Interval Training Improves Depressive Symptoms But Not Anxious Symptoms in Healthy Women

The Role of Gut Microbiota, Nutrition, and Physical Activity in Depression and Obesity-Interdependent Mechanisms/Co-Occurrence

Obesity and depression are interdependent pathological disorders with strong inflammatory effects commonly found worldwide. They determine the health status of the population and cause key problems in terms of morbidity and mortality. The role of gut microbiota and its composition in the treatment of obesity and psychological factors is increasingly emphasized. Published research suggests that prebiotic, probiotic, or symbiotic preparations can effectively intervene in obesity treatment and mood-dysregulation alleviation. Thus, this literature review aims to highlight the role of intestinal microbiota in treating depression and obesity. An additional purpose is to indicate probiotics, including psychobiotics and prebiotics, potentially beneficial in supporting the treatment of these two diseases.

Effects of high-intensity interval training on depressive and anxiety symptoms in healthy individuals: A systematic review and meta-analysis of randomized clinical trials

Although evidence regarding the effects of high-intensity interval training (HIIT) on mental health has increased in recent years, there is still no consensus regarding the effects of HIIT on the symptoms of depression and anxiety in a healthy population. Therefore, this systematic review aimed to investigate the effects of HIIT on depressive and/or anxiety symptoms in healthy individuals. The following four databases were searched: PubMed, Scopus, Embase, and PsycINFO. Only randomized clinical trials (RCTs) were included. We performed a random-effects meta-analysis based on standardized mean difference (SMD). The risk of bias was assessed using the RoB 2.0 tool, and the certainty of the evidence was evaluated based on recommendations GRADE. Eight RCTs evaluating 471 participants (81% female) were considered eligible for inclusion. The results of the meta-analysis showed that HIIT-based interventions had no significant effect on reducing anxiety (SMD = -0.17; 95% CI: -0.53, 0.19; p = 0.27) and depressive symptoms (SMD = -0.38; 95% CI: -1.06, 0.30; p = 0.17) compared with the passive control group. In conclusion, HIIT does not improve symptoms of depression and anxiety in healthy individuals. This finding is based on evidence of very low certainty. Therefore, the evidence is still not consistent enough to support HIIT as a viable strategy to reduce both outcomes because of the limited number of included studies and the overall quality of evidence.

Clinical value and mechanistic analysis of HIIT on modulating risk and symptoms of depression: A systematic review

Background

The exact causal mechanisms of depression remain unclear due to the complexity of the triggers, which has led to limitations in treating depression using modern drugs. High-intensity interval training (HIIT) is as effective as medication in treating depression without toxic side effects. Typically, HIIT requires less time commitment (i.e., shorter exercise duration) and exhibits pronounced benefits on depressive symptoms than other forms of physical exercise. This review summarizes the risk reduction and clinical effects of HIIT for depression and discusses the underlying mechanisms, providing a theoretical basis for utilizing HIIT in treating depression.

Methods

A database search was conducted in PubMed, Embase, Web of Science, and Scopus from inception up to October 2022. The methodological quality of the included literature was evaluated by the physiotherapy evidence database (PEDro) scale criteria. The review focused on evaluating the changes in depression risk or symptoms of HIIT interventions in healthy individuals, patients with depression, and patients with other disorders co-morbid with depression. Consequently, the mechanisms associated with depression related HIIT were summarized.

Results

A total of 586 participants (52 % female; mean age: 43.58±8.93 years) from 22 studies were included. Implementing HIIT using different exercise types alleviates depressive symptoms in individuals with depression and in individuals with depression who have exhibited comorbidities and reduced depression scale scores in subjects immediately after acute exercise. In addition, the long-interval HIIT and short-interval HIIT in the treatment of patients with cardiovascular or psychiatric disorders may reduce depressive symptoms via complex exercise-related changes on several levels, including by effecting the following measures: releasing monoamines, reducing neuronal death, inducing neurogenesis, modulating the functional homeostasis of the HPA axis, and enhancing the level of inflammation in the body.

