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A 2015 meta-analysis comparing HIIT to moderate intensity continuous training (MICT) in people with [[coronary artery disease]] found that HIIT leads to greater improvements in VO<sub>2</sub> max but that MICT leads to greater reductions in body weight and heart rate.<ref name=Liou2015>{{cite journal|vauthors=Liou K, Ho S, Fildes J, Ooi SY |title=High Intensity Interval versus Moderate Intensity Continuous Training in Patients with Coronary Artery Disease: A Meta-analysis of Physiological and Clinical Parameters|journal=Heart Lung Circ|volume=25|issue=15|pages=01269–X|date=July 2015|pmid=26375499|doi=10.1016/j.hlc.2015.06.828|type=Meta-Analysis}}</ref> A 2014 meta-analysis found that improvement to [[cardiorespiratory fitness]], as measured by VO<sub>2</sub> max, of individuals with lifestyle-induced chronic cardiovascular or metabolic diseases (including [[hypertension|high blood pressure]], obesity, [[heart failure]], coronary artery disease, or [[metabolic syndrome]]) who completed a HIIT exercise program was nearly double that of individuals who completed a MICT exercise program (19.4% increase and 10.3% increase, respectively).<ref name=Weston2014>{{cite journal|vauthors=Weston KS, Wisloff U, Coombes JS |title=High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis|journal=Br J Sports Med|volume=48|issue=16|pages=1227–1234|date=August 2014|pmid=24144531|doi=10.1136/bjsports-2013-092576|s2cid=4650328|type=Systematic Review & Meta-Analysis}}</ref>
A 2015 meta-analysis comparing HIIT to moderate intensity continuous training (MICT) in people with [[coronary artery disease]] found that HIIT leads to greater improvements in VO<sub>2</sub> max but that MICT leads to greater reductions in body weight and heart rate.<ref name=Liou2015>{{cite journal|vauthors=Liou K, Ho S, Fildes J, Ooi SY |title=High Intensity Interval versus Moderate Intensity Continuous Training in Patients with Coronary Artery Disease: A Meta-analysis of Physiological and Clinical Parameters|journal=Heart Lung Circ|volume=25|issue=15|pages=01269–X|date=July 2015|pmid=26375499|doi=10.1016/j.hlc.2015.06.828|type=Meta-Analysis}}</ref> A 2014 meta-analysis found that improvement to [[cardiorespiratory fitness]], as measured by VO<sub>2</sub> max, of individuals with lifestyle-induced chronic cardiovascular or metabolic diseases (including [[hypertension|high blood pressure]], obesity, [[heart failure]], coronary artery disease, or [[metabolic syndrome]]) who completed a HIIT exercise program was nearly double that of individuals who completed a MICT exercise program (19.4% increase and 10.3% increase, respectively).<ref name=Weston2014>{{cite journal|vauthors=Weston KS, Wisloff U, Coombes JS |title=High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis|journal=Br J Sports Med|volume=48|issue=16|pages=1227–1234|date=August 2014|pmid=24144531|doi=10.1136/bjsports-2013-092576|s2cid=4650328|type=Systematic Review & Meta-Analysis}}</ref>

A 2019 [[clinical trial]] assessed the effects of HIIT on [[Blood vessel|vascular]] health in inactive people and found that HIIT has beneficial vascular effects, based on observed decreases in [[arterial wall]] thickness and increase in [[Endothelium|endothelial]] function.<ref name=":02">{{Cite journal |last=Ramírez-Vélez |first=Robinson |last2=Hernández-Quiñones |first2=Paula Andrea |last3=Tordecilla-Sanders |first3=Alejandra |last4=Álvarez |first4=Cristian |last5=Ramírez-Campillo |first5=Rodrigo |last6=Izquierdo |first6=Mikel |last7=Correa-Bautista |first7=Jorge Enrique |last8=Garcia-Hermoso |first8=Antonio |last9=Garcia |first9=Ronald G. |date=2019-02-04 |title=Effectiveness of HIIT compared to moderate continuous training in improving vascular parameters in inactive adults |url=https://doi.org/10.1186/s12944-019-0981-z |journal=Lipids in Health and Disease |volume=18 |issue=1 |pages=42 |doi=10.1186/s12944-019-0981-z |issn=1476-511X |pmc=PMC6362599 |pmid=30717757}}</ref> The trial also found that HIIT had stronger effects than medium intensity continuous training (MICT) in enhancing [[Flow-mediated dilation|flow mediated dilation]] and lowering [[pulse wave velocity]] in inactive adults from the greater blood flow and [[vasodilation]] of blood vessels stimulated by HIIT. <ref name=":02" /> Increased flow mediated dilation allows for greater opening of an artery and increased blood flow, allowing for more oxygen to be supplied throughout the body during activity.<ref name=":02" /> Pulse wave velocity is used to monitor [[arterial stiffness]]; which increases with age and high blood pressure, leading to a higher probability of cardiovascular problems including hypertension or a stroke.<ref name=":02" />


