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MICT or HIIT ± RT Programs for Altering Body Composition in Postmenopausal Women


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Purpose: To compare body composition changes induced by moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), or HIIT + resistance training (RT) programs (3 days/week, 12 weeks) in postmenopausal women with overweight/obesity, and to determine whether fat mass reduction is related to greater fat oxidation (FatOx). Methods: Participants (n=27) were randomized in three groups: MICT (40min at 55-60% of peak power output, PPO), HIIT (60 x 8s at 80-90% of peak heart rate, 12s active recovery), and HIIT + RT (HIIT + 8 whole-body exercises: 1 set of 8-12 repetitions). DXA was used to measure whole-body and abdominal/visceral fat mass (FM) and fat-free mass (FFM). FatOx was determined at rest, during a moderate-intensity exercise (40min at 50% of PPO), and for 20 minutes post-exercise, before and after training. Results: Overall, energy intake and physical activity levels did not vary from the beginning to the end of the intervention. Body weight and total FM decreased in all groups over time, but significant abdominal/visceral FM losses were observed only in HIIT and HIIT + RT groups. When expressed in percentage, total FM, FFM, and muscle mass were significantly modified only by HIIT + RT training. FatOx did not change at rest, but increased similarly in the three groups during and after exercise. Therefore, the HIIT-induced greater FM loss was not related to higher FatOx during or after exercise. Conclusions: MICT or HIIT ± RT could be proposed to non-dieting postmenopausal women with overweight/obesity to decrease weight and whole-body FM. The HIIT programs were more effective than MICT in reducing abdominal/visceral FM. RT addition did not potentiate this effect, but increased the percentage of muscle mass.
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MICT or HIIT ± RT Programs for Altering Body
Composition in Postmenopausal Women
Laboratory of Metabolic Adaptations during Exercise in Pathologic and Physiologic Conditions (AME2P), Université Clermont
Auvergne, EA 3533, Clermont-Ferrand, FRANCE;
Center of Resources, Expertise and Performance in Sports (CREPS),
Bellerive-sur-Allier, FRANCE;
Department of Cardiology, Vichy Hospital, Vichy, FRANCE;
Clermont-Ferrand University
Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, FRANCE;
Department of Sport Medicine and Functional Explorations,
Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, FRANCE;
(CNRH-AURA), Clermont-Ferrand, FRANCE;
UFR Medicine, Université Clermont Auvergne, Clermont-Ferrand, FRANCE;
INRA, Human Nutrition Unit UMR1019, Clermont-Ferrand, FRANCE
MICT or HIIT ± RT Programs for Altering Body Composition in Postmenopausal Women. Med. Sci. Sports Exerc., Vol. 52, No. 3,
pp. 0000, 2020. Purpose: This study aimed to compare body composition changes induced by moderate-intensity continuous training
(MICT), high-intensity interval training (HIIT), or HIIT + resistance training (RT) programs (3 d·wk
, 12 wk) in postmenopausal women
who are overweight/obese, and to determine whether fat mass reduction is related to greater fat oxidation (FatOx). Methods: Participants
(n= 27) were randomized in three groups: MICT (40 min at 55%60% of peak power output), HIIT (60 8 s at 80%90% of peak HR,
12 s active recovery), and HIIT + RT (HIIT +8 whole-body exercises: 1 set of 812 repetitions). Dual-energy x-ray absorptiometry was used
to measure whole-body and abdominal/visceral fat mass (FM) and fat-free mass. FatOx was determined at rest, during a moderate-intensity
exercise (40 min at 50% of peak power output), and for 20 min postexercise, before and after training. Results: Overall, energy intake and
physical activity levels did not vary from the beginning to the end of the intervention. Body weight and total FM decreased in all groups over
time, but significant abdominal/visceral FM losses were observed only in HIIT and HIIT + RT groups. When expressed in percentage, total
FM, fat-free mass, and muscle mass were significantly modified only by HIIT + RT training. FatOx did not change at rest but increased
similarly in the three groups during and after exercise. Therefore, the HIIT-induced greater FM loss was not related to higher FatOx during
or after exercise. Conclusions: MICT or HIIT ± RT could be proposed to nondieting postmenopausal women who are overweight/obese to
decrease weight and whole-body FM. The HIIT programs were more effective than MICT in reducing abdominal/visceral FM. RT addition
did not potentiate this effect but increased the percentage of muscle mass. Key Words: MENOPAUSE, (INTRA)-ABDOMINAL FAT
In women, the incidence of obesity, type 2 diabetes, and
cardiovascular diseases (CVD) significantly increases af-
ter menopause and is related to an increase of fat mass
(FM) (13), loss of fat-free mass (FFM) (especially muscle
mass) (3), and body fat distribution alterations (1,4). The
increase of subcutaneous and particularly intra-abdominal
FM (i.e., visceral FM) after menopause partly explains the
higher CVD risk in postmenopausal women (5).
Menopause is associated with a decrease of the resting met-
abolic rate (RMR) (6) and fat oxidation (FatOx) during phys-
ical activity (7,8) and a lower total energy expenditure (EE)
(8,9). Although literature data show that the diet and physical
activity combination promotes longer-term weight and/or FM
loss, exercise alone also might have positive effects, particu-
larly on subcutaneous and intra-abdominal FM (10), if the
training program is well supervised and if the EE leads to a
negative energy balance (11).
The American College of Sports Medicine has recommended
moderate-intensity continuous training (MICT) in obese patients
for losing weight and/or FM (11). This strategy is efficient in
pre- and postmenopausal women who are overweight or obese
(12,13). Currently, high-intensity interval training (HIIT), which
includes repeated bouts of high-intensity effort followed by
varied recovery times (14), is considered a time-efficient and
safe strategy to reduce total FM and particularly subcutaneous
and intra-abdominal FM in people who are overweight or
Address for correspondence: Nathalie Boisseau, Ph.D., Laboratoire des
Adaptations Métaboliques à lExercice en conditions Physiologiques et
Pathologiques (AME2P), 3 rue de la Chebarde, 63171, Aubière Cedex,
France; E-mail:
Submitted for publication June 2019.
Accepted for publication September 2019.
Supplemental digital content is available for this article. Direct URL citations
appear in the printed text and are provided in the HTML and PDF versions
of this article on the journals Web site (
Copyright © 2019 by the American College of Sports Medicine
DOI: 10.1249/MSS.0000000000002162
Copyright © 2019 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
Copyedited by: Mary Grace Trillana
obese (15). Our group demonstrated that in postmenopausal
nondieting women with type 2 diabetes, HIIT is more effective
for reducing central obesity than MICT and can be proposed as
an alternative exercise program in this population (16). Resis-
tance training (RT) does not enhance weight loss but may
increase FFM and decrease FM, and it is associated with
health risk reduction (11). Although several previous publica-
tions have focused on RT or MICT + RT effects on body com-
position (17,18), only few randomized trials compared the
effect of a combined HIIT + RT program in overweight/obese
adults (19,20), and no study has been performed on postmen-
opausal women. The effects of HIIT ± RT programs on FM
losses may be partly due to the increase of RMR, total EE,
and FatOx (21). No study has thoroughly evaluated the effect
of HIIT or HIIT + RT on these parameters in postmenopausal
women, but limited posttraining muscle mass gain in the female
population could alter these adaptations (22).
