Combined High-intensity Interval Training Research Articles

COMBINED HIGH-INTENSITY INTERVAL TRAINING FOR PEOPLE WITH DISORDERS OF GUT BRAIN INTERACTION: A CASE REPORT

AIMS The efficacy of high intensity exercise for improving symptoms of chronic idiopathic constipation, a highly prevalent disorder of gut brain interaction (DGBI), remains uncertain. The aim of this case report was to investigate the feasibility, safety, and efficacy of 8-weeks of combined high-intensity interval training (C-HIIT) for a person (female, 23 years old) with chronic constipation. METHODS The participant enrolled in the C-HIIT for DGBI controlled trial that aims to recruit 32 participants with DGBI. Following comprehensive assessments of gastrointestinal symptoms, neuromuscular fitness, cardiorespiratory fitness and mental health, the participant completed an 8-week intervention consisting of thrice weekly 26-minute C-HIIT sessions. These consisted of a 3-minute aerobic warm-up (treadmill; 50-60% peak heart rate [HRpeak]) followed by 4-minutes of high-intensity aerobic exercise at ≥85% HRpeak. After 1-minute rest, eight whole body resistance exercises were performed. These involved continuous repetitions with good technique for 1-minute at an ≥8/10 (very hard) rating of perceived exertion; 1-minute rest separated each exercise. Adverse events were recorded throughout the intervention. RESULTS The participant adhered to the intervention, attending 100% of sessions and reaching the prescribed intensity for 100% of aerobic and 80% of resistance exercises. Efficacy of the exercise training was indicated by a reduction in the severity of gastrointestinal symptoms measured via the irritable bowel syndrome-symptom severity scale (from 111 to 100) and the structured assessment of gastroIntestinal symptoms (39 to 12). There were some improvements in neuromuscular fitness (handgrip strength: 27 to 29.5 kg, 30-second sit to stands: 12 to 10 repetitions) and cardiorespiratory fitness (VO2max: 36.7 to 38.2 mL/kg/min). No changes were observed in mental health (Hospital Anxiety and Depression scale), and one non-serious adverse event (nausea post-eating), which was deemed not related to the intervention. CONCLUSION The C-HIIT intervention in a person with DGBI was feasible, efficacious and safe.

Effects of HIIT and Combined HIIT Programs on Cancer Related Fatigue and Cancer Pain: A Systematic Review and Meta-analysis.

This systematic review and meta-analysis assessed the effectiveness of high intensity interval training (HIIT) alone and combined HIIT programs compared to usual care (UC) on cancer-related fatigue (CRF) and pain related to cancer or cancer-related treatments. Articles published prior to January 2023 were searched in the following digital databases: PubMed, Cochrane Database of Systematic Reviews and Cochrane Controlled Clinical Trials (CENTRAL), Web of Science, Scopus and ScienceDirect. Randomized controlled trials (RCTs) were included that met the following criteria: (i) adult cancer patients and survivors (>18 years old); (ii) HIIT or combined HIIT programs vs usual care; (iii) assessment of fatigue and pain. Cochrane tool was used for assessing Risk of Bias (RoB) and Review Manager (RevMan 5.2) was used for data analysis. Based on limited number (12) of studies included, we found HIIT and combined HIIT interventions have significant effect sizes on reducing both CRF (standardized mean difference (SMD) = 0.63, 95% confidence interval (95% CI): 0.42 to 0.84, p < 0.001) and cancer-associated pain (SMD = 0.44, 95% CI = 0.25 to 0.63, p < 0.001). systematic review and meta-analysis indicate that HIIT and combined HIIT programs can reduce cancer-related fatigue and pain.

A 2-week combined high-intensity interval training regulates inflammatory status in young females with obesity