===Metabolic effects===
===Metabolic effects===

Revision as of 19:12, 4 March 2022

This article is about the cardiovascular exercise made popular in the 2010s. For the 1970s weight training, see High intensity training.
HIIT with dumbbells

High-intensity interval training (HIIT) is a training protocol alternating short periods of intense or explosive anaerobic exercise with brief recovery periods until the point of exhaustion, which thereby relies on "the anaerobic energy releasing system almost maximally."[1] The method involves exercises performed in repeated quick bursts at maximum or near maximal effort with periods of rest or low activity between bouts. The very high level of intensity, the interval duration and number of bouts distinguish it from aerobic (cardiovascular) activity, because the body significantly recruits anaerobic energy systems (although not completely to the exclusion of aerobic pathways).[2] Although there are varying forms of HIIT-style workouts which may involve exercises associated with both cardiovascular activity and also resistance training, HIIT's crucial features of maximal effort, duration, and short rest periods (thereby triggering the anaerobic pathways of energy production) materially differentiate it from being considered a form of cardiovascular exercise.[3] Though there is no universal HIIT session duration, a HIIT workout typically lasts under 30 minutes in total as it uses the anaerobic energy systems which are typically used for short, sharp bursts. The times vary, based on a participant's current fitness level.[4] Traditional HIIT initially had been designed to be no longer than 20 seconds on with no more than 10 seconds off; however intervals of exercise effort tend to range from 20 to 45 seconds but no longer than 75 seconds, at which point the aerobic system would then kick in.[5]

HIIT workouts provide improved athletic capacity and condition as well as improved glucose metabolism.[6] Compared with longer sessions typical of other regimens, HIIT may not be as effective for treating hyperlipidemia and obesity, or improving muscle and bone mass.[7] However, research has shown that HIIT regimens produced significant reductions in the fat mass of the whole-body in young women.[8] Some researchers also note that HIIT requires "an extremely high level of subject motivation" and question whether the general population could safely or practically tolerate the extreme nature of the exercise regimen.[9]

Procedure

HIIT exercise sessions generally consist of a warm up period followed by repetitions of high-intensity exercises separated by medium intensity exercises for recovery, then a cool-down period. The high-intensity exercise should be done at near maximum intensity. The medium exercise should be about 50% intensity. The number of repetitions and length of each depends on the exercise, but maybe as little as three repetitions with just 20 seconds of intense exercise.[10] The specific exercises performed during the high-intensity portions vary. Most of the research on HIIT has been done using a cycling ergometer, but other exercises like a rowing ergometer, running, stair climbing and uphill walking can also be effective.[11]

There is no specific formula for HIIT. Depending on one's level of cardiovascular development, the moderate-level intensity can be as slow as walking. A common formula involves a 2:1 ratio of work to recovery periods, for example, 30–40 seconds of hard sprinting alternated with 15–20 seconds of jogging or walking, repeated to failure.

The entire HIIT session may last between four and thirty minutes, meaning that it is considered to be an excellent way to maximize a workout limited by time constraints.[12] Use of a clock or timer is recommended to keep accurate times, the number of rounds, and intensity.

Branches

Peter Coe regimen

A type of high-intensity interval training with short recovery periods was used in the 1970s by the athletics coach Peter Coe when setting sessions for his son Sebastian Coe. Inspired by the principles propounded by the German coach and university professor Woldemar Gerschler and the Swedish physiologist Per-Olof Åstrand, Coe set sessions involving repeated fast 200 meter runs with only 30 seconds recovery between each fast run.[13]

Tabata regimen

A version of HIIT was based on a 1996 study[14] by Ritsumeikan University Professor Izumi Tabata (田畑泉) et al. initially involving Olympic speedskaters. The study used 20 seconds of ultra-intense exercise (at an intensity of about 170% of VO2max) followed by 10 seconds of rest, repeated continuously for 4 minutes (8 cycles). The exercise was performed on a mechanically braked cycle ergometer. Tabata called this the IE1 protocol.[15] In the original study, athletes using this method trained 4 times per week, plus another day of steady-state training, for 6 weeks and obtained gains similar to a group of athletes who did steady state training (70% VO2max) 5 times per week. The steady state group had a higher VO2max at the end (from 52 to 57 mL/(kg•min)). However the Tabata group had achieved comparable aerobic improvements but only exercised 4 minutes per day on their 4 HIIT days compared to 60 minutes for the aerobic group. The Tabata group also started lower and gained more overall (from 48 to 55 mL/(kg•min)). Also, only the Tabata group had gained anaerobic capacity benefits.

