thrice-weekly HIIT or usual care control group. Participants in the HIIT groups will receive weekly exercise training sessions for 16 weeks, prescribed either once or three times weekly. Each HIIT session will consist of a supervised program of four 4-min high-intensity intervals at 85%-95% peak heart rate (HRpeak) interspersed with 3-min active recovery intervals at 50%-70% HRpeak. Participants in the once-weekly HIIT group will perform the 25-min HIIT bout three times with a break between each 25-min HIIT bout. The usual care control group will receive bi-weekly health education classes. The outcome assessments will be conducted at baseline, 16 weeks (post-intervention) and 32 weeks (follow-up). The primary outcome will be total body adiposity assessed by dual-energy X-ray absorptiometry (DXA). The secondary outcome measures will include markers of cardiovascular and metabolic health (body composition, cardiorespiratory fitness, blood pressure, and blood lipids), mental health, cognitive performance, health-related quality of life, sleep quality, habitual physical activity, diet, medication, adverse events and adherence to the intervention.

Impact of the project

The findings from this study are expected to consolidate the therapeutic efficacy of HIIT for the management of central obesity and inform the comparative compliance, feasibility and suitability of once-weekly and thrice-weekly HIIT as exercise strategies to manage obesity. In particular, the present study is expected to provide a novel perspective on the utility of low-frequency HIIT (i.e., once-weekly) as an effective and sustainable exercise strategy to tackle the obesity pandemic. The anticipated findings will hold substantial translational value by informing public health policies and enhancing exercise compliance in the physically inactive obese population.

Trial registration

ClinicalTrials.gov (NCT04887454).

Effects of Exergaming on executive function and motor ability in children: A systematic review and meta-analysis

This study aimed to evaluate the effectiveness of Exergaming in improving executive function and motor ability across different groups of children and adolescents. We searched several databases, including PsycINFO, Web of Science, Embase, PubMed, SPORT Discus, Scopus, and the Cochrane Central Register of Controlled Trials, for randomized controlled trial (RCT) studies published from inception until November 25, 2023, to identify studies investigating the effect of Exergaming on motor and executive function in children. The protocol was registered with PROSPERO (CRD42023482281). A total of 37 randomized controlled trials were included in this study. Our results indicate that Exergaming can influence children's cognitive flexibility [SMD = 0.34, 95%CI(0.13,0.55), I2 = 0.0%, P = 0.738], inhibition control [SMD = 0.51, 95%CI (0.30,0.72), I2 = 0.0%, P = 0.473], global cognitive [SMD = 0.87, 95%CI (0.50,1.23), I2 = 0.0%, P = 0.974], working memory [SMD = 0.18, 95%CI(-0.16, 0.52), I2 = 46.5%, P = 0.096], gross motor skills [SMD = 0.82, 95%CI (0.30, 1.35), I2 = 79.1%, P<0.001], fine motor skills [SMD = 0.71, 95%CI (0.22,1.21), I2 = 78.7%, P<0.001], balance [SMD = 0.61, 95%CI (0.34, 0.88), I2 = 59.5%, P = 0.001], and cardiorespiratory [SMD = 0.48, 95%CI (0.16, 0.79), I2 = 58.4%, P = 0.019]. While these findings suggest that Exergaming can promote children's cognitive flexibility, inhibitory control, global cognition and motor abilities, the effect on working memory was not statistically significant. Further high-quality randomized controlled trials are warranted to explore the potential benefits of Exergaming for different groups of children, including those with specific needs.

Effect of high-intensity interval training and moderate-intensity continuous training on blood lactate clearance after high-intensity test in adult men

This study compared the effects of High-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on blood lactate clearance. 21 adult males were equally and randomly assigned to the HIIT and MICT groups, and completed 8 weeks of training. Before the training intervention, after 4 weeks and 8 weeks of training, all subjects were tested for blood lactate levels between 0 and 55 min after the same high-intensity test. The results show that after 8 weeks, blood lactate levels were significantly lower than pre-tests in both the HIIT and MICT groups at "0-55 min" after high-intensity test (p < 0.05), and the blood lactate clearance percentage at15-min and 30-min in both groups were significantly higher than the pre-tests (P < 0.01). The blood lactate levels in the HIIT group were significantly lower than those in the MICT group at 15 min and 30 min after test (P < 0.05), and the blood lactate clearance percentage at 30 min in the HIIT group was significantly higher than those in the MICT group (P < 0.05). In conclusion, both HIIT and MICT enhance blood lactate clearance in adult males post high-intensity test, with HIIT demonstrating superior effectiveness, making it a viable alternative to MICT.

