Milanović, Zoran

Sporiš, Goran

Weston, Matthew

Sports Medicine

English

Zoran Milanović

Goran Sporiš

Matthew Weston

Crossref

Effectiveness of High-Intensity Interval Training (HIT) and Continuous Endurance Training for VO2max Improvements: A Systematic Review and Meta-Analysis of Controlled Trials

Background Enhancing cardiovascular fitness can lead to substantial health benefits. High-intensity interval training (HIT) is an efficient way to develop cardiovascular fitness, yet comparisons between this type of training with traditional endurance training are equivocal. Objective Our objective was to meta-analyse the effects of endurance training and HIT on the maximal oxygen consumption (VO2max) of healthy, young to middle-aged adults. Methods Six electronic databases were searched (MEDLINE, PubMed, SPORTDiscus, Web of Science, CINAHL and Google Scholar) for original research articles. A search was conducted and search terms included ‘high intensity’, ‘HIT’, ‘sprint interval training’, ‘endurance training’, ‘peak oxygen uptake’, ‘VO2max’. Inclusion criteria were controlled trials, healthy adults aged 18-45 y, training duration ≥2 weeks, VO2max assessed pre- and post-training. Twenty-eight studies met the inclusion criteria and were included in the meta-analysis. This resulted in 723 participants with a mean ± SD age and initial fitness of 25.1 ± 5 y and 40.8 ± 7.9 mL•kg-1•min-1, respectively. We made probabilistic magnitude-based inferences for meta-analysed effects based on standardized thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject standard deviations (SDs) for baseline VO2max. Results The meta-analysed effect of endurance training on VO2max was a possibly large beneficial effect (4.9 mL•kg-1•min-1; 95% confidence limits ±1.4 mL•kg-1•min-1), when compared with no exercise controls. A possibly moderate additional increase was observed for typically younger subjects (2.4 mL•kg-1•min-1; ±2.1 mL•kg-1•min-1) and interventions of longer duration (2.2 mL•kg-1•min-1; ±3.0 mL•kg-1•min-1), and a small additional improvement for subjects with lower baseline fitness (1.4 mL•kg-1•min-1; ±2.0 mL•kg-1•min-1). When compared to no exercise controls, there was likely large beneficial effect of HIT (5.5 mL•kg-1•min-1; ±1.2 mL•kg-1•min-1), with a likely moderate greater additional increase for subjects with lower baseline fitness (3.2 mL•kg-1•min-1; ±1.9 mL•kg-1•min-1) and interventions of longer duration (3.0 mL•kg-1•min-1; ±1.9 mL•kg-1•min-1), and a small lesser effect for typically longer HIT repetitions (-1.8 mL•kg-1•min-1; ±2.7 mL•kg-1•min-1). The modifying effects of age (0.8 mL•kg-1•min-1; ±2.1 mL•kg-1•min-1) and work:rest ratio (0.5 mL•kg-1•min-1; ±1.6 mL•kg-1•min-1) were unclear. When compared to endurance training, there was a possibly small beneficial effect for HIT (1.2 mL•kg-1•min-1; ±0.9 mL•kg-1•min-1) with small additional improvements for typically longer HIT repetitions (2.2 mL•kg-1•min-1; ±2.1 mL•kg-1•min-1), older subjects (1.8 mL•kg-1•min-1; ±1.7 mL•kg-1•min-1), interventions of longer duration (1.7 mL•kg-1•min-1; ±1.7 mL•kg-1•min-1), greater work:rest ratio (1.6 mL•kg-1•min-1; ±1.5 mL•kg-1•min-1) and lower baseline fitness (0.8 mL•kg-1•min-1; ±1.3 mL•kg-1•min-1). Conclusion Endurance training and HIT both elicit large improvements in the VO2max of healthy, young to middle-aged adults with the gains in VO2max being greater following HIT, when compared to endurance training