Meta-inflammation is a pathological aspect of immunometabolism disturbances in obesity. This inflammatory state is promoted by inflammatory cytokine overexpression partially related to the toll-like receptor 4 pathway. Here, we assessed the direct effects of exercise (in the absence of body fat changes) on serum cytokine concentration by constructing a short-term exercise training intervention among overweight/obese subjects. Thirty young inactive females were allocated to two groups: the inactive group (IG, continued their inactive lifestyle, n = 15) and the active group (AG, participated in two weeks combined high-intensity interval training, n = 15). Before and after the intervention, serum cytokines’ concentration was measured by ELISA technique. The body composition parameters did not significantly change in both groups. Interleukin (IL)-10 levels were increased significantly in comparison with both pre-testing (P = 0.008) and IG (P = 0.007) values. Also, there was a significant decrease in tumor necrosis factor-α levels compared to IG (P = 0.05). No statistically significant changes (P > 0.05) were found in interferon (IFN)-γ (Δ% = −20.41), pentraxin 3 (Δ% = −13.57), and fibroblast growth factor 21 (FGF21) (Δ% = 24.02). However, FGF21 changes revealed a significant positive correlation with IL-10 (r = 0.65) and a significant negative correlation with IFN-γ (r = 0.58). Although our exercise training protocol reduced the TLR4 activities and induced an anti-inflammatory environment, this impact seems to be not related to body fat changes, indicating the direct immunomodulatory impact of exercise. More interventions are needed to evaluate the clinical implications of crosstalk between skeletal muscle, liver, adipose tissue, and inflammatory response. La méta-inflammation (ou inflammation systémique de bas grade) est un aspect pathologique des troubles de l’immunométabolisme dans l’obésité. Cet état inflammatoire est favorisé par la surexpression inflammatoire des cytokines en partie liée à la voie du toll-like receptor 4. Nous avons évalué les effets directs de l’exercice (en l’absence de changements de masse grasse corporelle) sur la concentration sérique de cytokines lors d’une intervention d’entraînement à court terme chez les sujets en surpoids ou obèses. Trente jeunes femmes inactives ont été réparties en deux groupes : le groupe inactif (IG, a continué son mode de vie inactif, n = 15) et le groupe actif (AG, lequel a participé à deux semaines d’interval training combiné à haute intensité, n = 15). Avant et après l’intervention, la concentration de cytokines sériques a été mesurée par la technique ELISA. Les paramètres de composition corporelle n’ont pas changé de manière significative dans les deux groupes. Les niveaux d’interleukine (IL)-10 ont augmenté de manière significative par rapport aux valeurs pré-test (AG : p = 0,008 ; IG : p = 0,007). En outre, il y a eu une diminution significative des niveaux de tumor necrosis factor α (AG vs IG : p = 0,05). Aucun changement statistiquement significatif (p > 0,05) n’a été trouvé pour l’interféron (IFN)-γ (Δ % = –20,41), la pentraxine 3 (Δ % = –13,57) et le facteur de croissance des fibroblastes 21 (FGF21) (Δ % = 24,02). Cependant, les changements de FGF21 ont révélé une corrélation positive significative avec l’IL-10 (r = 0,65) et une corrélation négative significative avec l’IFN-γ (r = 0,58). Bien que notre protocole d’entraînement physique ait réduit les activités de TLR4 et induit un environnement anti-inflammatoire, cet impact ne semble pas être lié aux changements de graisse corporelle, indiquant l’impact immunomodulateur direct de l’exercice. D’autres interventions sont nécessaires pour évaluer les implications cliniques des interactions entre le muscle squelettique, le foie, le tissu adipeux et la réponse inflammatoire.

Investigating the Effect of High-intensity Interval Training on Serum Levels of Antioxidants and Oxidative Stress in Overweight and Obese Girls

Background and Objective: The prevalence of obesity has increased dramatically worldwide over the last 50 years. The results of some studies suggest that obesity and overweight are related to increased oxidative stress. The aim of this study is to investigate the effect of combined high-intensity interval training on serum levels of antioxidants and oxidative stress in obese and overweight girls. Materials and Methods: Twenty-four obese and overweight girls volunteered to participate in this semi-experimental study. The subjects were randomly divided into two groups: the training group (n=12, age: 21.6±2.0, weight: 71.00 ± 4.13, BMI: 28.58 ± 1.68 and the control group (n=12, age: 20.1 ± 9.2, weight: 71.75 ± 5.40, BMI: 28.08 ± 1.59). The training group (4 weeks/4 sessions per week) performed combined high-intensity interval training, while the control group did not exercise during the intervention. Data were analyzed using repeated measures analysis at a significance level of 0.05. Results: Antioxidant capacity (TAC), glutathione (GSH) and blood lipid profiles (TC, TG, HDL-c, LDL-c) showed no insignificant changes compared to the control group after four weeks of combined high-intensity interval training (P&gt;0.05). On the other hand, malondialdehyde (MDA) levels showed a significant decrease after the intervention compared to the control group (P&lt;0.05). Conclusion: 8 weeks of combined high-intensity interval training significantly reduced MDA levels. According to the results, this type of training protocol can therefore be considered an effective method to reduce oxidative stress in obese and overweight girls.

High-intensity Interval Training On Muscle Strength And Rate Of Torque Development In Female Lacrosse Players.