High-intensity interval training mitigates the progression of periodontitis and improves behavioural aspects in rats

AIM

To investigate the effects of high-intensity interval training (HIIT) on periodontitis (PD) progression and behavioural outcomes.

MATERIALS AND METHODS

Forty-eight Wistar rats were divided into four groups: non-trained (NT); non-trained with PD; HIIT with PD; and HIIT. The HIIT protocol, involving daily treadmill sessions, spanned 8 weeks, with PD induced by ligature after the 6th week. Behavioural tests were conducted to assess anxiety and memory. Post euthanasia, we evaluated the systemic inflammatory profile and oxidative stress markers in the hippocampus and amygdala. A morphological evaluation and elemental composition analysis of the mandibular alveolar bone were performed.

RESULTS

PD exacerbated alveolar bone level, bone surface damage and alterations in calcium and phosphorus percentages on the bone surface (p < .05), while HIIT attenuated these changes (p < .05). HIIT improved systemic inflammatory markers altered by PD (tumour necrosis factor [TNF]-α, interleukin [IL]-10, TNF-α/IL-10 and IL-1β/IL-10 ratios, p < .05). PD animals exhibited lower total antioxidant capacity and levels of thiobarbituric acid reactive substances in the amygdala and hippocampus, respectively (p < .05). HIIT maintained these parameters at levels similar to those in NT animals. HIIT improved anxiety and memory outcomes altered by PD (p < .05).

CONCLUSIONS

HIIT attenuates systemic inflammation, anxiety and memory outcomes promoted by PD.

Unfolding the role of exercise in the management of sleep disorders

Sleep disorders are prevalent among the general population and even more in individuals suffering from chronic diseases. Recent data reveal promising effects of physical exercise as a non-pharmacological approach for improving sleep and managing various sleep disorders. However, more studies with proper design and methodology should be conducted in the future to obtain a clearer understanding of the subject. The role of exercise in preventing and improving sleep disorders is probably much higher than what is currently exploited. To fully exploit the potential benefit of physical activity on sleep disorders in the future, it is necessary to identify the relevant tools to assess sleep-wake disorders and establish specific exercise protocols tailored to different sleep disorders. The present manuscript aims to review the literature on the use of exercise in managing selected sleep disorders. Regular exercise, including short-term aerobic activity, resistance training, and mind-body exercises, can effectively improve sleep quality, particularly in cases of insomnia and sleep-disordered breathing. Additionally, increasing evidence supports the effectiveness of aerobic and strength training, and body-mind exercises such as yoga in managing sleep-related movement disorders. Exercise can be a safe, affordable, and efficient tool in enhancing sleep quality and improving sleep disorders. Per se, regular exercise could play an adjuvant role alongside with established therapies, or a valid alternative when the pharmacological approach is limited by side effects, interactions, or inefficacy. More research is needed to define how exercise affects the physiology of sleep, and consequently how to use exercise in patients with sleep disorders.

Effects of high-intensity interval and continuous moderate aerobic training on fitness and health markers of older adults: A systematic review and meta-analysis

BACKGROUND

High-intensity interval training (HIIT) promotes similar or superior gains in physical fitness and health compared to continuous moderate-intensity training (MICT) in young individuals. However, the effectiveness of HIIT in older adults is uncertain.

OBJECTIVE

This meta-analysis compared the effects of HIIT and MICT on cardiorespiratory fitness, body composition, vascular, metabolic, and hormonal variables, cognitive function, and quality of life in older adults.

METHODS

PubMed, Embase, Cochrane, Web of Science, Scopus, and SportDiscus databases were searched from inception until December 2023. Trials included adults ≥ 60 y. Hedge's effect sizes (g) were calculated and study quality and features of training interventions were tested as moderators.

