Effectiveness of high-intensity interval training for weight loss in adults with obesity: a randomised controlled non-inferiority trial

Andrea D'Amuri; Juana Maria Sanz; Eleonora Capatti; Francesca Di Vece; Filippo Vaccari; Stefano Lazzer; Giovanni Zuliani; Edoardo Dalla Nora; Angelina Passaro

doi:10.1136/bmjsem-2020-001021

Effectiveness of high-intensity interval training for weight loss in adults with obesity: a randomised controlled non-inferiority trial

BMJ Open Sport Exerc Med. 2021 Jul 20;7(3):e001021. doi: 10.1136/bmjsem-2020-001021. eCollection 2021.

Authors

Affiliations

¹ Department of Translational Medicine, University of Ferrara, Ferrara, Emilia Romagna, Italy.
² Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Emilia Romagna, Italy.
³ Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Emilia Romagna, Italy.
⁴ Department of Medical Sciences, University of Udine, Udine, Friuli Venezia Giulia, Italy.

Abstract

Introduction: Obesity treatment guidelines suggest moderate-intensity continuous training (MICT), but the patient's compliance to this indication remains low. High-intensity interval training (HIIT) is a time sparing training mode whose metabolic effects are not clear. This study aimed to determine whether a 12-week HIIT was more effective than MICT for weight loss in obese adults.

Methods: 44 obese subjects were randomised and trained with isoenergetic treadmill exercises for 12 weeks: MICT (60% of maximal oxygen peak, VO₂peak) or HIIT (3-7 repetition of 3 min 100% of VO₂peak interspersed by 1.5 min 50% of VO₂peak). The primary outcome was a change in body weight; the secondary outcomes were changes in body composition, blood pressure, lipid profile, glycaemia, insulin and VO₂peak.

Results: 32 subjects (53% male, mean age: 38.5 years, mean body mass index: 35.5 kg/m²) completed the trial. MICT and HIIT showed comparable effect within groups in weight loss (-6.0 kg (-9.0 kg to -3.0 kg) vs -5.7 kg (-8.3 kg to -3.1 kg)), changes in fat mass (-2.9% (-4.4% to -1.4%) vs -3.6% (-5.9% to -1.2%)), fat free mass (-5.3% (-7.8% to -2.8%) vs -5.5% (-8.3% to -2.6%)), diastolic blood pressure (-5.5 mm Hg (-10.6 mm Hg to -0.3 mm Hg) vs -5.8 mm Hg (-11.3 mm Hg to -0.3 mm Hg)) and low-density lipoprotein cholesterol (-16.4 mg/dL (-30.8 mg/dL to -2.0 mg/dL) vs -14.7 mg/dL (-25.6 mg/dL to -3.8 mg/dL)). There was a significant change between groups in VO₂peak (HIIT: +461.6 mL (329.3‒593.8 mL); MICT: +170.5 mL (86.7-254.4 mL); p<0001) and duration of sessions (HIIT: 35.0 min (31.7 ‒35.6 min); MICT: 46.5 min (40.2‒48.3 min); p<0.001). No significant changes in systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, glycaemia or plasma insulin were observed.

Conclusions: In healthy adults with obesity, HIIT compared with MICT induced similar weight loss and cardiovascular risk factors improvement but resulted in a larger increase in cardiorespiratory fitness over a shorter period.

Keywords: aerobic fitness; body composition; metabolism; obesity.