Sports, which include lacrosse, require sudden directional changes and rapid alterations in pace both of which are highly dependent on explosive skeletal muscle force production. Previous research has shown that high-intensity interval training (HIIT) increases maximal sprint speed, muscle power, and overall performance in field sports. Limited research on the potential of HIIT to impact skeletal muscle strength and rate of torque development in lacrosse players exist. PURPOSE: To determine the effects of HIIT in combination with lacrosse specific training on lower-limb skeletal muscle strength and rate of torque development in female high school lacrosse players (15 ± 2 yrs.). METHODS: Fourteen healthy female lacrosse players from a local high school performed HIIT three times per week in addition to their specific lacrosse training program for 11 weeks (preseason plus competitive season). Right lower-limb skeletal muscle performance was assessed Pre, Mid, and Post-HIIT training with concentric knee extensor contractions at three angular velocities (0, 1.6, and 3.1 rad·s-1). Outcome measures included: peak torque (Nm), time-to-peak torque (s), and rate of torque development (Nm·s-1). RESULTS: Isometric and concentric (3.1 rad·s-1) strength increased across the HIIT and lacrosse specific training period by 20% and 10%, respectively (p < 0.05). Combined training had no influence on time-to-peak torque (Pre: 2.2 ± 0.9 s; Post: 2.6 ± 0.5 s; p > 0.05). Rate of torque development for the first 50 ms of contraction increased by 42% at the mid-point [Pre: 607.3 ± 451.1; Mid: 862.7 ± 292.7 Nm·s-1, p < 0.05) and remained elevated at the Post-HIIT assessment (Post: 864.7 ± 255.4 Nm·s-1). No change in rate of torque development was observed over the 100-200 ms period of contraction. CONCLUSIONS: Combined HIIT with lacrosse specific training improved both static and dynamic knee extensor strength and enhanced rate of torque development within the first 50 ms of contraction in female high school lacrosse players. The inclusion of HIIT to standard pre-season and competitive lacrosse season training demonstrated no negative effects on lower-limb skeletal muscle performance.

Therapeutic Effects of High-Intensity Interval Training Exercise Alone and Its Combination with Ecdysterone Against Amyloid Beta-Induced Rat Model of Alzheimer's Disease: A Behavioral, Biochemical, and Histological Study.

Hippocampal oxidative stress has a vital role in the pathophysiology of Alzheimer's disease (AD)-associated behavioral deficits. Ecdysterone (Ecdy), a natural product and primary steroid hormone, exhibits anti-oxidative and neuroprotective effects. High-intensity interval training (HIIT) has emerged as an effective method for improving physiological brain functions. The present study was designed to investigate the comparative effects of separate and combined HIIT and Ecdy treatment on behavioral functions, hippocampal oxidative status, histological changes in an amyloid-beta (Aβ)-induced rat model of AD. Adult male rats were treated simultaneously with HIIT exercise and Ecdy (10mg/kg/day; P.O.), starting ten days after Aβ-injection, and they continued for eight consecutive weeks. At the end of the treatment course, the behavioral functions of the rats were assessed by commonly-used behavioral paradigms. Subsequently, brain samples were collected for histological analysis and hippocampus samples were collected for biochemical analysis. Results illustrated that Aβ injection impaired learning and memory performances in both novel object recognition and Barnes maze tests, reduced exploratory/locomotor activities in open field test, enhanced anxiety-like behavior in elevated plus-maze (P < 0.05). These behavioral deficits accompanied hippocampal oxidative stress (decreased total antioxidant capacity content and glutathione peroxidase enzyme activity, increased total oxidant status and malondialdehyde level) and neuronal loss in the cerebral cortex and hippocampus in H&E staining (P < 0.05). HIIT and Ecdy improved anxiety-like behavior, attenuated total oxidant status and malondialdehyde, and prevented the neuronal loss (P < 0.05). However, their combination resulted in a more complete and powerful improvement in all the above-mentioned Aβ-related deficits (P < 0.05). Overall, these data provide evidence that a combination of HIIT and Ecdy treatment improves Aβ-induced behavioral deficits, possibly through ameliorating hippocampal oxidative status and preventing neuronal loss.

Effect of aerobic exercise intensity on health-related quality of life in severe obesity: a randomized controlled trial