RESULTS

Twenty-nine trials including 1,227 subjects (65.4 ± 3.3 y). HIIT and MICT elicited significant (p < 0.021) and similar (p > 0.156) 'gs' for VO2max (0.722 vs. 0.490), maximal workload/peak power output ratio (0.290 vs. 0.372),% fat (-0.297 vs. -0.262), glycemia (-0.273 vs. -0.334), systolic (-0.465 vs. -0.341), and diastolic blood pressure (-0.566 vs. -2.311). HIIT (p < 0.04) but not MICT (p > 0.170) produced significant 'gs' for fat mass (-0.245 vs. -0.103), waist circumference (-0.239 vs. -0.116), testosterone (0.339 vs. 0.170), and complex Stroop test (-0.595 vs. -0.250). Increases in the VO2max occurred only in controlled trials after HIIT but not MICT (Q = 6.286, p = 0.012; HITT-g = 1.068, p < 0.0001 vs. MICT-g = 0.109, p= 0.596).

CONCLUSION

HIIT and MICT produced similar changes in most of the investigated variables. In trials with greater quality (controlled vs. non-controlled trials), cardiorespiratory gains were higher in HIIT vs. MICT. These findings suggest that HIIT might be suitable for improving fitness and health in older adults.

Intensity and Pace Calculation of Ultra Short Race Pace Training (USRPT) in Swimming-Take-Home Messages and Statements for Swimming Coaches

A recently referenced method known as ultra short race pace training (USRPT), designed to familiarize swimmers with the pace of a swimming event by using high volumes and submaximal intensities, has emerged as an efficient approach, enhancing performance and predicting swimming outcomes. Despite its recognized benefits, particularly its lower physiological burden compared to other training methods, research on USRPT is still in its early stages. There are misunderstandings related to its intensity and the pace of calculation. This systematic review aims to provide valid statements identifying the pros and cons of USRPT as a training stimulus and providing swimming coaches with key messages and advice about this training method. For the analysis, 90,612 studies from PubMed, EBSCO, Science Direct, and Google Scholar databases were screened to research the background, intensity, and pace calculation of the USRPT method, although only four met the inclusion criteria. The final screening of the selected studies was conducted using a PRISMA-P document. USRPT has the potential to become a dominant training stimulus, offering a precise alternative to the often vague training sets that many swimmers use. However, further studies focusing on specific aspects of intensity and pace calculation within USRPT sets are needed for comprehensive understanding. In conclusion, USRPT appears to be a submaximal variation of high-intensity interval training (HIIT) with low blood lactate relevance to swimming events. Also, the pace calculation must be implemented considering the different demands of each point of a swimming event.

A Systematic Review and Meta-Analysis of Randomized Trials to Evaluate the Impact of Exercise on Heart Rate Variability Post-Bariatric Surgery

Bariatric surgery is an approach used to treat patients with obesity in a small minority of eligible patients. Non-pharmacological therapies are important to maintain decent health status post-bariatric surgery. We performed a systematic review with meta-analysis to evaluate the effects of exercise on heart rate variability (HRV) in patients submitted to bariatric surgery. The searches were made via MEDLINE/PubMed (via the National Library of Medicine), EMBASE, Web of Science, and Scopus databases. We included non-blind, single-, or double-blind randomized control trials in patients older than 18 years of age submitted to bariatric surgery. The intervention group should be submitted to an exercise training protocol, including aerobic, strength, and other exercise modality after bariatric surgery. We documented 245 studies, and after screening and eligibility phases, only 4 were included. We observed no significant change for the SDNN: subtotal = 19.74 (CI: -4.98, 44.45), p = 0.12, I2 = 85% (very low quality of evidence); pNN50: subtotal = 13.09 (CI: -9.17, 35.35), p = 0.25, I2 = 93% (very low quality of evidence); RMSSD: subtotal = 8.44 (CI: -3.61, 25.50), p = 0.17, I2 = 95% (very low quality of evidence); SD1: subtotal = 9.36 (CI: -4.48, 23.21), p = 0.19, I2 = 96% (very low quality of evidence). We could not detect significant effects of exercise on resting HRV after bariatric surgery. The low certainty of the results via the evidence level analysis suggest further studies might be beneficial.