Therefore, the aim of this study was to compare the effects
of 12-wk MICT, HIIT, and HIIT + RT programs on body
composition and FatOx in postmenopausal women who were
overweight or obese (see Figure, Supplemental Digital Con-
tent, 12-wk MICT, HIIT, and HIIT + RT programs on body
composition and FatOx in postmenopausal women with
overweight/obesity, We
hypothesized that compared with the traditional MICT, HIIT
programs could be more efficient in reducing whole-body
and abdominal/visceral FM and to favor FatOx, and that
HIIT + RT, by also improving FFM and RMR, could offer
the best benefits.
The study was approved by the relevant ethics committee
(Comité de Protection des Personnes Sud Est VI, CPPAU1303)
and was registered on via the Protocol Reg-
istration System (ClinicalTrials.Gov: NCT 03357016). After
receiving detailed information on the study objectives and
protocol, all participants signed a written informed consent.
Thirty-five women (mean age, 62.4 ± 6.7 yr) were recruited
according to the following inclusion criteria: postmenopausal
women, body mass index (BMI) >25 and 40 kg·m
, and
stable eating habits and physical activity for at least 3 months.
Noninclusion criteria were as follows: medical contraindica-
tions to intense physical activity, painful joints, and taking hor-
mone replacement therapy. Finally, 30 postmenopausal women
who were overweight or obese were selected for the three
12-wk interventional programs ( F1Fig. 1). None of the participants
had history of chronic arterial or respiratory disease, CVD, or en-
docrine disorders. All participants reported low levels of physical
activity, based on the Global Physical Activity Questionnaire
(GPAQ) results (23). Upon recruitment, participants were
randomly assigned to an exercise modality (HIIT [n= 10],
MICT [n= 10], HIIT + RT [n= 10]). A familiarization period
of at least 10 d allowed participants to get accustomed to the
exercise equipment before training.
Experimental design
Anthropometric and body composition measure-
ments. Body weight was measured to the nearest 0.1 kg on
a Seca 709 scale (Balance Seca 709, France) in fasting condi-
tions, with the subjects wearing only underwear. Height was
measured to the nearest 0.5 cm with a wall-mounted stadiometer.
BMI was calculated as body weight (kg) divided by the square
of height (m
). Waist circumference (cm) was measured midway
between the last rib and the upper iliac crest, and hip circumfer-
ence was measured at the level of the femoral trochanters. Both
measures were taken in standing position with a measuring tape.
Sagittal abdominal diameter (supine abdominal height) was
measured with a HoltainKahn abdominal caliper (Holtain
Limited, Crymych, Pembs, UK) to the nearest millimeters in
the sagittal plane at the level of the iliac crests (L4L5) during
normal expiration, with the subject lying supine on a firm bench
with knees bent. Abdominal skinfold thickness was measured
at four different sites (at 15 and 7 cm to the right and left of
the navel) with a Harpenden Skinfold Caliper (Mediflex Corp.,
FIGURE 1Flowchart of participantsrecruitmentAQ2 .
http://www.acsm-msse.org2Official Journal of the American College of Sports Medicine
Copyright © 2019 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
Long Island, NY), and the mean subcutaneous abdominal
skinfold thickness was then calculated (16). The same experi-
enced investigator took all anthropometric measurements at
baseline and after 12 wk of training.
Adipose and FFM tissue localization. Total body and
regional FM as well as FFM (expressed as kg and percent of
body mass) were measured with a dual-energy x-ray absorptiom-
etry (DXA) scanner (QDR-4500A; Hologic, Inc., Marlborough,
MA). Two regions of interest were manually isolated and
analyzed by an experienced technician: the area from L1
to L2 to the pubic rami to determine the total abdominal FM
(kg) and the area from the iliac crest to the feet to calculate
the lower-body FM (kg). The same operator performed all
analyses. Total visceral FM (kg) was estimated from the total
abdominal FM on DXA, mean subcutaneous abdominal skinfold
thickness, and abdominal height, as previously described (16).
Preliminary visitmaximal exercise testing. V
was measured during a graded exhaustive exercise test on a
cycle ergometer (Ergoline, Bitz, Germany). After a 3-min
warm-up at 30 W, power output was increased by 10 W·min
until the participants exhaustion (the test lasted between 10
and 15 min after warm-up). Participants werestrongly encour-
aged by the experimenters throughout the test to perform a
maximal effort. Respiratory gases (V
and V
measured breath by breath through a mask connected to O
and CO
analyzers (Oxycon pro-Delta; Jaeger, Hoechberg,
Germany). V
was determined as the highest oxygen
uptake during a 15-s period. Ventilatory parameters were
averaged every 30 s. Heart activity was monitored by ECG
throughout the test, and HR was recorded continuously. The
achievements of V
criteria were as follows: 1) oxygen
uptake reaching a plateau with increasing work rate, 2) RER
values higher than 1.1, and 3) peak HR (PHR) within 10% of
the age-predicted maximal values (24). The peak power output
(PPO), expressed in watts or Wkg
, was considered the
highest power measured at V
Training Programs
We made the choice to have similar EE between MICT and
HIIT sessions and to have the same session duration between
MICT and HIIT + RT because lackof time is a barrier to exer-
cise for people who are overweight or obese. Thus, before the
beginning of the training programs, the EE induced by an HIIT
session (20 min duration) was measured in four subjects
using a Metamax 3B apparatus (Matsport, France), and the
time needed to spend the same energy was calculated during
the MICT session. The mean EE spent for each HIIT or MICT
session was 180 ± 22 kcal, and the time required for an MICT
session was established to 40 min. Therefore, each HIIT + RT
session lasted 40 min (20 min of HIIT and 20 min of RT).
Participants performed three exercise sessions per week for
12 wk (total = 36 sessions). Sessions were generally in the
morning on Monday, Wednesday, and Friday, to allow a suf-
ficient recovery period, and were supervised by an experi-
enced physical activity instructor. Each session included
also 5-min warm-up and 2-min cooldown periods, in addition
to the formal training.
MICT. The MICT session consisted of 40 min at 55%60%
of the participants PPO performed continuously on a C-Max
Club Fitness bike. During the first 6 wk, the intensity was
set at 55% of the PPO and was increased to 60% for the last
6 wk to take into account the participantsaerobic fitness
improvement. Each participants resistance, pedal cadence
(5070 rpm), and power (W) were controlled to reach the
expected intensity.
HIIT. The HIIT training program was based on the protocol
by Maillard et al. (16), an attractive and feasible cycling
program for postmenopausal women who are overweight
or obese. The HIIT protocol consisted of repeated cycles
of sprinting/speeding for 8 s followed by slow pedaling
(2030 rpm) for 12 s on a WattBike pro Concept2 (with a
freewheel and a double air and magnetic braking system).
Resistance was very low to facilitate acceleration and limit
bicyclewheel inertia. Resistance was controlled to reach
~80% of each participants PHR during the 20-min session.