BackgroundAerobic exercise is an important part of obesity treatment and may improve health-related quality of life (HRQOL). The objective of this study was to compare the effect of two different exercise programs on health-related quality of life in patients with severe obesity.MethodsThis was a single-center, open-label, randomized, parallel-group study comparing the effects of a 24-week moderate-intensity continuous training (MICT) program and a combined high-intensity interval training program with MICT (HIIT/MICT). The primary objective (specified secondary outcome) was to assess HRQOL by using the general health dimension of the Short Form Health Survey (SF-36). The secondary objectives were to assess other dimensional SF-36 scores, the impact of weight on the physical and psychosocial aspects of quality of life (IWQOL-Lite), and the burden of obesity-specific weight symptoms (WRSM).Results73 patients were enrolled and reported patient reported outcome measures, with 71 patients (55% females) allocated to either MICT (n = 34) or HIIT/MICT (n = 37). In the intention-to-treat analysis, general health scores increased between baseline and 24-week follow-up in both the HIIT/MICT group and the MICT group, with a mean change of 13 (95% CI 6–21) points and 11 (95% CI 5–17) points, respectively, with no difference between the groups. The effect sizes of these changes were moderate. The vitality and social functioning scores of SF-36, and the physical function and self-esteem scores of IWQOL-Lite increased moderately in both groups, with no difference between groups. The tiredness, back pain, and physical stamina scores based on WRSM showed moderate to strong changes in both the groups.ConclusionsPatients who had completed a combined HIIT/MICT program did not experience larger improvements in general health compared with those completing a clean 24-week MICT program. Exercise may confer general health benefits independent of intensity.Trials registrationRegional Committees for Medical and Health Research Ethics south east, Norway, October 23, 2013 (identifier: 2013/1849) and ClinicalTrials.gov December 8, 2014 (identifier: NCT02311738).

High-Intensity Interval and Resistance Training Improve Health Outcomes in Older Adults With Coronary Disease.

Both high-intensity interval training (HIIT) and resistance exercises (R) are used in cardiac rehabilitation in patients with coronary artery disease (CAD). However, the combined effect of an HIIT+ R exercise program in older adults with CAD is not well investigated. The study's purpose was to assess the changes in anthropometric parameters, physical activity, functional capacity, physiological parameters, and quality of life (QoL) in this population following a combined HIIT+ R program. The study was a 2-group (n= 45 each) randomized controlled single-blinded trial. The study was done at a treatment clinic of a tertiary hospital. The mean age of participants was 69.23 ± 4.9years. The HIIT+ R group performed 8 sessions (1/wk) of HIIT+ R training. The 30minutes of the active exercise phase consisted of ten 3-minute bouts. Each bout comprised of 1minute of high-intensity treadmill walking at 85% to 90% maximum heart rate (MHR), followed by a low-intensity walking at 60%-70% MHR, followed by low-to moderate-intensity resistance training. The Usual Care group underwent conventional medical treatment. Anthropometric measurements [weight, body mass index (BMI), waist circumference, body fat percentage, lean body mass], physical activity (International Physical Activity Questionnaire), functional capacity (Incremental Shuttle Walking Test), physiologic measurements (blood pressure, heart rate), and QoL (36-Item Short Form Health Survey) were measured pre- and postintervention. Significant group and time interaction were found for the participants in the HIIT+ R Group for BMI (P= .001), body fat percentage (P= .001), waist circumference (P < .001), physical activity (P < .001), functional capacity (P < .001), and QoL (P= .001) compared with the UC Group. Significant improvement in systolic blood pressure (P= .001) was seen in the HIIT+ R group. A combined HIIT+ R training protocol in older adults with CAD can be useful in producing desired health outcomes. Further evaluation of longer duration exercise programs with more frequent dosing needs to be evaluated for their benefits and sustainability.

The Effects of Exercise Order on the Psychophysiological Responses, Physical and Technical Performances of Young Soccer Players: Combined Small-Sided Games and High-Intensity Interval Training.

Simple SummarySmall-sided games are very popular training methods, among other commonly used strategies, for enhancing the functional and sport-specific skills of young soccer players. In addition, high-intensity interval training has the potential to increase the aerobic capacity of youths. No study has compared the order effects of combined small-sided games and high-intensity interval training on the physical performances, psychophysiological responses, and technical skills of young soccer players. The results of this research show practical information that can help to design training programmes for youth soccer players.This study aimed to compare the order effects of combined small-sided games (SSGs) and high-intensity interval training (HIIT) on the psychophysiological responses and physical and technical performances of young soccer players. Twenty-four soccer players (aged 14.63 ± 0.71 years) were randomly divided into SSGs + HIIT (n = 12) and HIIT + SSGs (n = 12) for 6 weeks. The SSGs consisted of two 4–16 min rounds of 2, 3, and four-a-side games with 2 min of passive resting, whereas the HIIT consisted of 6–10 min of high-intensity runs at varying intensities (from 90 to 100%). Pre-test and post-test elements included a 5–30 m sprint test, countermovement jump test, zigzag agility test with the ball and without the ball, repeated sprint ability test, speed dribbling ability test, three-corner run test, and Yo-Yo Intermittent Recovery Test level 1. Both combined training interventions produced similar improvements in physical performance and technical responses (p ≥ 0.05, d values ranging from 0.40 to 1.10). However, the combined HIIT + SSGs training produced meaningfully lower perceived exertion (p = 0.00, d = 2.98) and greater physical enjoyment (p = 0.00, d = 4.28) compared with the SSGs + HIIT intervention. Furthermore, the SSGs + HIIT group showed a higher training load than those from the HIIT + SSGs group for all weeks (p ≤ 0.05, d values ranging from 1.36 to 2.05). The present study’s results might be used by coaches and practitioners to design training programmes for youth soccer players.