Brief cycling intervals incrementally increase the number of hematopoietic stem and progenitor cells in human peripheral blood

Introduction

Peripheral blood stem cell (PBSC) donation is the primary procedure used to collect hematopoietic stem and progenitor cells (HSPCs) for hematopoietic stem cell transplantation. Single bouts of exercise transiently enrich peripheral blood with HSPCs and cytolytic natural killer cells (CD56dim), which are important in preventing post-transplant complications. To provide a rationale to investigate the utility of exercise in a PBSC donation setting (≈3 h), this study aimed to establish whether interval cycling increased peripheral blood HSPC and CD56dim concentrations to a greater degree than continuous cycling.

Methods

In a randomised crossover study design, eleven males (mean ± SD: age 25 ± 7 years) undertook bouts of moderate intensity continuous exercise [MICE, 30 min, 65%-70% maximum heart rate (HRmax)], high-volume high intensity interval exercise (HV-HIIE, 4 × 4 min, 80%-85% HRmax) and low-volume HIIE (LV-HIIE, 4 × 2 min, 90%-95% HRmax). The cumulative impact of each interval on circulating HSPC (CD34+CD45dimSSClow) and CD56dim concentrations (cells/µL), and the bone marrow homing potential of HSPCs (expression of CXCR-4 and VLA-4) were determined.

Results

There was an increase in HSPC concentration after two intervals of LV-HIIE (Rest: 1.84 ± 1.55 vs. Interval 2: 2.94 ± 1.34, P = 0.01) and three intervals of HV-HIIE only (Rest: 2.05 ± 0.86 vs. Interval 3: 2.51 ± 1.05, P = 0.04). The concentration of all leukocyte subsets increased after each trial, with this greatest for CD56dim NK cells, and in HIIE vs. MICE (LV-HIIE: 4.77 ± 2.82, HV-HIIE: 4.65 ± 2.06, MICE: 2.44 ± 0.77, P < 0.0001). These patterns were observed for concentration, not frequency of CXCR-4+ and VLA-4+ HSPCs, which was unaltered. There was a marginal decrease in VLA-4, but not CXCR-4 expression on exercise-mobilised HSPCs after all trials (P < 0.0001).

Discussion

The results of the present study indicate that HIIE caused a more marked increase in HSPC and CD56dim NK cell concentrations than MICE, with mobilised HSPCs maintaining their bone marrow homing phenotype. LV-HIIE evoked an increase in HSPC concentration after just 2 × 2-minute intervals. The feasibility and clinical utility of interval cycling in a PBSC donation context should therefore be evaluated.

Exploring the Molecular Adaptations, Benefits, and Future Direction of Exercise Training: Updated Insights into Cardiovascular Health

This review emphasizes the globally accepted physical activity guidelines and explores the various molecular adaptations that occur with continuous exercise. It is essential to highlight the critical roles of cardiorespiratory fitness, muscular strength, and muscle mass in reducing mortality and enhancing quality of life. It has been shown in various studies that there are certainly substantial reductions in cardiovascular and all-cause mortality among individuals with high cardiorespiratory fitness levels. Resistance training is also examined, which, likewise, reveals significant mortality benefits, even with minimal weekly engagement. When delving into the molecular mechanisms, it is apparent that exercise training favorably influences certain cardiovascular conditions, mostly owing to its effect on enhanced lipid metabolism, improvement in glucose regulation, ability to modulate inflammation and oxidative processes, and induction of other cardioprotective effects like improved sympathetic tone and left ventricular remodeling. Cardiovascular diseases and malignancy also share the same risk factors, which explains why exercise can also mitigate the risk of developing many types of cancers. But despite these advancements in research, cardiovascular diseases continue to be prevalent, which may suggest the need to devise other means of promoting physical activity involvement. These approaches may include a greater emphasis on the societal benefits of increased exercise adherence, facilitated by community involvement and technological advancements in fitness tracking devices. We conclude that the future directions for exercise research should emphasize the need for personalized or tailored exercise programs to make it more engaging, accessible, and inclusive for a diverse set of people.

MICT ameliorates hypertensive nephropathy by inhibiting TLR4/NF-κB pathway and down-regulating NLRC4 inflammasome

BACKGROUND

Hypertensive nephropathy (HN) is one of the main causes of end-stage renal disease (ESRD), leading to serious morbidity and mortality in hypertensive patients. However, existing treatment for hypertensive nephropathy are still very limited. It has been demonstrated that aerobic exercise has beneficial effects on the treatment of hypertension. However, the underlying mechanisms of exercise in HN remain unclear.