All participants could complete the full 20-min exercise
program at this intensity after two or three sessions. HR was
continuously monitored (A300, Polar, Finland) to control the
intensity. Overall, the mean intensity during an HIIT session
corresponded to 85% ± 4% of PHR.
HIIT + RT. HIIT was always performed before RT to nor-
malize the concurrent training effects (25). The HIIT session
was the same as for the HIIT alone group. The upper- and
lower-body muscular strength was measured using the one-
repetition maximum (1RM) method with bench press and
leg press exercises on UniversalTM weight machines, as
previously described (26). Briefly, a warm-up of 510 rep-
etitions at 40%60% of the perceived maximum was per-
formed, followed by 35 repetitions at 60%80% of the
perceived maximum. Three to four subsequent attempts were
then made to determine the 1RM for each exercise. Rest
periods (35 min) were introduced between lifts to ensure
optimal recovery.
The RT program included two different training circuits
with 10 exercises/each and was based on the program by Marx
et al. (27). Circuit 1 included leg press, bench press, knee ex-
tension, cable row, dumbbell calf raise, elbow flexion, abdom-
inal muscle, triceps exercises with upper pulley, plank, and
bum exercises. Circuit 2 included knees extension, pullover,
leg press, side raise with dumbbells, dumbbell calf raise, tri-
ceps exercises with upper pulley, hip thrust, chin rowing,
and plank to upright row. Participants performed a single-set
circuit, with a load of 812 repetitions at around 80% of
1RM, with 1- to 1.5-min rest period between exercises. The
workouts were individually supervised by the same certified
personal trainer. When participants achieved more than 12RM,
the load was adjusted to remain in the planned intensity zone.
Participant alternated between circuits every 3 wk to minimize
boredom and to create some variation in the exercise choice.
RMR and substrate oxidation. Subjects arrived at the
laboratory at 7:30 AM after overnight fast (12 h). Participants
PHYSICAL ACTIVITY, BODY COMPOSITION, AND WOMEN Medicine & Science in Sports & Exercise
Copyright © 2019 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
were asked to eat a similar dinner for the pre- and posttraining
session the evening before and to avoid any kind of strenuous
exercise the day before. The experiment was conducted in a
ventilated room at a temperature of 19°C20°C. RMR and
substrate oxidation were determined from respiratory gases
using a Metamax 3B apparatus (Matsport, France). Carbohy-
drate oxidation and FatOx were measured at rest, during mod-
erate-intensity prolonged exercise, and during the recovery
period. Exercise consisted in 40 min of cycling at 55% of their
PPO determined before and after training on a cycle ergometer
(Ergoline, Bitz, Germany). Cadence was maintained between
60 and 70 rpm. HR was continuously monitored (A300, Polar,
Finland). Resting gas exchange data were recorded for 10 min,
with the subject sitting on the bicycle. The last 2 min of gas
exchange data from each stage were averaged to calculate
and V
that were then used to determine the RER
(RER = V
). Recording was continued during the
recovery period for 20 min.
RMR assessment was considered valid in the presence of a
minimum of 10 min of steady state with less than 10% of fluc-
tuations in oxygen consumption (V
). RMR (kcal·d
calculated using the Weir equation (28), and substrate oxida-
tion (g·min
) was calculated using the Fraynsequations
(29), as follows:
RMR ¼3:941 V
þ1:1106 V
carbohydrate CHOðÞoxidation ¼4:55 V
3:21 V
FatOx ¼1:67 ̇
1:67 ̇
Physical activity and dietary assessments. Partici-
pants were asked to maintain their normal levels of physical
activity during the 12-wk study period. Their usual weekly
level of physical activity was determined at baseline and after
12 wk using the French version of the GPAQ (23). They were
also asked to maintain their normal eating habits for the study
period. At baseline and at week 12 of training, each participant
filled in a 7-d food intake diary that was evaluated by a dieti-
cian using a nutrition analysis software program (Nutrilog®,
Marans, France).
Biochemical assays. Blood samples were taken the
week before starting the training (preintervention) and then
24 d after thelast exercise session (postintervention), depend-
ing on the participantsavailability and to avoid any potential
effect of the last exercise session on the results. After overnight
fasting, a cannula was inserted in the antecubital vein, and
whole blood was collected in EDTA- and fluoride-containing
vacutainers tubes. The plasma concentration of total cholesterol
(TC), HDL cholesterol (HDL-C), and triglycerides (TG) was
immediately measured, using a Synchron Clinical System
UniCel DxC analyzer (Beckman Coulter, Brea, CA) and a
cholesterol oxidase method for TC (CHOL reagent), a direct
homogeneous method for HDL-C (HDLD reagent), and a
lipase/glycerol kinase method for TG (GPO reagent). The
LDL cholesterol (LDL-C) fraction was indirectly quantified
using the equation described by Friedewaldet al. (30). Plasma
glucose concentration was immediately determined using the
hexokinase method (UniCel DxC analyzer, Synchron). Plasma
insulin concentration was measured by enzyme-linked immu-
nosorbent assay from Sigma-Aldrich Insulin Elisa kit (Paris,
France). HbA1c values were evaluated with a high-performance
liquid chromatography (HPLC) Variant II analyzer equipped
with the new 2702101 NU Kit (Bio-RadLaboratories,
Hercules, CA).
The HOMA-IR index was calculated using the following
formula: HOMA-IR = [Fasting glucose (mmol·L
insulin (μU·mL
Statistical analyses. Before the study start, the sample
size required for a statistical power of 80% was calculated
based on previous results on FM loss after HIIT training in
women (31). On the basis of a two-sided type I error of 5%,
a minimum difference of 1.5 ± 0.88 kg, as described by
Tremblay et al. (32), for FM loss could be detected with seven
women per group. Our samplewas increased to 10 women per
group at the beginning of the intervention to take into account
participants lost to follow-up.
All statistical analyses were carried out with the STATISTICA
version 12.00 software (StatSoft Inc., Tulsa, OK). Data are
presented as the mean ± SD. The data normal distribution
was tested using the KolmogorovSmirnov test, and the ho-
mogeneity of variance was tested with the F-test. Data were
log-transformed, when appropriate, before statistical analyses.
Two-way repeated-measures ANOVA was used to determine
group and time effects and grouptime interactions. When a
significant effect was found, post hoc multiple comparisons
were performed using the NewmanKeuls test. The effect size
was reported when significant main or interaction effects were
detected. The effect size was assessed using the partial eta-squared
) and ranked as follows: 0.01 = small effect, 0.06 = mod-
erate effect, 0.14 = large effect (33). Baseline values and
changes between the baseline and the study end (delta change:
[12 wkbaseline/baseline] 100) were also compared among
groups, using one-way ANOVA. Differences with a Pvalue
0.05 were considered statistically significant.
Participantscharacteristics. Of the 30 postmenopausal
females randomized in the three training groups (n= 10/group),
27 were retained for the analysis (n= 3 left the study for differ-
ent reasons listed in Fig. 1). At baseline, the mean age was not
significantly different among groups (MICT, 67.1 ± 7.2 yr;
HIIT, 59.9 ± 5.9 yr; HIIT + RT, 61.1 ± 5.4 yr) as well as total
body weight (MICT, 80.4 ± 7.1 kg; HIIT, 81.6 ± 12.7 kg;
HIIT + RT, 75.6 ± 8.9 kg) and total FM (MICT, 30.6 ± 5.3 kg;
HIIT, 27.6 ± 10.7 kg; HIIT + RT, 28.1 ± 5.8 kg) ( T1Table 1).