Combined high-intensity interval training as an obesity-management strategy for adolescents

ABSTRACT Effective and safe exercise protocols for obesity management in adolescents are imperative. This study aimed to analyse compliance, efficacy, and safety of combined high-intensity interval training circuit (HIIT) in the management of obesity (including overweight) in adolescents, compared to traditional training (TT). Data from 55 adolescents (47.3% girls) (TT n = 31; HIIT n = 24), aged 12–18 (mean age of 14.3 ± 1.7), with overweight and obesity (median BMI z-score of 2.95), were assessed at baseline and month 6 (Clinicaltrials.gov/NCT02941770). During the 6-month intervention, participants in both exercise groups attended two exercise sessions/week (60 min/session) along with a set of appointments with a paediatrician, nutritionist, and exercise physiologist. Forty-six participants completed the intervention (TT n = 23; HIIT n = 23). Exercise session attendance (≥80%) was significantly higher among HIIT participants (73.9 vs. 13.0%, p < .001). HIIT, but not TT, showed a significant decrease in BMI z-score (d = 0.40, p < .001), body fat mass (BFM, %) (d = 0.41, p = .001), and trunk fat mass (d = 0.56, p < .001), as well as a significant increase in muscle mass (MM, %) (d = 0.28, p = .001) between baseline and 6 months. According to generalized estimating equations, time-by-attendance interactions (instead of time-by group) were found in BMI z-score (β = 0.25, 95%CI: 0.17, 0.33), BFM (β = 2.29, 95%CI: 1.02, 3.56), trunk fat mass (β = 2.94, 95%CI: 1.70, 4.18), and MM (β = −1.16, 95%CI: −1.87, −0.45). No adverse events were reported during HIIT sessions. Although compliance may mediate the impact of an exercise protocol on health-related outcomes, HIIT showed to be safe, with higher compliance compared to TT, which may result in improved outcomes overtime.

Exercise Training Enhances Angiogenesis-Related Gene Responses in Skeletal Muscle of Patients with Chronic Heart Failure.

Peripheral myopathy consists of a hallmark of heart failure (HF). Exercise enhanced skeletal muscle angiogenesis, and thus, it can be further beneficial towards the HF-induced myopathy. However, there is limited evidence regarding the exercise type that elicits optimum angiogenic responses of skeletal muscle in HF patients. This study aimed to (a) compare the effects of a high-intensity-interval-training (HIIT) or combined HIIT with strength training (COM) exercise protocol on the expression of angiogenesis-related factors in skeletal muscle of HF patients, and (b) examine the potential associations between the expression of those genes and capillarization in the trained muscles. Thirteen male patients with chronic HF (age: 51 ± 13 y; BMI: 27 ± 4 kg/m2) were randomly assigned to a 3-month exercise program that consisted of either HIIT (N = 6) or COM training (N = 7). Vastus lateralis muscle biopsies were performed pre- and post-training. RT-PCR was used to quantify the fold changes in mRNA expression of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 2 (VEGFR-2), hypoxia-inducible factor 1 alpha (HIF-1α), angiopoietin 1 (Ang-1), angiopoietin 2 (Ang-2), angiopoietin receptor (Tie2), and matrix metallopeptidase 9 (MMP-9), and immunohistochemistry to assess capillarization in skeletal muscle post-training. There was an overall increase in the expression levels of VEGF, VEGFR-2, HIF-1α, Ang2, and MMP9 post-training, while these changes were not different among groups. Changes in capillary-to-fibre ratio were found to be strongly associated with Tie2 and HIF-1α expression. This was the first study demonstrating that both HIIT and combined HIIT with strength training enhanced similarly the expression profile of angiogenic factors in skeletal muscle of HF patients, possibly driving the angiogenic program in the trained muscles, although those gene expression increases were found to be only partially related with muscle capillarization.

Synergistic effects of high-intensity interval training (HIIT) and intake of nettle on serum levels of chemerin and beta cells function in type 2 diabetic rats.