Conclusion

HIIT is a relatively safe and effective antidepressant, which may involve multiple neurobiological mechanisms (release of monoamines, reducing neuronal death, inducing neurogenesis, modulating the functional homeostasis of the HPA axis, and enhancing the level of inflammation in the body), thereby reducing the risk or symptoms of depression in participants.

EXERCISE SCIENCE IN HIGH SCHOOL BIOLOGY TEXTBOOKS

ABSTRACT The content of high school textbooks related to physical activity and exercise is of utmost importance because physical activity and exercise are considered important tools in maintaining and improving health. Our objective was to analyze the presence and quality of exercise science content in high school biology textbooks approved by the National Textbook Plan. A guiding document was developed to enable the analysis of the textbooks. The topics investigated were: I) the extent of content related to exercise science; II) misconceptions about exercise science; III) health benefits attributed to exercise. The academic qualifications of the textbook authors were also analyzed. All analyzed textbooks (n = 9) featured some degree of exercise science content. In addition, ~67% of textbooks analyzed had at least one misconception regarding exercise science, the most common being related to biochemistry and muscle physiology. Also, 93.8% of the authors had undergraduate degrees in biological sciences; 43.8% had doctoral degrees. In conclusion, all high school biology textbooks presented content related to exercise science; however, most of them presented at least one misconception regarding exercise science. Thus, we suggest that the Brazilian National Textbook Plan should improve the criteria for analyzing biology textbooks. Level of Evidence III; Economic and decision analyses - Development of an economic or decision model.

Feasibility of Online High-Intensity Interval Training (HIIT) on Psychological Symptoms in Students in Lockdown During the COVID-19 Pandemic: A Randomized Controlled Trial

Objective

We aimed to evaluate the feasibility of an online High-Intensity Interval Training (HIIT) program on clinical psychological symptoms in higher education students in the context of the COVID-19 pandemic lockdown.

Materials and Methods

During the lockdown, 30 students aged 18-25 years, who had been screened previously with a cut-off score ≥5 in the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, were randomly assigned to either the 4-week HIIT program with three sessions per week conducted through online videos, or a no-intervention control group. The primary outcome was the feasibility assessment. The secondary outcome was a psychological self-report with the 21-items Depression, Anxiety, and Stress Scale (DASS-21). Assessment and intervention were performed in compliance with social distancing rules.

Results

Two participants in the HIIT were lost to follow-up, leaving 13 participants vs. 15 in the control group. We observed high adherence (87%) and complete safety for mental and physical status with the HIIT intervention delivered by online videos. The Mann-Whitney test demonstrated a significant (group × time, P-Value = 0.046) reduction of clinical stress symptoms and a trend (group × time, P-Value = 0.08) toward reduction of clinical depression symptoms, both favoring the HIIT group. No significant (group × time, P-Value = 0.118) interaction was found for anxiety symptoms.

Conclusion

The online HIIT program was found to be feasible and safe in a clinical sample of young adults, who were experiencing social and physical restrictions due to COVID-19. HIIT reduced stress and depressive symptoms and thus these preliminary results show promise for broader application among higher education students during the present lockdown necessitated by the global COVID-19 health crisis.

Psychological Adaptations to High-Intensity Interval Training in Overweight and Obese Adults: A Topical Review