The participantscompliance with the training program was
97% ± 1%. No adverse event was reported during testing or
training in any group.
http://www.acsm-msse.org4Official Journal of the American College of Sports Medicine
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Habitual energy intake and EE. Physical activity levels
(GPAQ scores) were comparable between pre- and posttraining
in all groups. For all participants, the daily energy intake and the
percentage of energy contribution from macronutrients did not
significantly change during the intervention period. No signifi-
cant dietary intake difference was observed in the three groups
at baseline and after 3 months (mean values, 1563 kcal ±276
preintervention vs 1557 kcal ±255 postintervention).
Aerobic fitness. V
) and PPO (watts
or Wkg
) were not different in the three groups at baseline
(Table 1). Overall, aerobic fitness (V
and PPO) signifi-
cantly increased after the 12-wk intervention (time effect,
P< 0.0001, η
= 0.71). A group effect was noted concerning
) and PPO (when expressed in watts,
but not in Wkg
) with lower values in the MICT group than
in the HIIT and HIIT + RT groups (P=0.042,η
Anthropometric measurements and whole-body
composition. Overall, body weight (kg), total FM (kg),
and waist and hip circumferences (cm) were significantly de-
creased after the 12-wk intervention (time effect, P=0.02,
= 0.37, respectively) (Table 1). When the abso-
lute values were expressed in percentage (%), total FM de-
creased and FFM and muscle mass increased only in the
HIIT + RT group (P=0.02,η
= 0.20). The percentage of total
FM loss (kg) was higher (but not significant, P= 0.07) in the
HIIT and HIIT + RT groups than that in the MICT group
(3.06% ± 4.2%, 4.43% ± 3.1%, and 0.05% ± 3.9%, re-
spectively), but with a large size effect (η
=0.19)( F2Fig. 2).
Abdominal and visceral FM. Baseline total abdominal
(kg) and visceral FM (kg) were similar in the three groups.
At the end of the training period, total abdominal FM (kg)
TABLE 1. Anthropometric measurements, body composition, and aerobic fitness in the MICT, HIIT, and HIIT + RT groups at baseline (pre) and at the end (post) of the training programs.
Pre Post Pre Post Pre Post G T G T
BMI (kg·m
) 31.2±3.0 30.9±2.8 31.5±4.3 31.1±4.4 31.4±4.0 31.1±3.7 0.99 0.02 0.98
0.00 0.21 0.00
Waist circumference (cm) 100.8 ± 5.4 99.2 ± 6.0 100.9 ± 9.3 97.1 ± 8.8 101.4 ± 10.0 98.8 ± 10.8 0.91 0.01 0.44
0.00 0.44 0.09
Hip circumference (cm) 109.7 ± 6.6 107.2 ± 7.3 110.1 ± 9.1 107.8 ± 7.6 106.3 ± 9.6 104.3 ± 8.1 0.58 0.001 0.97
0.04 0.44 0.09
Body weight (kg) 80.5 ± 7.1 79.7 ± 7.3 81.6 ± 12.7 80.8 ± 12.9 75.6 ± 8.9 74.9 ± 8.0 0.41 0.02 0.95
0.07 0.21 0.00
Total FM (kg) 30.7 ± 5.3 30.7 ± 5.4 27.7 ± 10.7 27.1 ± 10.6 28.1 ± 1.9 26.8 ± 1.8 0.50 0.002 0.06
0.06 0.34 0.21
Total FM (%) 37.9 ± 4.0 38.3 ± 4.4 33.7 ± 11.6 33.4 ± 11.5 36.9 ± 3.8 35.5 ± 3.8* 0.66 0.02 0.03
0.03 0.20 0.25
Total FFM (kg) 49.8 ± 3.7 49.1 ± 4.0 45.1 ± 15.6 44.9 ± 15.5 47.6 ± 4.2 48.1 ± 3.6 0.41 0.88 0.19
0.07 0.00 0.13
Total FFM (%) 62.1 ± 4.0 61.7 ± 4.4 56.3 ± 19.3 56.7 ± 19.3 64.1 ± 3.8 64.5 ± 3.9* 0.67 0.02 0.03
0.03 0.20 0.25
Muscle mass (kg) 47.7 ± 3.6 47.1 ± 3.9 43.3 ± 14.9 43.1 ± 14.9 45.7 ± 4.0 46.1 ± 3.3 0.44 0.79 0.29
0.07 0.00 0.10
Muscle mass (%) 59.5 ± 3.9 59.2 ± 4.2 54.0 ± 18.5 54.3 ± 18.6 60.7 ± 3.8 62.0 ± 3.9* 0.61 0.02 0.03
0.04 0.19 0.25
Total abdominal FM (kg) 7.6 ± 1.7 7.6 ± 1.7 7.4 ± 1.9 6.9 ± 1.9* 7.2 ± 1.7 6.5 ± 1.7* 0.67 10
0.03 0.73 0.48
Visceral FM (kg) 4.2 ± 1.7 4.4 ± 1.8 4.5 ± 1.1 4.3 ± 1.0 3.1 ± 1.4 2.9 ± 1.4**
*** 0.08 0.48 0.02
0.19 0.02 0.27
) 25.3±2.8 28.5±2.9 30.5±6.9 35.6±6.4 31.5±4.1 35.0±4.1 0.04 10
0.24 0.71 0.11
PPO(W) 85±9 102±12 96±23 122±21 104±13 120±14 0.04 10
0.24 0.71 0.09
PPO (W·kg
) 1.1±0.1 1.3±0.2 1.2±0.4 1.4±0.7 1.4±0.2 1.6±0.2 0.1 10
0.18 0.76 0.10
Values are presented as mean ± SD. Muscle mass = FFM bone mineral content from DXA.
*P0.005 (pre vs post in the same group).
**P0.05 (HIIT + RT vs MICT).
***P0.05 (HIIT + RT vs HIIT).
G, group effect; T, time effect; G T, grouptime interaction; FFM, free-fat mass.
FIGURE 2Body composition AQ2changes (based on dual-energy x-ray
absorptiometry imaging) between the baseline and the end of the 12-wk
training program in the MICT (n= 8), HIIT (n= 10), and HIIT + RT
(n= 9) groups. Data are presented as mean ± SD. delta change
(%) = [(12 wk baseline/baseline) 100]. #P0.01: HIIT + RT vs
MICT group. $P0.01: HIIT vs MICT group.
PHYSICAL ACTIVITY, BODY COMPOSITION, AND WOMEN Medicine & Science in Sports & Exercise
Copyright © 2019 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
was significantly reduced only in the HIIT and HIIT+RT
groups (grouptime interaction; P<0.008,η
(Table 1). When expressed as delta change values, abdominal
and visceral FM changes were reduced only in the HIIT and
HIIT + RT groups and were significantly different from MICT
(Fig. 2). No significant difference was noted after training
between the HIIT and the HIIT + RT groups.