This animal study aimed to demonstrate the synergistic effect of high-intensity interval training (HIIT) and alcoholic extract of nettle on serum chemerin and beta cells function in type 2 diabetic male rats. Thirty-two STZ-induced diabetic male Wistar rats were randomly divided into four groups including the control group, the supplemented group with 200mg/day of nettle, the training group with five sessions per week of HIIT, and the group with combined nettle and HITT intervention. Body weight, lipid profile, beta cells function, and chemerin level were assessed after eight weeks of the intervention. The values of chemerin significantly decreased in combined HIIT and nettle intervention group compared to the control group (p=0.001). The levels of glucose and insulin decreased significantly in nettle group, exercise group, and combined HIIT and nettle group (p=0.001). The present study found that intense interval exercise with the consumption of alcoholic extract of nettle can affect the performance of beta cells, glucose, and insulin. Future human studies are warranted.

Impact of combined training with different exercise intensities on inflammatory and lipid markers in type 2 diabetes: a secondary analysis from a 1-year randomized controlled trial

BackgroundExercise is a well-accepted strategy to improve lipid and inflammatory profile in individuals with type 2 diabetes (T2DM). However, the exercise intensity having the most benefits on lipids and inflammatory markers in patients with T2DM remains unclear. We aimed to analyse the impact of a 1-year combined high-intensity interval training (HIIT) with resistance training (RT), and a moderate continuous training (MCT) with RT on inflammatory and lipid profile in individuals with T2DM.MethodsIndividuals with T2DM (n = 80, aged 59 years) performed a 1-year randomized controlled trial and were randomized into three groups (control, n = 27; HIIT with RT, n = 25; MCT with RT, n = 28). Exercise sessions were supervised with a frequency of 3 days per week. Inflammatory and lipid profiles were measured at baseline and at 1-year follow-up. Changes in inflammatory and lipid markers were assessed using generalized estimating equations.ResultsAfter adjusting for sex, age and baseline moderate-to-vigorous physical activity (MVPA), we observed a time-by-group interaction for Interleukin-6 (IL-6) in both the MCT with RT (β = − 0.70, p = 0.034) and HIIT with RT (β = − 0.62, p = 0.049) groups, whereas, only the HIIT with RT group improved total cholesterol (β = − 0.03, p = 0.045) and LDL-C (β = − 0.03, p = 0.034), when compared to control. No effect was observed for C-reactive protein (CRP), cortisol, tumour necrosis factor-α (TNF-α), soluble form of the haptoglobin-hemoglobin receptor CD163 (sCD163), triglycerides and HDL-C in both groups (p > 0.05).ConclusionsFavorable adaptations on IL-6 were observed in both the HIIT and MCT combined with RT groups following a long-term 1-year exercise intervention in individuals with T2DM. However, only the HIIT with RT prevented further derangement of total cholesterol and LDL-C, when compared to the control group. Therefore, in order to encourage exercise participation and improve inflammatory profile, either exercise protocols may be prescribed, however, HIIT with RT may have further benefits on the lipid profile.Trial registration Clinicaltrials.gov ID: NCT03144505

Meta-inflammatory state and insulin resistance can improve after 10 weeks of combined all-extremity high-intensity interval training in sedentary overweight/obese females: a quasi-experimental study.

The effects of exercise training on suppression of inflammation have been proposed as a therapeutic approach in recent years to modify the obesity-induced inflammatory status and immunometabolic disorders. The present study aimed to assess the impacts of an all-extremity combined high-intensity interval training (HIIT) on inflammatory state and glycolipid metabolism in young sedentary overweight and obese females. This was an quasi-experimental study which was applied by comparing two groups. The participants were allocated to two active (AG, n = 15) and inactive (IG, n = 15) groups. The serum level of adiponectin, interleukin (IL)-10, pentraxin 3 (PTX3), and tumor-necrosis factor α (TNFα) was measured in all subjects. Also, glycolipid metabolism was assessed by measuring the fasting lipid profile parameters, glucose, and insulin levels and calculating the homeostasis model assessment of insulin resistance (HOMA2-IR). Following a 10-week combined all-extremity HIIT in the active subjects, the TNFα, PTX3/IL-10, and TNFα/adiponectin were significantly reduced. However, the absolute levels of adiponectin, IL-10, and PTX3 remained unchanged. Additionally, a significant decrease was found in insulin, LDL, and HOMA2-IR, while insulin sensitivity and HDL levels showed a significant increase in the active group compared to the inactive group. Our 10-week time-efficient combined all-extremity HIIT promoted an anti-inflammatory state and glycolipid metabolism improvement, suggesting this protocol as a practical therapeutic approach in sedentary obese females.

