Previously, the use of moderate-intensity continuous training (MICT) has generally been considered the most beneficial exercise treatment modality for the prevention/management of metabolic type disease. More recently, however, high-intensity interval training (HIIT) has emerged into the clinical setting as a potential alternative to traditional MICT in the management of such diseases, but the comparative effects are not well understood. Use of HIIT has the potential to induce favorable physiological remodeling that is similar or even superior to MICT, despite a considerably lower exercise volume and time commitment. Many studies have therefore examined the efficacy of HIIT relative to MICT with respect to reducing the development and progression of numerous metabolic conditions including obesity, type 2 diabetes, and the metabolic syndrome. Despite this, however, the efficacy of HIIT relative to MICT in reversing the specific symptoms and adverse effects of those at risk of, or afflicted with metabolic disease is not well understood. Moreover, HIIT is often perceived as very stressful and demanding, which could potentially render it unsafe and/ or unappealing for clinical populations whom are already at a higher risk of experiencing adverse events. Furthermore, the optimal prescriptive variables (volume, intensity, duration, rest) of a HIIT protocol that elicit the greatest benefits for each of the aforementioned clinical cohorts have not been established. This review article aims to explore the use of HIIT with respect to the above. Firstly, the efficacy of HIIT is examined relative to MICT in the management of metabolic diseases, with particular relevance to physiological adaptations, health outcomes, and potential mechanisms. Secondly, the potential safety issues relating to the suitability and tolerability of HIIT for clinical populations, as well as the optimal HIIT prescriptive variables for such clinical populations are discussed. authors utilized a HIIT protocol which has previously been shown to reduce body fat in overweight individuals, 20 one may speculate that the protocol was insufficient to promote significant improvements in body composition for their overweight subjects. In support of this, the authors also reported that peak BP (systolic BP<250mmHg) and heart rate (<90% MHR) were within normal limits for exercise, and the protocol was well tolerated by participants with no adverse events, which may question the specific exercise prescriptive variables adopted. Obesity is also characterized in many cases by a reduction in insulin sensitivity. 25 Here this has been associated with an increase in levels of TNF-α, this increase in TNF-α is thought to interfere with insulin related glucose signaling in the muscle viathe IRS-1/P13K pathways (25). Interestingly chronic exercise has been shown to significantly (P<0.01) lower the circulating levels of TNF-α.
Keywords26 Hence, while the recent interest in HIIT has led to the notion that it may be more effective than MICT as a means of reducing bo...