RMR, substrate oxidation, and EE. None of the train-
ing modes altered RMR (kcal·d
) and substrate oxidation at
rest (
T2 Table 2). Overall, all training programs increased FatOx
during moderate-intensity exercise (expressed as percentage
of EE or g·min
) and during the recovery period (time effect,
= 0.47) (F3 Fig. 3). Concomitantly, carbohydrate
oxidation decreased. No group effect was noted. EE (kcal)
during exercise and during recovery did not change between
pre- and postintervention in any group.
Metabolic profile. The lipid profile and glycemic param-
eters at baseline and after the 12-wk intervention are listed in
T3 Table 3. Overall, plasma TG levels decreased after the inter-
vention (time effect, P=0.02,η
= 0.22), without any group
effect or grouptime interaction. Whatever the training mode,
TC, HDL-C, and LDL-C levels did not change. Glycemia,
insulinemia, HbA1c, and HOMA-IR were not modified by
the intervention.
The aim of this study was to compare the body composition
and FatOx changes induced by a 12-wk MICT, HIIT, or
HIIT + RT intervention in postmenopausal women who were
TABLE 2. Substrate utilization and EE at rest, during moderate-intensity continuous exercise (50% of PPO), and during the 20-min recovery time in the MICT,HIIT,andHIIT+RTgroupsat
baseline (pre) and after (post) the training programs.
Pre Post Pre Post Pre Post G T G T
RMR (kcal·d
) 1403 ± 259 1430 ± 259 1615 ± 206 1514 ± 230 1426 ± 317 1392 ± 317 0.23 0.56 0.68
0.11 0.01 0.03
FatOx (g·min
) 0.05 ± 0.02 0.05 ± 0.02 0.06 ± 0.02 0.06 ± 0.02 0.04 ± 0.02 0.05 ± 0.01 0.23 0.47 0.98
0.12 0.02 0.00
FatOx (%) 48.5 ± 17.5 50.3 ± 15.0 48.0 ± 14.5 53.7 ± 12.8 44.2 ± 15.5 48.8 ± 8.5 0.67 0.26 0.90
0.03 0.05 0.00
CHOOx (g·min
) 0.14 ± 0.04 0.14 ± 0.03 0.16 ± 0.05 0.13 ± 0.04 0.16 ± 0.06 0.14 ± 0.05 0.73 0.16 0.95
0.02 0.08 0.05
CHOOx (%) 51.5 ± 17.5 49.7 ± 15.0 52.0 ± 14.5 46.3 ± 12.8 55.9 ± 15.5 51.3 ± 8.5 0.67 0.26 0.90
0.03 0.05 0.00
EE (kcal·min
) 0.97 ± 0.18 0.99 ± 0.17 1.12 ± 0.14 1.05 ± 0.16 0.99 ± 0.22 0.97 ± 0.22 0.23 0.56 0.69
0.11 0.01 0.03
FatOx (g·min
) 0.17 ± 0.03 0.21 ± 0.05 0.16 ± 0.03 0.22 ± 0.06 0.18 ± 0.03 0.22 ± 0.05 0.68 10
0.03 0.48 0.02
FatOx (%) 41.9 ± 5.7 51.8 ± 10.8 39.8 ± 5.5 50.7 ± 11.1 40.6 ± 5.2 53.6 ± 10.9 0.72 10
0.03 0.44 0.01
CHOOx (g·min
) 0.60 ± 0.7 0.52 ± 0.12 0.67 ± 0.18 0.57 ± 0.15 0.72 ± 0.18 0.52 ± 0.17 0.46 0.006 0.46
0.06 0.27 0.06
CHOOx (%) 58.1 ± 5.7 48.2 ± 10.8 60.2 ± 5.5 49.3 ± 11.1 59.4 ± 5.2 46.3 ± 10.9 0.72 10
0.03 0.44 0.01
EE (kcal·min
) 3.7±0.3 3.9±0.4 4.0±0.8 4.0±0.7 4.3±0.9 4.0±0.6 0.45 0.63 0.29
0.06 0.00 0.10
FatOx (g·min
) 0.08 ± 0.03 0.09 ± 0.03 0.08 ± 0.03 0.08 ± 0.04 0.07 ± 0.02 0.07 ± 0.02 0.69 10
0.03 0.48 0.02
FatOx (%) 52.5 ± 10.8 57.2 ± 12.1 52.6 ± 10.8 55.9 ± 11.0 47.6 ± 12.3 53.9 ± 10.0 0.72 10
0.03 0.44 0.01
CHOOx (g·min
) 0.20 ± 0.05 0.21 ± 0.10 0.18 ± 0.04 0.18 ± 0.09 0.21 ± 0.06 0.17 ± 0.06 0.47 0.006 0.45
0.06 0.27 0.06
CHOOx (%) 47.5 ± 10.8 42.8 ± 12.1 47.4 ± 10.8 44.1 ± 11.0 52.4 ± 12.3 46.0 ± 10.0 0.72 10
0.03 0.44 0.01
EE (kcal·min
) 1.5±0.3 1.6±0.4 1.4±0.3 1.4±0.6 1.4±0.3 1.3±0.3 0.45 0.63 0.29
0.06 0.01 0.10
Values are presented as mean ± SD.
G, group effect; T, time effect; G T, grouptime interaction; CHOOx, carbohydrate oxidation.
FIGURE 3FatOx (g·min
)AQ2at rest, during exercise (50% of PPO), and
during the 20-min recovery in the MICT (n= 8), HIIT (n=10),and
HIIT + RT (n= 9) groups at baseline and after the 12-wk intervention.
Data are presented as mean ± SD. The values at rest correspond to the
mean of the last 5 min. The values during the recovery period correspond
to the mean of the 20-min postexercise period. Six values are presented for
the cycling exercise period (at 15, 20, 25, 30, 35 and 40 min of exercise).
***Time effect (pre- vs postintervention), P0.005.
http://www.acsm-msse.org6Official Journal of the American College of Sports Medicine
Copyright © 2019 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
overweight or obese. All three modalities improved body
composition (body weight, FM loss), but HIIT (alone and with
RT) led to a greater percentage of FM loss. Moreover, abdom-
inal and visceral FM (%) were only reduced in the HIIT and
HIIT + RT groups and were significantly different from
MICT. Our results also indicate that HIIT-induced total or
(intra)-abdominal FM losses were not related to higher FatOx
during moderate-intensity exercise or during the 20-min post-
exercise period.
Physical activity is recommended in the framework of
weight management programs to prevent weight gain, to in-
duce weight loss, and to avoid weight regain after weight loss.
Indeed, exercise on its own may generate significant weight
and FM loss (10) with beneficial effects on health (11). Fur-
thermore, (intra)-abdominal FM reduction is of interest due
to FM association with CVD risks (34). The current interna-
tional guidelines generally suggest endurance training as the
best strategy for weight loss and FM reduction in both sexes.
In the last position stand by the American College of Sports
Medicine (11), moderate-intensity physical activity (between
150 and 250 min·wk
) is recommended for preventing weight
gain, and more exercise for providing significant weight loss.