In popular culture, "Tabata training" has now come to refer to a wide variety of HIIT protocols and exercise regimens [16] that may or may not have similar benefits to those found in Tabata's original study.

Gibala regimen

Professor Martin Gibala and his team at McMaster University in Canada have been researching high-intensity exercise for several years. Their 2010 study on students[17] uses 3 minutes for warming up, then 60 seconds of intense exercise (at 95% of VO2max) followed by 75 seconds of rest, repeated for 8–12 cycles (sometimes referred to as "The Little Method"). Subjects using this method training 3 times per week obtained gains similar to what would be expected from subjects who did steady-state (50–70% VO2max) training five times per week. While still a demanding form of training, the general public could use this exercise protocol with nothing more than an average exercise bike.

Gibala's group published a less intense version of their regimen in a 2011 paper in Medicine & Science in Sports & Exercise. This was intended as a gentler option for sedentary people who had done no exercise for over a year. It included 3 minutes of warm-up, 10 repetitions of 60-second bursts at 60% peak power (80–95% of heart rate reserve) each followed by 60 seconds of recovery, and then a 5-minute cool-down.[18]

Zuniga regimen

Jorge Zuniga, assistant professor of exercise science at Creighton University, set out to determine how to fit the highest volume of work and oxygen consumption into the smallest amount of time. He found that intervals of 30 seconds at 90% of power output at VO2 max followed by 30 seconds of rest allowed for the highest VO2 consumption and the longest workout duration at specified intensity. Alternative protocols considered included 100% of maximum power output on the same interval schedule, similar to the Coe regimen, and 90% of maximum power output for three minutes, similar to traditional interval training.[19]

Zuniga's protocol has been implemented with great success by students of his who were participating in Creighton's Army ROTC program. Cadets completing the protocol twice a week saw greater improvements in APFT scores than in years past.[citation needed]

Vollaard regimen

Dr Niels Vollaard at the University of Stirling proposed that when high-intensity intervals are done at ‘all-out’ intensities, associated health benefits plateau after performing 2 or 3 sprint repetitions. This led to the development of a 10-minute exercise routine consisting of easy pedalling interspersed with two 20-second ‘all-out’ cycling sprints.[20] In a 2017 meta-analysis, Vollaard indeed showed that common protocols with as many as 6 to 10 repetitions of 30-second ‘all-out’ sprints do not improve aerobic fitness more than the ‘2x20-s’ protocol.[21] It is claimed that this short protocol may remove many of the drawbacks that make other high-intensity interval training protocols unsuitable for the general population.[22]

In a BBC Horizon program in February 2012, Jamie Timmons, professor of systems biology at the University of Loughborough, put Michael Mosley through this exercise bike regimen, but with three sprints instead of two. This was done three times a week for a total of 30 minutes of exercise per week (3 minutes of intense exercise), plus warm-up and recovery time.

Regimen comparison

Wood et al. compared HIIT of eight 1-minute bouts at 85% maximum Watts (Wmax) interspersed with 1-minute active recovery at 25% Wmax, to sprint interval training of eight 30-second bouts at 130% Wmax interspersed with 90-second active recovery at 25% Wmax (Total time-matched at 24 minutes including warm-up & cooldown). Their conclusion was "HIIT is the recommended routine" but "the magnitude of differences in various parameters between regimens was small; therefore, preference for either modality may be up to the individual".[23]

Health effects

Cardiovascular effects

A 2015 systematic review and meta-analysis of randomized controlled trials found that HIIT training and traditional endurance training both lead to significantly improved cardiovascular fitness in healthy adults ages 18–45 but greater improvements in VO2 max were seen in those participating in the HIIT exercise regimen.[24] Another analysis also found that HIIT regimens of one month or longer effectively improve cardiovascular fitness in adolescents and lead to moderate improvements in body composition.[25] Furthermore, a separate systematic review and meta-analysis of seven small randomized controlled trials found that HIIT (defined as four intervals of four minutes at 85–95% of max heart rate with three-minute intervals at 60–70% of max heart rate) was more effective than moderate-intensity continuous training at improving blood vessel function and markers of blood vessel health.[26]