METHODS

The spontaneously hypertensive rats (SHR) were trained for 8 weeks on a treadmill with different exercise prescriptions. We detected the effects of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) on inflammatory response, renal function, and renal fibrosis in SHR. We further investigated the relationship between TLR4 and the NLRC4 inflammasome in vitro HN model.

RESULTS

MICT improved renal fibrosis and renal injury, attenuating the inflammatory response by inhibiting TLR4/NF-κB pathway and the activation of NLRC4 inflammasome. However, these changes were not observed in the HIIT group. Additionally, repression of TLR4/NF-κB pathway by TAK-242 inhibited activation of NLRC4 inflammasome and alleviated the fibrosis in Ang II-induced HK-2 cells.

CONCLUSION

MICT ameliorated renal damage, inflammatory response, and renal fibrosis via repressing TLR4/NF-κB pathway and the activation of NLRC4 inflammasome. This study might provide new references for exercise prescriptions of hypertension.

High-Intensity Interval Versus Moderate-Intensity Continuous Exercise Training on Glycemic Control, Beta Cell Function, and Aerobic Fitness in Women with Type 2 Diabetes

Objective: This study aimed to compare the effects of High-Intensity Interval Training (HIIT) and Moderate-Intensity Continuous Training (MICT) on glycemic control, beta-cell function, and aerobic fitness in women with Type 2 Diabetes Mellitus (T2DM). Methods: Thirty-six women with T2DM were assigned equally to HIIT, MICT, and control (CON) groups. Participants in the exercise cohorts underwent a 12-week training regimen (three sessions per week), while the CON group maintained an inactive lifestyle. Glycaemia variables, beta-cell function, maximal oxygen uptake (VO2max), lipid profiles, and body composition were assessed at baseline and post-intervention. Results: Both HIIT and MICT interventions led to significant improvements in glucose, insulin, HbA1c, and insulin resistance index. Moreover, visceral adiposity index (VAI), lipid accumulation product (LAP), total cholesterol (TC), and low-density lipoprotein (LDL) levels significantly decreased in the HIIT and MICT groups after 12 weeks. Triglyceride (TG) levels decreased only after MICT, while high-density lipoprotein (HDL) levels increased after both interventions. Maximal oxygen uptake (VO2max), body mass, body mass index (BMI), and waist circumference (WC) significantly improved in all exercise groups. Notably, the HIIT group showed greater reductions in body mass compared to MICT. Nevertheless, beta-cell function remained unaltered after these two exercise regimens. Conclusion: Both HIIT and MICT interventions effectively managed T2DM in women, regardless of exercise intensity. The HIIT regimen can be considered for time-efficient lifestyle interventions in people with T2DM.

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.

Applicability of a supramaximal high-intensity interval training program for older adults previously not engaged in regular exercise; analyses of secondary outcomes from the Umeå HIT Study

This analysis of secondary outcomes investigated the applicability of supramaximal high-intensity interval training (HIT) with individually prescribed external intensity performed on stationary bicycles. Sixty-eight participants with a median (min; max) age of 69 (66; 79), at the time not engaged in regular exercise were randomized to 25 twice-weekly sessions of supramaximal HIT (20-min session with 10 × 6-s intervals) or moderate-intensity training (MIT, 40-min session with 3 × 8-min intervals). The primary aim was outcomes on applicability regarding; adherence to prescribed external interval intensity, participant reported positive and negative events, ratings of perceived exertion (RPE 6-20), and affective state (Feeling Scale, FS -5-5). A secondary aim was to investigate change in exercise-related self-efficacy (Exercise Self-Efficacy Scale) and motivation (Behavioural Regulations in Exercise Questionnaire-2). Total adherence to the prescribed external interval intensity was [median (min; max)] 89 % (56; 100 %) in supramaximal HIT, and 100 % (95; 100 %) in MIT. The supramaximal HIT group reported 60 % of the positive (112 of 186) and 36 % of the negative (52 of 146) events. At the end of the training period, the median (min; max) session RPE was 15 (12; 17) for supramaximal HIT and 14 (9; 15) for MIT. As for FS, the median last within-session rating was 3 (-1; 5) for supramaximal HIT and 3 (1; 5) for MIT. Exercise-related motivation increased (mean difference in Relative Autonomy Index score = 1.54, 95 % CI [0.69; 2.40]), while self-efficacy did not change (mean difference = 0.55, 95 % CI [-0.75; 1.82]), regardless of group. This study provide support for supramaximal HIT in supervised group settings for older adults.