Teeside University's Research Repository

Table 1. Summary of characteristics of all studies meeting the inclusion criteria Study  Population, age (y), No. of subjects, groups (n), Duration (weeks) Total sessions Group Exercise intensity No. of reps Total reps Reps duration (s) Work/rest ratio Δ VO2max (%) Outcomes and results  Start End      Astorino et al. [26] Recreational active men (n=16) and women (n=13), age: 25.3±4.5 y,  HIT (n=20), CON (n=9) 3 weeks 6 HIT All-out 4 6 30 30 0.10 6.1 HIT ↑ VO2max , oxygen pulse and power output NC in resting BP, HR and force production Nybo et al. [27] Untrained inactive men (n=36), age:20-43  y, HIT (n=8), END (n=9), CON (n=11), STR (n=8) 12 weeks 36 HIT 95-100 % HRmax 5 5 180 120 2.0 14.0 HIT was less efficient than END for resting HR, fat percentage and ratio between total and HDL cholesterol. END ↓ body mass and fat percentage NC in total bone mass and lean body mass in HIT and END groups. 36 END 80% HRmax - - - 3,600 - 7.4 Osei-Tuta et al. [28] Healthy  Caucasian sedentary men and women (n=40), age:20-40 y, END (n=15), CON (n=10) 8 weeks 40 END 60-79 HRmax - - - 1,800 - 7.2 VO2max ↑ in END. END ↓ fat percentage (-6.7%), tension and total mood disturbance. Trapp et al. [11] Healthy nonsmoking, inactive women (n=45), age: 18-30 y, HIT (n=15), END (n=15), CON (n=15) 15 weeks 45 HIT 95-100% HRmax 60 60 2 700 8 0.67 26.4 HIT and END ↑ VO2max compared to CON group; only HIT ↓ total body mass, fat mass, trunk fat and insulin level. NC in adiponectin levels in HIT and END groups 45 END 75% HRmax - - - 1,200 – 2,400 - 19.4 Gormley et al. [29] Healthy young men and women (n=61), age: 18-44 y, HIT (n=13), END (n=13), CON (n=14) 6 weeks 18 HIT 100% HRR 5 5 90 300 1 20.2 HIT and END ↑ VO2max;  NC in resting HR and BP in any group 24 END 75% HRR - - - 2,400 - 9.6 Ciolac et al. [30] Healthy young college women (n=44), age: 20-30 y, HIT (n=16), END (n=16), CON (n=12) 16 weeks 48 HIT 80-90%VO2max 14 14 672 60 0.5 15.7 HIT and CON were equally ↓ ambulatory blood pressure and ↓↓ insulin;  48 END 60-70% VO2max - - - 2,400 - 8.0 Study  Population, age (y), No. of subjects, groups (n), Duration (weeks) Total sessions Group Exercise intensity No. of reps Total reps Reps duration (s) Work/rest ratio Δ VO2max (%) Outcomes and results  Start End      Bayati et al. [31] Young active males (n=16), age: 25.0±0.8 y, HIT (n=8), CON (n=8) 4 weeks 12 HIT 125% Pmax 6 10 96 30 0.25 9.7 HIT ↑ power at VO2max (+16.1%) and peak power output (+7.4%); blood lactate recovery ↑ in HIT compared to CON NC in mean power output Metcalfe et al. [32] Healthy sedentary young men and women (n=29), age; 22.5±2.0 y, HIT (n=15), CON (n=14) 6 weeks 18 HIT All-out 1 2 35 10 - 20 - 13.4 HIT ↑insulin sensitivity  by 28% in men Ziemann et al. [33] Recreationally active men (n=21), age: 21.3±1.0 y, HIT  (n=10), CON (n=11) 6 weeks 18 HIT 80% pVO2max 6 6 108 90  0.5 11.0 HIT  ↑ anaerobic threshold (3.8  mL·kg-1·min-1), work output (12.5 J·kg-1), glycolytic work (11.5 J·kg-1), mean power (0.3 W·kg-1), peak power (0.4 W·kg-1), and max power (0.4 W·kg-1); Ben Abderrahman et al. [34] Male physical education students (n=15), age: 20.6±0.7 y, HIT (n=9), CON (n=6) 7 weeks 21 HIT 105-110% MAS 8 10 66 30 1 5.9 NC in time spent above 95% of VO2max in absolute and relative values Burgomaster et al.  [35] Healthy young men (n=10) and women (n=10), age:23.56±1.0 y, HIT (n=10), END (n=10) 6 weeks 18 HIT All-out 4 6 30 30 0.11 7.3 HIT and END ↑ in mitochondrial markers for skeletal muscle and lipid oxidation; both groups ↑ VO2max compared to control group without changes between training groups NC in percentage of body fat and energy intake in all groups 30 END 65% VO2peak - - - 2,400 -3,600  9.8 Chtara et al. [36] Male physical education students (n=48), age: 21.4±1.3 y, HIT (n=10), CON (n=9)  12 weeks 24 END 100% vVO2max 5 5 120 - - 9.8 HIT ↑ in  vVO2max 10.38%  Hottenrott  et al. [6] Recreational endurance men(n=15) and women (n=15), age: 43.4±6.9 y, HIT (n=14), END (n=16)  12 weeks 36 HIT All-out 4 10 936 30 0.33 18.5 HIT and END ↑↑ peak oxygen uptake, resting HR, VLT and visceral fat, body mass; END ↑ total body fat and fat free mass compared to HIT. NC in maximal lactate for both groups    24 END 75-85% VLT - - - 1,800 – 7,200 - 7.0 Study  Population, age (y), No. of subjects, groups (n), Duration (weeks) Total sessions Group Exercise intensity No. of reps Total reps Reps duration (s) Work/rest ratio Δ VO2max (%) Outcomes and results  Start End      Lo et al. [37] Healthy nonathletic men (n=34), age: 20.4±1.36 y, HIT (n=10), STR (n=10), CON (n=14)  24 weeks 72 END 75-85% HRR - - - 1,800 - 20.5 END and STR ↑ VO2max and lower body strength; STR ↑ upper body strength, lean mass and body size of arm and calf compared to END and CON groups. McKay et al. [38] Young adult men (n=12), age:25.0±4.0 y, HIT (n=6), END (n=6)  3 weeks 8 HIT 120% WRmax 8 12 60 60 1 4.3 HIT and END ↑ VO2max after training programme; HIT and END ↓ time constant for VO2 response by  ~20% after only 2 days of training and by  ~40% post-training, with no difference between groups; 8 END 65% VO2max - - - 5,400 – 7,200 - 7 Tabata et al. [39] Young male students (n=14), age: 23.0±1.0 y, HIT (n=7), END (n=7) 6 weeks 30 HIT 170% VO2max 7 8 225 20 2 14.6 END did not increase anaerobic capacity but ↑↑ in VO2max; HIT ↑↑ VO2max  by 7 mL·kg-1·min-1 and anaerobic capacity by 28%.   30 END 70% VO2max - - - 3,600 - 9.4 Cocks et al. [40] Young sedentary men (n=16), age: 21.0±0.7 y, HIT (n=8), END (n=8) 6 weeks 18 HIT All-out 4 5 85 30 0.11 7.6 HIT and END ↑ VO2peak and maximal power output (END 16%, HIT 9%); both groups  ↓ in HRR, mean and diastolic BP with no difference between group; NC in systolic BP in both groups 30 END 65% VO2peak - - - 2,400 – 3,600 - 15.6 Dunham and Harms [41] Physically active, healthy, untrained subjects (n=15), age: 21.3±2.3 y, HIT (n=8), END (n=7) 4 weeks 12 HIT 90% VO2max 5 5 60 60 0.33 9.6 HIT and END ↑ VO2max and time trials following training with no differences between groups; HIT ↑ in maximum inspiratory pressure compared to END; NC in expiratory flow rates in both groups 12 END 60-70% VO2max - - - 2,700 - 5.5 Edge et al. [42] Recreationally female students (n=16), age: 20.0±1.0 y, HIT (n=8), END (n=8) 5 weeks 15 HIT 120–140% LT 2 10 100 120 2 14.0 HIT and END ↑ in VO2peak and the LT (7–10%), with no significant differences between groups;  NC in percentage of VO2peak at which LT occurred 15 END 80-95% LT - - - - - 14 Study  Population, age (y), No. of subjects, groups (n), Duration (weeks) Total sessions Group Exercise intensity No. of reps Total reps Reps duration (s) Work/rest ratio Δ VO2max (%) Outcomes and results  Start End      Esfarjani and Laursen [43] Healthy recreational men (n=17), age: 20.0±2.0 y, HIT1 (n=6), HIT2 (n=6), END (n=5)       10 weeks 20 HIT 75% vVO2max 5 8 130 200 1 9.2 HIT1↑ in VO2max, vVO2max (+6.4%), Tmax (5%) and VLT (+11.7%); HIT2 ↑ in VO2max, vVO2max (+7.8%), Tmax (32%), and VLT (+11.7%) but not VLT; NC in these variables were found in END. HIT1↑ in VO2max and Tmax compared to END. 20 HIT 130% vVO2max 7 12 190 30 0.11 6.2 40 END 75% vVO2max - - - 3,600 - 2.1 Macpherson et al. [44] Healthy young recreationally active men (n = 12) and women (n = 8), age: 24.0±3.0 y, HIT (n=6), END (n=5) 6 weeks 18 HIT All-out 4 6 90 30 0.11 11.5 HIT and END ↑ body composition, 2000-  run time trial performance and VO2max; Fat mass ↓ by 12.4% with HIT and 5.8% with END; Lean mass ↑ 1% in both groups. None of these improvements differed between groups 18 END 65% VO2max - - - 1,800 – 3,600 - 12.5 Shepherd et al. [45] Healthy sedentary men (n=16), age: 21.5±1.0 y, HIT (n=8), END (n=8) 6 weeks 18 HIT All-out 4 6 90 30 0.11 7.6 HIT and END ↑↑ VO2peak, fat free mass, and maximum workload;  NC in relative fat mass. 30 END 65% VO2peak - - - 2,400 – 3,600 - 15.6 Helgerud et al. [5] Healthy nonsmoking men (n=24), age: 24.6±3.8 y, HIT1 (n=6), HIT2 (n=6), END1 (n=6), END2 (n=6)      8 weeks 24 HIT1 