Recent evidence suggests that HIIT can be a time-efficient
strategy to decrease whole-body and (intra)-abdominal FM
in sedentary overweight/obese individuals (15,35). In their
meta-analysis, Wewege et al. (35) evaluated the effect of HIIT
and MICT on weight and FM changes in overweight and
obese individuals. They found that both HIIT and MICT pro-
grams improved FM and waist circumference, even in the ab-
sence of body weight changes. They also showed that HIIT
and MICT were similarly efficient, but that HIIT training re-
quired ~40% less time commitment. The meta-analysis by
Maillard et al. (15) focused on HIIT effects on whole-body
and (intra)-abdominal FM loss in normal weight and over-
weight/obese individuals. The authors confirmed that HIIT is
a time-efficient strategy to decrease not only whole-body FM
but also abdominal and visceral FM. On the other hand, results
were less convincing in postmenopausal women. Indeed, only
three studies have evaluated the effects of HIIT on body
composition in this population (16,36,37), and only one showed
a positive effect of HIIT on total and (intra)-abdominal FM loss
(16). To our knowledge, no study is available on the effects of
HIIT + RT on body composition in postmenopausal women.
Our results indicate that MICT, HIIT, and HIIT + RT pro-
grams (3 sessions per week, 12 wk) decrease body weight,
waist and hip circumferences, and whole-body FM in post-
menopausal women who are overweight/obese. This confirms
the conclusions of the two previously mentioned meta-
analyses. However, when expressed as delta change values
(postpre/pre 100), our study showed that in postmenopausal
women, FM losses were significantly higher in the HIIT and
HIIT + RT (3.1kgand4.4 kg, respectively) than in the
MICT group (0.1 kg). Compared with the three studies on
postmenopausal women and HIIT-induced body composition
changes, our results are similar to those of the study performed
by Maillard et al. (16), but in contradiction with those reported
by Mandrup et al. (36) and Steckling et al. (37) who did not
detect any HIIT effect on total FM. These discrepancies could
be explained by the different exercise modalities (14). Indeed,
we used the same HIIT protocol as Maillard et al. (16) (i.e.,
60 8 s at 80%90% of PHR, 12 s active recovery), whereas
Mandrup et al. (36) and Steckling et al. (37) used three blocks
of varying intervals with multiple periods of maximum per-
formance for 1 h and 4 4 min 90% HR
+ 3 min active
recovery 70 HR
, respectively. Furthermore, in the study
by Mandrup et al. (36), women were not obese, and it is well
known that HIIT-induced FM loss is more effective in obese
individuals (15). Finally, Mandrup et al. and Steckling et al.
did not evaluate dietary intakes and/or physical activity levels
during their interventions. A spontaneous increase of energy
intake or a decrease in total EE could explain the absence of
effect on FM in these works. In our study, the levels of phys-
ical activity and total energy intake remained unchanged,
strengthening our conclusion that HIIT is an efficient strategy
to lose body weight and FM in postmenopausal women who
are overweight/obese.
At baseline, the plasma values were within the normal ranges,
and this may explain why training did not modify the lipid profile
TABLE 3. Glycemic control and lipid profile in the MICT, HIIT, and HIIT + RT groups at baseline (pre) and after (post) the training programs.
Pre Post Pre Post Pre Post G T G T
Glycemia (mmol·L
) 1.2 ± 0.7 1.2 ± 0.4 1.2 ± 0.3 1.2 ± 0.3 1.2 ± 0.6 1.2 ± 0.7 0.19 0.47 0.74
0.13 0.02 0.03
Insulinemia (μU·L
) 11.2 ± 3.0 9.1 ± 3.3 12.9 ± 14.8 12.5 ± 13.0 11.5 ± 3.3 11.7 ± 4.4 0.82 0.27 0.79
0.02 0.05 0.03
HbA1c (%) 5.6 ± 0.5 5.5 ± 0.4 6.1 ± 0.9 6.0 ± 0.7 5.8 ± 0.2 5.7 ± 0.2 0.19 0.52 0.50
0.13 0.02 0.06
HOMA-IR 3.0 ± 1.2 2.2 ± 0.8 3.9 ± 4.7 3.8 ± 4.4 2.8 ± 0.8 3.0 ± 1.4 0.64 0.39 0.42
0.04 0.03 0.07
TC (mmol·L
) 6.3 ± 1.3 6.3 ± 1.3 5.6 ± 1.1 5.4 ± 1.2 6.2 ± 1.0 6.2 ± 1.0 0.27 0.43 0.86
0.10 0.03 0.01
HDL-C (mmol·L
) 1.7 ± 0.4 1.6 ± 0.1 1.7 ± 0.9 1.7 ± 0.5 1.7 ± 0.5 1.7 ± 0.4 0.82 0.77 0.69
0.01 0.00 0.03
LDL-C (mmol·L
) 3.5 ± 1.6 3.6 ± 1.4 3.3 ± 0.8 3.4 ± 0.8 3.9 ± 1.0 3.9 ± 0.8 0.40 0.83 0.79
0.08 0.00 0.02
TG (mmol·L
) 1.4 ± 1.1 1.1 ± 0.5 1.2 ± 0.7 0.9 ± 0.4 1.2 ± 0.5 1.2 ± 0.6 0.43 0.02 0.41
0.07 0.22 0.07
Values are presented as mean ± SD.
G, group effect; T, time effect; G T, grouptime interaction; C, cholesterol; TG, triglycerides.
PHYSICAL ACTIVITY, BODY COMPOSITION, AND WOMEN Medicine & Science in Sports & Exercise
Copyright © 2019 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
and glucose homeostasis. Although our participants did not
have hypertriglyceridemia (defined as a TG concentration
higher than 150 mg·dL
or 1.7 mmol·L
) and higher risk
of CVD (38), we observed a decrease of TG levels over time,
but without difference between groups.
Our results also demonstrate that only HIIT and HIIT + RT
significantly decreased (intra)-abdominal FM (i.e., subcutane-
ous FM from the abdomen and visceral FM). Itis worth noting
that despite exercising almost half the time compared with the
MICT group (20 vs 40 min), women in the HIIT group lost
7.4% of total abdominal FM and 3.2% of visceral FM. Con-
versely, no change was observed in the MICT group, and the
total abdominal FM loss in the HIIT + RT group was not
higher than inthe HIIT group, despite the longer exercise time
(40 min). These results confirm the meta-analysis by Maillard
et al. (15) showing that HIIT significantly reduces abdominal
(P= 0.007) and visceral (P= 0.018) FM, with no difference
between men and women.
The mechanisms underlying HIIT-induced total and (intra)-
abdominal FM loss are still not completely elucidated but
might partly be explained by significant higher lipolysis dur-
ing exercise and greater postexercise total and abdominal
FatOx (15). These adaptations are probably facilitated by the
higher excess postexercise oxygen consumption observed af-
ter exercises performed above 75% V
(39). Indeed, lipid
oxidation decreases above 40%50% V
, but higher in-
tensities still induce significant lipolysis from β-adrenergic
receptors stimulation. Thus, HIIT can increase plasma FFA
levels during exercise and then promote greater FatOx during
the recovery period. This adaptation could explain why peo-
ple who are engaged in regular vigorous physical activities
are less fat than those who never take part in such activities
(32). After an acute session of HIIT, MICT, or high-intensity
resistance training (HIRT
AQ3 ) performed by recreationally active
women, Wingfield et al. (40) demonstrated lower RER in the
HIIT than the MICT and HIRT
AQ3 groups (30 and 60 min of re-
covery), confirming the higher postexercise FatOx in HIIT.