Regular exercise has been reported as a fundamental piece of the management and treatment puzzle of obesity, playing a vital role in numerous psychological indicators. However, it is unclear whether high-intensity interval training (HIIT) can improve critical psychological health markers such as adherence, exercise enjoyment, affective responses, health-related quality of life, anxiety, and depression in overweight and obese adults. The purpose of this topical review was to catalogue studies investigating the psychological responses to HIIT in order to identify what psychological outcomes have been assessed, the research methods used, and the results. The inclusion/exclusion criteria were met by 25 published articles investigating either a traditional, single-component (84%) or a hybrid-type, multi-component (16%) HIIT protocol and involving 930 participants with overweight/obesity. The present topical review on HIIT-induced psychological adaptations shows that this popular exercise mode, but also demanding for the masses, can meaningfully increase the vast majority of the selected mental health-related indices. These improvements seem to be equal if not greater than those observed for moderate-intensity continuous training in overweight and obese adults. However, further research is needed in this area, focusing on the potential mechanisms behind positive alterations in various psychological health parameters through larger samples and high-quality randomized controlled trials.

A Latent Class Analysis of Mental Health Severity and Alcohol Consumption: Associations with COVID-19-Related Quarantining, Isolation, Suicidal Ideations, and Physical Activity

The present study examined latent class cluster group patterns based on measures of depression and anxiety symptom severity and alcohol consumption during the COVID-19 pandemic. Hypothesized correlates with latent class cluster groups including quarantining, self-isolation, suicidal ideations, sitting hours per day, and physical activity (vigorous intensity exercise in minutes per week) were examined. The delimited participant sample consisted of 606 university young adults 18 to 25 years of age (M = 21.24 ± 1.62). Latent cluster analysis (LCA) modeled patterns of depression and anxiety symptom severity and alcohol consumption during the COVID-19 pandemic. Between group analysis and multinomial logistic regression analysis were used to examine relationships between latent class clusters and correlates including quarantining, self-isolation, suicidal ideations, sitting hours per day, and physical activity (vigorous intensity exercise in minutes per week). LCA results showed that six latent cluster groups provided optimal model-to-date fit based on mental health symptom severity and alcohol consumption (L 2  = 56.31, BIC = 5012.79, AIC = 4849.74, and the bootstrap L 2 p-value = .88; Entropy R 2  = .89). Identified latent class clusters were as follows: cluster one = moderate anxiety and depression severity and moderate alcohol consumption (n = 156; 25.7%); cluster two = high mental health severity and alcohol consumption (n = 133; 21.9%); cluster three = low mental health symptoms and moderate alcohol consumption (n = 105; 17.3%); cluster four = lowest mental health severity and alcohol consumption (n = 95; 15.7%); cluster five = moderate depression severity, low anxiety severity, and low alcohol consumptions (n = 74; 12.2%); and cluster six = moderate anxiety severity, low depression severity, and low alcohol consumption (n = 43; 7.1%). Multinomial logistic regression analysis results found that quarantining, self-isolation, suicidal ideations, sedentary behavior, and physical activity were differentially associated with cluster group membership. Findings from this study demonstrate associations between COVID-19 public health restrictions, suicidal ideations, and declines in mental health and increases in alcohol consumption among young adult university students.

Distinct Protocols of Physical Exercise May Improve Different Aspects of Well-being in Women With Polycystic Ovary Syndrome

The purpose of this study to assess the effects of different protocols of physical exercise on the domains of the quality of life (QoL), sexual function, anxiety, and depression scores in women with polycystic ovary syndrome (PCOS). Data of 112 women with PCOS were extracted from 2 trials with different protocols of physical exercise: continuous aerobic training (ContinuousAT, n = 23), intermittent aerobic training (IntermittentAT, n = 22), and progressive resistance training (ResistanceT, n = 43) alongside a control group (CG, n = 24). Volunteers who completed self-report questionnaires-Female Sexual Function Index (FSFI), the Hospital Anxiety and Depression Scale (HADS), and the MOS 36-Item Short-Form Health Survey (SF-36) for QoL-preprotocol and postprotocol of physical exercise were included. Within groups, from baseline to week 16, all ContinuousAT, IntermittentAT, and ResistanceT protocols promoted improvements in multiple FSFI domains and HADS scores. However, ResistanceT did not improve the QoL aspects. Between groups, from other physical training protocols, the IntermittentAT was most effective for QoL and FSFI domains as well as HADS scores. It is concluded that all interventions were effective and improved indicators of sexual function, anxiety, and depression. When comparing protocols, interval training with high-intensity stimuli and active recovery was more effective.