A 2015 meta-analysis comparing HIIT to moderate intensity continuous training (MICT) in people with coronary artery disease found that HIIT leads to greater improvements in VO2 max but that MICT leads to greater reductions in body weight and heart rate.[27] A 2014 meta-analysis found that improvement to cardiorespiratory fitness, as measured by VO2 max, of individuals with lifestyle-induced chronic cardiovascular or metabolic diseases (including high blood pressure, obesity, heart failure, coronary artery disease, or metabolic syndrome) who completed a HIIT exercise program was nearly double that of individuals who completed a MICT exercise program (19.4% increase and 10.3% increase, respectively).[28]

A 2019 clinical trial assessed the effects of HIIT on vascular health in inactive people and found that HIIT has beneficial vascular effects, based on observed decreases in arterial wall thickness and increase in endothelial function.[29] The trial also found that HIIT had stronger effects than medium intensity continuous training (MICT) in enhancing flow mediated dilation and lowering pulse wave velocity in inactive adults from the greater blood flow and vasodilation of blood vessels stimulated by HIIT. [29] Increased flow mediated dilation allows for greater opening of an artery and increased blood flow, allowing for more oxygen to be supplied throughout the body during activity.[29] Pulse wave velocity is used to monitor arterial stiffness; which increases with age and high blood pressure, leading to a higher probability of cardiovascular problems including hypertension or a stroke.[29]

Metabolic effects

HIIT significantly lowers insulin resistance compared to continuous training or control conditions and leads to modestly decreased fasting blood glucose levels and increased weight loss compared to those who do not undergo a physical activity intervention.[30] Another study found that HIIT was more effective than moderate-intensity continuous training at fasting insulin levels (31% decrease and 9% decrease, respectively).[31]

Fat oxidation

A 2007 study examined HIIT's physiological effects on fat oxidation in moderately active women.[32] The participants in the study performed HIIT (defined as ten sets of 4-minute cycling bursts at an intensity of 90% VO2max separated by 2 minutes of rest) every other day over a 2-week period. The study found that seven sessions of HIIT over a 2-week period improved whole body fat oxidation and the capacity for skeletal muscle to oxidize fat in moderately active women. A 2010 systematic review of HIIT summarized the results of HIIT on fat loss and stated that HIIT can result in modest reductions of subcutaneous fat in young and healthy individuals, but greater reductions for overweight individuals.[33] A 2018 meta-analysis examining 39 studies found HIIT, particularly running, to be a time-efficient strategy in decreasing abdominal and visceral fat-mass deposits.[34]

Brain power

A 2017 study examined the effect of HIIT on cognitive performance among a group of children (N=318).[35] The authors show that HIIT is beneficial to cognitive control and working memory capacity when compared against "a blend of board games, computer games, and trivia quizzes" and that this effect is mediated by the BDNF polymorphism. They conclude that the study "suggests a promising alternative to enhance cognition, via short and potent exercise regimens". A meta-analysis by the same group showed that HIIT can elicit short term brain improvements similar to those usually observed with aerobic exercise.[36]

Dangers of HIIT

The American College of Sports Medicine suggests asking permission from one's doctor before starting HIIT, particularly if there is a history of coronary heart disease. This is to ascertain its safety and allow the patient to build up the intensity of exercise without causing harm. [37] It is advised to start a lower intensity and go at one's own pace.[38]

There is a risk of injury due to fatigue and overtraining, so it is advised to allow time for recovery.[39][40] Research from Rutgers University demonstrated that the knees, shoulders, and ankles were the most commonly involved injuries. More specifically, knee and ankle sprains were very common. Based on that, neuromuscular training and pre-strengthening programs are recommended to improve flexibility, particularly before exercise.[41]

See also

References

  1. ^ Tabata, Izumi; Nishimura, Kouji; Kouzaki, Motoki; Hirai, Yuusuke; Ogita, Futoshi; Miyachi, Motohiko; Yamamoto, Kaoru (October 31, 1996). "Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and ˙VO2max". Medicine & Science in Sports & Exercise. 28 (10): 1327–1330. doi:10.1097/00005768-199610000-00018. PMID 8897392 – via journals.lww.com.
  2. ^ Tabata, Izumi; NISHIMURA, KOUJI; Kouzaki, Motoki; HIRAI, YUUSUKE; Ogita, Futoshi; Miyachi, Motohiko; YAMAMOTO, KAORU (1996-11-01). "Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO(2max)". Medicine and Science in Sports and Exercise. 28 (10): 1327–30. doi:10.1097/00005768-199610000-00018. PMID 8897392.
  3. ^ "Penn Medicine: Workout Debate: Experts Weigh in on Cardio VS. HIIT". www.pennmedicine.org. Retrieved 2022-01-31.
  4. ^ "HIIT FAQ (Frequently Asked Questions about High-Intensity Interval Training)". DOHIIT. Retrieved 2017-08-25.
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External links

Scholia has a profile for high-intensity interval training (Q2756206).
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