It is now recognized that higher amount of visceral/abdominal
fat is lost in HIIT compared with MICT programs (15). As the
content of β-adrenergic receptors is higher in intra-abdominal
than in subcutaneous adipose tissue (41), the higher HIIT-
induced sympathetic nervous system stimulation could explain
the larger reliance on visceral FM. Moreover, visceral adipose
tissue is characterized by smaller adipocytes, greater lipolytic
activity, and lower responses to the antilipolytic effects of
insulin compared with subcutaneous depots (42). Lastly,
subcutaneous or (intra)-abdominal FM losses may also be
facilitated by HIIT-induced PGC1-αtranscription stimula-
theincreaseofPGC1-αexpression in muscle tissue may in-
duce endocrine effects on adipose tissue and adipokines,
leading to higher FatOx. Altogether, this may explain why
HIIT promotes greater abdominal and visceral FM losses
compared with the traditional MICT.
We also made the hypothesis that HIIT, compared with
MICT, might increase FatOx at rest and during free-living
physical activities (walking, cycling, gardening, etc.) by altering
metabolic flexibility. To test this hypothesis, we determined
FatOx before and after the training period at rest and during a
moderate-intensity exercise (40 min at 50% of PPO) and during
the 20-min recovery time. None of the training modes altered
RMR (kcal·d
) and substrate oxidation at rest. As expected,
FatOx levels were significantly increased, but without any dif-
ference among the three groups. The mean FatOx change
measured after training (~+32%) was similar to what was re-
ported by other studies using the same amount of activity
(12 wk/3 times per week). For example, Talanian et al. (44)
showed an increase of 36% in whole-body FatOx during a
1-h cycling performed at 60% V
after an HIIT program
(2 wk, 7 sessions including 10 4 min at 90% V
2 min recovery) in young sedentary women who are over-
weight or obese. Our study, which was the first to compare
FatOx in postmenopausal women who were overweight/obese
at rest, during moderate-intensity physical activity and during
the recovery period after three different training programs, did
not find a greater effect of HIIT on metabolic flexibility and
no correlation appeared between FatOx and total or (intra)-
abdominal FM loss. Thus, the hypothesis of a greater FatOx
after HIIT programs was not verified in postmenopausal
women and cannotexplain the larger adipose tissue reduction.
Our study also examined the effects of HIIT combined with
RT on body composition in postmenopausal women. An in-
crease of muscle mass after HIIT + RT program might enhance
RMR and, therefore, the 24-h EE. The 24-h EE increase could
favor in turn body FM loss because a part of the EE is provided
through lipid oxidation. The recent meta-analysis by Sabag et al.
(45) shows that HIIT + RT leads to similar muscle mass gain
(hypertrophy) as RT alone. Furthermore, concurrent HIIT and
RT do not negatively affect muscle mass gain. However, these
results should be considered with caution because this meta-
analysis concerned 263 young participants (1834 yr) among
whom only 33 were inactive or untrained. Thus, these conclu-
sions are probably more adapted to young athletes than to indi-
viduals who are overweight/obese.
In our study, loss of total and (intra)-abdominal FM was not
significantly different in the HIIT and HIIT + RT groups. In
fact, the lack of muscle mass gain (kg) in the HIIT + RT group
could explain this finding. Indeed, the duration or volume and/
or intensity of the RT protocols in our study could have been
insufficient to induce a significant increase of muscle mass.
It is not possible to compare our results with the literature be-
cause this is the first study dealing with HIIT + RT effects on
body composition in postmenopausal women. However, three
studies on endurance training + RT have been performed. For
example, Martin et al. (46) did not find any effect of HIIT or
combined training (aerobic + resistance exercises) on total
body fat (%) and muscle mass index (kg.m
) in postmeno-
pausal women after a 12-wk intervention. Davidson et al. (42)
found greater total, abdominal, and visceral FM losses after
a 6-month MICT + RT program (30 min walking at 65%70%
+ 9 resistance exercises, 3 d·wk-1) compared with MICT
or RT alone in older obese adults. These adaptations were
http://www.acsm-msse.org8Official Journal of the American College of Sports Medicine
Copyright © 2019 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
associated with significant skeletal muscle gain, which may
confirm the potential link between muscle mass gain and FM
loss after RT. Finally, Nunes et al. (47) demonstrated a decrease
of whole-body FM (0.3%) after a 12-wk MICT + RT program
(60 min of walking at 70% of PHR and resistance exercises at
) in postmenopausal women. However,
they did give any information on FFM and muscle mass
changes. Additional studies using different RT modalities
(duration, volume, and intensity) are probably needed to deter-
mine whether RT alone or together with HIIT might promote
muscle mass gain in postmenopausal women, leading to sig-
nificant FM loss.
One of the limitations of this study concerns the groups
tested. Indeed, it is difficult to conclude about a potential effect
of HIIT + RT without knowing whether the RT intervention
alone could induce positive adaptations. Thus, to determine
whether the RT intervention can favor muscle adaptations, it
would have been interesting to add also an RT group. We de-
cided to have the same session duration for the MICT and
HIIT + RT programs because a lack of time has been cited
as a barrier for overweight/obese people. This limited the
amount of RT work, and this might not have been enough to
induce muscle mass gain, especially in women. Furthermore,
we can also hypothesize that the HIIT + RT combination
may alter muscle adaptations by inducing molecular pathway
interferences between training modalities. Indeed, it has been
suggested that endurance training performed before RT nega-
tively affects RT adaptations through inhibition of the AKT
mTOR pathway activation by AMPK (25). Finally, a last group,
MICT+ RT, might induce different adaptations but appeared
to us less attractive due to the duration of the session (1h).
In conclusion, a 12-wk cycling MICT or HIIT ± RT program
(3 sessions per week) can be proposed to nondieting postmeno-
pausal women who are overweight/obese to decrease weight
and whole-body FM. HIIT programs seems more successful
in reducing (intra)-abdominal FM than the traditional moderate
continuous training. As the level of subcutaneous abdominal
and visceral FM is correlated with the CVD risk, this study
confirms that HIIT is an effective and time-efficient modality
to reduce such risk in this population. HIIT + RT did not po-
tentiate this effect but improved body composition by in-
creasing the percentage of FFM, including muscle mass.
HIIT-induced greater total and (intra)-abdominal FM loss is
not related to changes in metabolic flexibility at rest, during
moderate-intensity exercise, or during the recovery period.
Additional studies are needed to better understand the under-
lying mechanisms of HIIT-induced FM loss and to determine
whether the concomitant muscle mass gain induced by RT
potentiates these adaptations.
The authors want to thank all the study participants for their kind
collaboration, the nurse, Anne Misson, Cyril Chomarat, and Renaud
Laurent for their kind assistance during the training sessions and their
help in data collection.