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

AimsPeople with type 2 diabetes (T2D) have a greater prevalence of musculoskeletal and neuropathic pain. This exploratory analysis investigated whether exercise of different intensities leads to changes in self-reported musculoskeletal pain or symptoms of diabetic neuropathy in inactive individuals with type 2 diabetes. MethodsThirty-two inactive adults with T2D (59% male, mean age 58.7 ± 9.1yrs, median HbA1c 7.8%) were randomised to usual care (CON), supervised combined aerobic and resistance moderate-intensity continuous training (C-MICT), or supervised combined high-intensity interval training (C-HIIT). At baseline and 8-weeks, musculoskeletal and neuropathic pain were evaluated using a modified Nordic Musculoskeletal Questionnaire and the Neuropathy Total Symptom Score-6 respectively. Quantitative sensory testing was used to determine thermal, mechanical and vibration detection thresholds, as well as pain pressure thresholds. Adverse events were recorded throughout the intervention. ResultsCompared to CON, reduction in musculoskeletal pain intensity was significantly greater for C-HIIT (MD −5.4, 95% CI [−10.6 to −0.2], p = 0.04) and non-significantly greater for C-MICT (MD −5.9 [−12.4 to 0.7], p = 0.08). Changes in neuropathy symptoms were not different between C-HIIT and CON (MD 1.0 [−0.9 to 2.8], p = 0.31), or C-MICT and CON (MD 0.2 [−3.1 to 3.6], p = 0.89). No differences in sensory function were observed between groups. Similar rates of adverse events were seen in both exercise interventions (19 C-HIIT; 17 C-MICT), all but one of which were mild. ConclusionsPreliminary data suggests 8-weeks of high-intensity combined aerobic and resistance exercise may be safely prescribed for inactive individuals with T2D and may reduce musculoskeletal pain but not neuropathic symptoms.Trial Registration:ACTRN12615000475549.

The combined effect of high-intensity interval training and intermittent fasting on lipid profile and peroxidation in Wistar rats under high-fat diet

High-fat diet is considered as the main risk factor for the development of dyslipidemia and lipid peroxidation, which in turn results in serious health problems such as cardiovascular disease, type 2 diabetes, and some forms of cancers. Therefore, the purpose of this study was to investigate the combined effect of high-intensity interval training (HIIT) and intermittent fasting (IF) on lipid profile and peroxidation in Wistar rats under a high-fat diet. A total of 28 male Wistar rats went through a high-fat diet for 12 weeks. Then, they were randomly divided into four groups: (1) HIIT (3 days week−1 for 6 weeks), (2) IF (3 days week−1 for 6 weeks), (3) combined HIIT and IF (received both treatment for 6 weeks), and (4) control (CON). All groups were under a high-fat diet until the end of the study. According to the results, LDL levels significantly decreased in the HIIT group compared to the CON group, and in the IF and HIIT + IF groups, a non-significant increase in HDL was observed compared to the CON group. In HIIT + IF and HIIT groups, LDL/HDL ratio decreased significantly compared to the CON group (P < 0.05). Moreover, in IF group, a significant decrease in TG occurred in comparison with HIIT and HIIT + IF groups. A significant increase in serum MDA levels was observed in IF and HIIT + IF groups but not in the HIIT group in comparison with the CON group. Our results suggest that in subjects under a high-fat diet, both HIIT and IF may help to improve lipid profile, but their combination may not have any synergistic effect. Also, IF and HIIT + IF may increase lipid peroxidation in subjects under a high-fat diet.

Combined All-Extremity High-Intensity Interval Training Regulates Immunometabolic Responses through Toll-Like Receptor 4 Adaptors and A20 Downregulation in Obese Young Females

Metainflammation and malfunctions of toll-like receptor 4 (TLR4) are related to obesity-induced immunometabolic morbidities. There are almost no studies relating exercise training to the TLR4 pathway and its adaptors and negative regulators. Thirty young women with obesity (exercise group and control group) were included in a 10-week all-extremity combined high-intensity interval training program. The immunomodulatory impacts of exercise on TLR4, its related adaptors (TIR domain-containing adaptor-inducing IFN-β[TRIF], myeloid differentiation factor 88 [MyD88],and tumor receptor-associated factor 6 [TRAF6]), transcriptional factors (nuclear factor [NF]-κB and interferon regulatory factor 3 [IRF3]), and negative regulator (A20) mRNA levels were assessed by real-time PCR. Also, the serum concentration of TLR4 final products (tumor necrosis factor α [TNFα] and interferon γ [IFNγ]) was measured by ELISA. Cardiorespiratory and body composition parameters were tested, as well. There was a significant improvement in body composition and cardiorespiratory fitness. This intervention downregulated TLR4 (from 2.25 ± 1.07 to 0.84 ± 1.01), MyD88 (from 4.53 ± 5.15 to 1.27 ± 0.88), NF-κB (from 1.61 ± 2.03 to 0.23 ± 0.39), IRF3 (from 1.22 ± 0.77 to 0.25 ± 0.36), and A20 (from 0.88 ± 0.59 to 0.22 ± 0.33) levels and reduced the TNFα concentrations (from 22.39 ± 11.43 to 6.26 ± 5.31) significantly in the exercise group, while no statistically significant change was found in TRIF and TRAF6 expression and IFNγ circulating levels. It is concluded that long-term exercise modifies the inflammatory pathways and modulates the immune function at the early stages of inflammation initiation in circulating immune cells. Accordingly, we suggest time-efficient exercise protocols as a possible therapy approach for the prevention of M1 polarization.