Exercise for affect and enjoyment in overweight or obese males: a comparison of high-intensity interval training and moderate-intensity continuous training

High-intensity interval training (HIIT) is effective for generating positive cardiovascular health and fitness benefits. This study compared HIIT and moderate-intensity continuous training (MICT) for affective state and enjoyment in sedentary males with overweight or obesity.Twenty-eight participants performed stationary cycling for 6 weeks × 3 sessions/week. Participants were randomly allocated to HIIT (N=16) (10 × 1-minute intervals at ~90% peak heart rate) or MICT (N=12) (30 minutes at 65-75% peak heart rate). Affective state changes were assessed after 6-weeks training. Enjoyment and acute change in affect were assessed after individual training sessions.HIIT participants reported improved positive affect following 6 weeks training (∆ 3.6 ± 4.6, p = 0.007, effect size d = 0.70), without corresponding improvement in negative affect (p = 0.48, d = -0.19). MICT did not induce any improvement in positive affect (p = 0.56, d = 0.16) or negative affect (p = 0.23, d = -0.41). Enjoyment ratings were comparable for both exercise formats (HIIT: 4.4 ± 0.4 on a 7-point scale; MICT: 4.3 ± 0.3; p = 0.70, d = 0.15).Six weeks of HIIT induced improvement in positive affect in sedentary participants with overweight or obesity. Enjoyment of training was only slightly above neutral levels for both training formats.What's already known about this topic? Exercise training can improve general affect however the optimal exercise characteristics for improving affect are unclear.Studies assessing the relative enjoyment of HIIT in comparison to MICT have largely been equivocal to date.What does this study add? HIIT can improve affective state in males with overweight or obesity.Six weeks of stationary cycling HIIT were rated as only mildly enjoyable, comparable to ratings for MICT.

Is High-Intensity Interval Training Suitable to Promote Neuroplasticity and Cognitive Functions after Stroke?

Stroke-induced cognitive impairments affect the long-term quality of life. High-intensity interval training (HIIT) is now considered a promising strategy to enhance cognitive functions. This review is designed to examine the role of HIIT in promoting neuroplasticity processes and/or cognitive functions after stroke. The various methodological limitations related to the clinical relevance of studies on the exercise recommendations in individuals with stroke are first discussed. Then, the relevance of HIIT in improving neurotrophic factors expression, neurogenesis and synaptic plasticity is debated in both stroke and healthy individuals (humans and rodents). Moreover, HIIT may have a preventive role on stroke severity, as found in rodents. The potential role of HIIT in stroke rehabilitation is reinforced by findings showing its powerful neurogenic effect that might potentiate cognitive benefits induced by cognitive tasks. In addition, the clinical role of neuroplasticity observed in each hemisphere needs to be clarified by coupling more frequently to cellular/molecular measurements and behavioral testing.

Presence of exercise physiology or similar coursework in the curricula of Brazilian health science undergraduate programs

Bolstered by evidence of the health benefits of exercise, health professionals advise their patients about it. Thus these professionals should have a basic knowledge of exercise physiology. In Brazil, a graduate degree is not mandatory, so for many health providers, the only opportunity to receive information on exercise physiology content is during their undergraduate study. Therefore, it is imperative that health science undergraduate programs include content on exercise physiology. The aim of the study was to verify the presence of exercise physiology (or similar coursework) in the curricula of seven health science undergraduate programs (biomedicine, physical education, nursing, physiotherapy, medicine, nutrition, and psychology). The study was divided into three phases: 1) a survey of the total number of undergraduate programs (n = 4,940) through an electronic system of the Brazilian Ministry of Education (e-MEC); 2) a random selection of 10% of the total undergraduate programs (n = 494) for further analysis of the curriculum; and 3) analysis of the curricula of the selected undergraduate programs. Of 494 undergraduate programs, we did not find curricula for 77 of them. Therefore, the final sample consisted of 417 undergraduate programs. In total, 65.9% of the undergraduate programs did not offer coursework in exercise physiology. The chi-square test revealed a significant association between undergraduate curricula in health science and the presence or absence of exercise physiology coursework [X²(6, n = 417) = 293.0, P < 0.0001]. We did not find exercise physiology coursework in most of the analyzed undergraduate programs. Alternatives to solve the lack of exercise physiology coursework would be the inclusion of content related to exercise physiology in professional/graduate education or in continuing education programs.