Take a Break for Memory Sake! Effects of Short Physical Activity Breaks on Inhibitory Control, Episodic Memory, and Event-Related Potentials in Children

The pervasive sedentary lifestyle exacerbated by the COVID-19 pandemic has significantly reduced physical activity (PA) among school-age children, necessitating innovative strategies to evaluate short PA breaks that are feasible in a classroom setting. This study explored the cognitive and neurophysiological (electroencephalography; EEG) impacts of short bouts of different PA modalities on inhibitory control (flanker task) and episodic memory (word recognition task) in children. Utilizing a within-participants cross-over design, thirty-six children (n = 36; 9-12 years old) attended the lab on three separate days with each visit including either a 9 min bout of sustained moderate-intensity cycling, high-intensity interval exercise (HIIE), or seated rest. Event-related potentials (ERPs) were assessed during the flanker task (P3 component) and the word recognition task (LPC and FN400 components) to elucidate the neural mechanisms underpinning behavioral outcomes. Findings indicated no differences in flanker performance but greater episodic memory recall for HIIE compared to seated rest. Neurophysiological results revealed no differences for P3, but notably larger amplitude for LPC and FN400 postcycling, particularly over parietal electrode sites. These results underscore the potential of short PA breaks to improve cognitive and neurocognitive function in children, offering a feasible integration strategy into daily school routines without extensive time commitment.

The PAD-adapted 30-20-10 during Nordic walking: A new exercise training session in patients with symptomatic peripheral artery disease

This study aimed to investigate the feasibility of a peripheral artery disease (PAD)-adapted 30-20-10 Nordic walking session in patients with symptomatic PAD and to compare the cardiovascular response of this new training session to a traditional walking (TW) and 4 × 4 minutes Nordic walking session. This is a prospective observational study. Patients with Fontaine stage II PAD were included. Patients participated in Nordic walking sessions, which were randomly assigned as TW, 4 × 4 minute intervals, and peripheral artery disease adapted 30-20-10 exercise session (PAD-adapted 30-20-10 sessions). PAD-adapted 30-20-10 and 4 × 4 minutes sessions consisted of 4 repetitions of 4 minutes of effort followed by 3 minutes of passive recovery. PAD-adapted 30-20-10 session was characterized by 4 continuous 1-min repetitions at 3 different walking speeds [high (30 seconds), moderate (20 seconds) and low (10 seconds)]. During the 4 × 4 minutes session, patients were asked to cover the maximal distance at a constant speed. During TW session, patients were asked to walk at a speed inducing moderate-to-severe claudication pain. Heart rate, rating of perceived exertion (RPE) and claudication pain intensity using a visual analog scale were assessed. The perceived enjoyment of each session was assessed using a visual analog scale ranging from 0 (not enjoyable) to 10 (very enjoyable). Eleven patients with chronic symptomatic PAD were included (62 ± 13 years; 54% women). The mean heart rate during the time of effort was significantly higher in PAD-adapted 30-20-10 group than in 4 × 4 minutes and TW groups (127 ± 12, 122 ± 12, 114 ± 11 bpm, respectively; P ≤ .001). The mean rating of perceived exertion (16 ± 1, 15 ± 1, 13 ± 1; P ≤ .001) and claudication pain intensity (8 ± 1, 7 ± 1; 7 ± 1 mm; P ≤ .019) were significantly higher during PAD-adapted 30-20-10 sessions than during 4 × 4 minutes and TW sessions. The perceived enjoyment was similar among sessions (8.7 ± 1.6 for TW, 8.6 ± 1.7 for 4 × 4 minutes, and 8.8 ± 1.8 mm for PAD-adapted 30-20-10 sessions; P = .935). The PAD-adapted 30-20-10 session is feasible and induces higher cardiovascular stimulation and claudication pain than 4 × 4 minutes and TW procedures in patients with symptomatic PAD. Despite these different responses, a similar perceived enjoyment among the sessions has been shown. Future investigations are needed to examine the effects of this new training session in these patients.