Assessment of the Effect of Short-Term Combined High-Intensity Interval Training on TLR4, NF-κB and IRF3 Expression in Young Overweight and Obese Girls

Obesity is commonly associated with immunometabolic dysfunctions. Activation of inflammatory macrophages through TLR4 (toll-like receptor 4) and the anti-inflammatory impact of exercise have been and are the new concerns among researchers. A new short-term combined high-intensity interval training was proposed in young sedentary overweight/obese females. All participants were allocated to one of two groups: the exercise group (EG) and the control group (CG), where the EG participated in a 2-week combined training and the CG continued its routine lifestyle. Gene expression levels of TLR4, NF-κB(nuclear factor κB), and IRF3 (interferon regulatory factor 3) were assessed by real-time PCR. Physiological, anthropometric, and biomedical metabolic factors were assessed. The between-group comparisons indicated a tendency to a decrease in NF-κB gene expression in the EG. The IRF3 levels were not significantly changed compared to CG and the levels before training. Fasting glucose levels and β-cell function revealed a significant improvement in EG. These findings indicated that this protocol decreased meta-inflammation levels and improved insulin resistance independent of body composition changes. Consequently, combined training may be recommended as a therapeutic approach in metabolic diseases.

The Effects of Combined High-Intensity Interval and Resistance Training on Glycemic Control and Oxidative Stress in T2DM

Background: As part of type 2 diabetes mellitus (T2DM) lifestyle management, exercise programs must be demonstrably effective and safe. Objectives: A randomized controlled trial (RCT) was used to evaluate the results of glycemic control and oxidative stress of a new T2DM management exercise program in a training facility setting. Methods: The study participants were randomly allocated into either an experimental (EXP) group who participated in the new training program or a control (CTR) group who participated in continuous cardiorespiratory exercise. Each participant’s glycemic control (glycated hemoglobin A, HbA1c), fitness level (maximum oxygen uptake, VO2max), and oxidative stress (malondialdehyde, MDA and superoxide dismutase, SOD) were measured before and after the training program. The 12-week training program combined high-intensity interval training (HIIT) three times a week with resistance training (RT) twice a week while gradually increasing the intensity. The HIIT element was comprised of one minute of high-intensity exercise and four minutes of low-intensity exercise. The RT element was comprised of nine exercises for the core, upper extremities, and lower extremities. Results: The 42 T2DM patients who participated in this RCT were 35 - 64 years old. The HbA1c level of the EXP group decreased (Δ = -0.43 ± 1.01%), although not significantly. The VO2max was higher in the EXP group (38.13 ± 5.93 mL/kg/min) than in the CTR group (32.09 ± 5.24 mL/kg/min, P = 0.004). The overall oxidative stress decreased in the EXP group (MDA level Δ = -0.14 ± 0.39 nm/mL) when compared to the CTR group (MDA level Δ = 0.18 ± 0.26 nm/mL, P = 0.011), and the SOD level significantly increased more in the EXP group [median Δ = 0.47 U/mL (interquartile range = 0.08 - 0.74 U/mL)] when compared to the CTR group (Δ = 0.14 ± 0.35 U/mL, P = 0.036). The EXP group’s composite effects score was significantly higher (8.72 ± 1.27) than the CTR group’s score (7.20 ± 1.08, P = 0.001). Conclusions: The combined HIIT and RT exercise program was not significantly improving glycemic control, however it lowered oxidative stress.

Effects of combined training with different intensities on vascular health in patients with type 2 diabetes: a 1-year randomized controlled trial

BackgroundExercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes.MethodsPatients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes.ResultsAfter adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = − 4.25, p < 0.01) and HIIT group (β = − 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = − 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = − 0.14, p < 0.01), and on the distensibility coefficient (β = − 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention.ConclusionsFollowing a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes.Trial registration clinicaltrials.gov ID: NCT03144505