Intensity of Physical Activity and Depressive Symptoms in College Students: Fitness Improvement Tactics in Youth (FITYou) Project

Purpose

To investigate whether the physical activity at different intensities is correlated with depressive symptoms in college students.

Patient and Methods

This cross-sectional study was a part of the Fitness Improvement Tactics in Youth Project, which was conducted in 2017. A total of 2,820 college freshmen aged 15-24 years were included in this study, of whom 699 (24.8%) were males and 2,121 (75.2%) were females. Depressive symptoms were measured using the Self-rating Depression Scale. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form. Covariates included sociodemographic, lifestyle-related, and health-related factors.

Results

A total of 560 (19.9%) college students had depressive symptoms. Total physical activity levels (METs•hour/week) were positively associated with frequency of breakfast intake (p = 0.050) but no other participant characteristics. Logistic regression analysis showed that the prevalence of depressive symptoms in the highest quartile of physical activity was lower than in the lowest quartile when adjusted for sex, age, ethnicity, only child, smoking status, alcohol use, breakfast frequency, daily sleep duration, body mass index, grip strength, and the number of metabolic syndrome components (odds ratios [95% confidence intervals (CI)]: 0.75 [0.58, 0.98], p = 0.036). Furthermore, high physical activity levels of low-intensity tended to moderately correlate to lower prevalence of depressive symptoms (odds ratios [95% CI]: Q1, 0.71 [0.55, 0.91], Q2, 0.77 [0.59, 1.01], Q3, 0.75 [0.57, 0.98], p for trend = 0.037). Associations of moderate and vigorous physical activity with depressive symptoms were not found. For secondary outcomes, sex-stratified analysis showed that similar findings were only found in females, but not males.

Conclusion

This study indicated that total physical activity and low-intensity physical activity were inversely associated with depressive symptoms in Chinese college students. All these observations showed gender differences.

H″IT″ting the Barriers for Exercising during Social Isolation

Aerobic exercise is traditionally recommended to improve general health and prevent many non-communicable diseases. However, the measures adopted to control the novel Coronavirus (COVID-19) outbreak culminated with closing of exercise facilities and fitness centers and, as a primary consequence, impaired aerobic exercise practice. This contributed to an increase in risk factors associated with physical inactivity such as insulin resistance, high blood pressure, low-grade inflammation, weight gain, and mental health problems. The scenario is worrisome, and it is important to propose alternatives for exercise practice during the COVID-19 pandemic. Interval training (IT) emerges as an exercise mode that might be feasible, low-cost, and potentially safe to be performed in many different places. IT consists of interspersing relative brief bouts of high-intensity exercise with recovery periods and promotes similar or greater health benefits when compared to moderate-intensity continuous exercise. Among the different types of IT, sprint interval training and "Tabata protocols" might be particularly useful during social isolation. These protocols can be controlled and performed without the need of complex equipment and can be adapted to different places, including domestic environments. In this article, we present variations of IT as possible alternatives to cope physical inactivity during COVID-19 pandemics with a focus on its practical applications. The protocols suggested can be performed without the need of specialized equipment or facilities, in a time-efficient manner, and aiming to prevent detraining or even improve physical fitness and general health.