90–95% HRmax 47 47 1128 15 1 6.4 HIT1 and HIT 2 ↑↑ VO2max compared to END1 and END 2; percentage increases in VO2max for the HIT1 and HIT 2 groups were 5.5 and 7.2%, respectively. Stroke volume of the heart ↑ in HIT1 and HIT2;  NC in blood volume, high-density lipoprotein and low-density lipoprotein in any groups after training programme 24 HIT2 90–95% HRmax 4 4 96 240 1.33 8.8 24 END1 70% HRmax - - - 2,700 - 1.8 Study  Population, age (y), No. of subjects, groups (n), Duration (weeks) Total sessions Group Exercise intensity No. of reps Total reps Reps duration (s) Work/rest ratio Δ VO2max (%) Outcomes and results  Start End           24 END2 85% HRmax - - - 1,455 - 2.0  Warburton et al. [46]  Healthy untrained men (n=20), age:30±4 y, HIT (n=6), END (n=6), CON (n=8)   12 weeks 36 HIT 90% VO2max 8 12 384 120 1 22.2 HIT and END ↑↑ VO2max and peak stroke volume, blood volume compared to CON; no differences between HIT and END in any parameters;  36 END 65% VO2max - - - 1,800 – 2,880 - 23 Berger et al. [47] Healthy sedentary men (n=11) and women (n=12), age:24±5 y, HIT (n=8), END (n=8), CON (n=7) 6 weeks 22 HIT  90% VO2max 15 20 445 60 1 21.0 HIT and END ↑↑ VO2max and pulmonary VO2max kinetics, compared to CON 22 END 60% VO2max - - - 1,800 - 20.0 Matsuo et al. [48] Sedentary men (n=42), age:26.5±6.2 y,  HIT (n=14), END (n=14) 8 weeks 40 HIT 80-85 % VO2max 3 3 120 180 1.5 22.5 HIT and END ↑↑ VO2max, HIT ↑↑ VO2max compared to END; only HIT ↑↑left ventricular mass, stroke volume and resting HR; 40 END 60-65% VO2max - - - 2,400 - 10.0 O'Donovan et al. [49] Sedentary men (n=42), age:41±4 HIT (n=13), END (n=14), CON (n=15) 24 weeks 72 HIT 80% VO2max - - - - - 15.7 HIT and END ↑↑ VO2max, HIT ↑HDL and ↓ LDL, NC in END for HDL and LDL 72 END 60% VO2max - - - - - 22.5 Sandvei et al. [50] Healthy young men (n=8) and women (n=15), age:25.2±0.7 y, HIT (n=11), END (n=12) 8 weeks 24 HIT 100% HRmax 5 10 189 30 0.16 5.3 HIT and END ↑ VO2max, HIT ↑insulin sensitivity and holesterol profil while NC for END  24 END 70-80% HRmax - - - 1,800 – 3,600 - 3.8  HIT- High-intensity interval training; END – continuous endurance training; STR – strength training CON – control group; VO2max – maximal oxygen uptake; vVO2max- running speed at VO2max; VO2peak - peak rate of oxygen consumption; rep – repetitions; HDL - high-density lipoprotein; max – maximal; Tmax – time to exhaustion at vVO2max; BP – blood pressure; HR- heart rate; HRmax – maximum heart rate; HRR – heart rate reserve; MAS – maximal aerobic speed; WRmax – work rate at maximal O2 uptake; pVO2max - maximal aerobic power; Pmax- power at VO2max LT- lactate threshold; VLT – velocity of the lactate threshold; NC – no changes p>0.05;  ↑- indicates significant increase p<0.05; ↑↑-indicates significant increase p<0.01;  ↓- indicates significant decreases p<0.05; ↓↓- indicates significant decreases p<0.01;  

Effectiveness of High-Intensity Interval Training (HIT) and Continuous Endurance Training for VO2max improvements: A Systematic review and Meta-Analysis of controlled trials

Teesside University Research

 Table 2. Effects of endurance training on VO2max. 
 
Effect on VO2max 
(mL•kg-1•min-1) 
Inference  Mean ±95%CL 
Main effect    
Endurance training vs control 4.9 ±1.4 Possibly large  
Modifying effectsa    
Age lower by 13.7 years 2.4 ±2.1 Possibly moderate  
Intervention duration longer by 13 weeks 2.2 ±3.0 Possibly moderate  
Baseline VO2max lower by 12.6mL•kg-1•min-1 1.4 ±2.0 Possibly small  
a modifying effects are presented as the effect of two standard deviations of the numerical 
covariates (i.e. a typically high value minus a typically low value) 
VO2max: maximal oxygen uptake. 
CL: confidence limits. 
: increase. 
 
 


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Effectiveness of High-Intensity Interval Training (HIT) and Continuous Endurance Training for VO2max improvements: A Systematic review and Meta-Analysis of controlled trials

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