The results of this study are presented clearly, honestly, and without
fabrication, falsification, or inappropriate data manipulation. The results
of the present study do not constitute endorsement by the American
College of Sports Medicine.
The authors declare that they have no competing interests.
M. D. was a PhD student on the MATISSE study and designed and
supervised the different training modalities. She met all participants,
collected and analyzed all HR monitoring data during training, super-
vised training sessions, collected and analyzed the data obtained for
RMR and during the prolonged exercise (FatOx measurements), car-
ried out the anthropometric measurements, and wrote the first and
subsequent drafts of the article. M. R. was a coinvestigator and assisted
with the study design. C. M., P. B., and M. D. were the physicians who
assisted with the study design and oversaw the medical aspects of the
study. A. B. and F. M. were the sport instructors who supervised training
sessions with MD and helped collected data for RMR and during the pro-
longed exercise (FatOx measurements). N. B. conceived the study idea
and was responsible for the overall study design and for monitoring data
collection. B. P. was responsible for all statistical analyses. All authors
read and approved the final manuscript.
The MATISSE Study was funded by the University of Clermont
Auvergne (AME2P laboratory). The funders had no role in the study
design, the collection, analysis, and interpretation of data, the writing of
the manuscript, and the decision to submit the article for publication.
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Background/Objectives To the best of our knowledge, there have been no previous studies conducted on the long-term effects of an exercise intervention on deficits in inhibitory control in obese individuals. The aim of this study was thus to examine the effect of 12 weeks of a combination of aerobic and resistance exercise on behavioral and cognitive electrophysiological performance involving cognitive interference inhibition in obese individuals. Methods Thirty-two qualified healthy obese women were randomly divided into either an exercise group (EG, age: 34.76 ± 5.52 years old; BMI: 29.35 ± 3.52 kg/m²) or a control group (CG, age: 33.84 ± 7.05 years old; BMI: 29.61 ± 4.31 kg/m²). All participants performed the Stroop task, with electrophysiological signals being collected simultaneously before and after a 12-week intervention. The estimated V̇O2max, muscular strength, and body fat percentage (measured with dual-energy X-ray absorptiometry) were also assessed within one week before and after the intervention. Participants in the EG group engaged in 30 min of moderate-intensity aerobic exercise combined with resistance exercise, 5 sessions per week for 12 weeks, while the participants in the CG group maintained their regular lifestyle without engaging in any type of exercise. Results The results revealed that although a 12-week exercise intervention did not enhance the behavioral indices [e.g., accuracy rates (ARs) and reaction times (RTs)] in the EG group, significantly shorter N2 and P3 latencies and greater P2 and P3 amplitudes were observed. Furthermore, the fat percentage distribution (e.g. total body fat %, trunk fat %, and leg fat %) and level of physical fitness (e.g. estimated V̇O2max and muscular strength) in the EG group were significantly improved. The changes prior to and after the intervention in the P3 amplitude and trunk fat percentage were significantly negatively correlated in the EG group (r = −0.521, p = 0.039). Conclusions These findings suggested that 12 weeks of aerobic exercise combined with resistance exercise in obese women affects cognitive function broadly, but not specifically in terms of inhibitory control. The percentage of decreased trunk fat may play a potential facilitating role in inhibition processing in obesity.
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Sarcopenia, an age-related disease characterized by loss of muscle strength and muscle mass, has attracted the attention of medical experts due to its severe morbidity, low living quality, high expenditure of health care, and mortality. Traditionally, persistent aerobic exercise (PAE) is considered as a valid way to attenuate muscular atrophy. However, nowadays, high intensity interval training (HIIT) has emerged as a more effective and time-efficient method to replace traditional exercise modes. HIIT displays comprehensive effects on exercise capacity and skeletal muscle metabolism, and it provides a time-out for the recovery of cardiopulmonary and muscular functions without causing severe adverse effects. Studies demonstrated that compared with PAE, HIIT showed similar or even higher effects in improving muscle strength, enhancing physical performances and increasing muscle mass of elder people. Therefore, HIIT might become a promising way to cope with the age-related loss of muscle mass and muscle function. However, it is worth mentioning that no study of HIIT was conducted directly on sarcopenia patients, which is attributed to the suspicious of safety and validity. In this review, we will assess the effects of different training parameters on muscle and sarcopenia, summarize previous papers which compared the effects of HIIT and PAE in improving muscle quality and function, and evaluate the potential of HIIT to replace the status of PAE in treating old people with muscle atrophy and low modality; and point out drawbacks of temporary experiments. Our aim is to discuss the feasibility of HIIT to treat sarcopenia and provide a reference for clinical scientists who want to utilize HIIT as a new way to cope with sarcopenia.
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The home confinement derived from the COVID-19 pandemic has led to drastic changes in people’s habits. This situation has influenced their eating, rest, physical activity and socialization patterns, triggering changes in their mental stability. It was demonstrated that physical activity is beneficial for people’s physical and mental health. By its moderate volume and requiring little space or material, high-intensity interval training (HIIT) could prove to be a valid alternative in a situation of confinement. The aim of the present study was to observe the impact of an 8-week HIIT protocol on the body composition and the depressive symptoms of adults in strict home confinement. A total of 21 healthy adults, both male and female, (35.4 ± 5.6 years old; 70.50 ± 12.1 kg; 171 ± 10 cm) were divided into an experimental group (EG, n = 11) who carried out an 8-week Tabata protocol, based upon calisthenic exercises with their own weight in their homes, and a control group (CG, n = 10) who did not carry out any systematic physical activity over the same period. Following the intervention, the EG experienced a significant reduction in percentage (t = 3.86, d = 0.57, p < 0.05) and in kg (t = 4.62, d = 0.29, p < 0.05) of body fat mass (BFM) and body fat mass index (BFMI) (t = 4.61, d = 0.31, p < 0.05), as well as a reduction in depressive symptoms (t = 6.48, d = 1.3, p < 0.05). These results indicate that HIIT is a potential public health tool that could possibly be prescribed to the population in case of future situations of home confinement.
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Weight resistance training (RT) has been shown to positively influence physical performance. Within the last two decades, a methodology based on monitoring RT through movement velocity (also called velocity-based resistance training, VBRT) has emerged. The aim of this PRISMA-based systematic review was to evaluate the effect of VBRT programs on variables related to muscle strength (one-repetition maximum, 1-RM), and high-speed actions (vertical jump, and sprint performance) in trained subjects. The search for published articles was performed in PubMed/MEDLINE, SPORT Discus/EBSCO, OVID, Web of Science, Scopus, and EMBASE databases using Boolean algorithms independently. A total of 22 studies met the inclusion criteria of this systematic review (a low-to-moderate overall risk of bias of the analyzed studies was detected). VBRT is an effective method to improve 1-RM, vertical jump and sprint. According to the results of the analyzed studies, it is not necessary to reach high muscle failure in order to achieve the best training results. These findings reinforce the fact that it is possible to optimize exercise adaptations with less fatigue. Future studies should corroborate these findings in female population.
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Interval training is a form of exercise that involves intermittent bouts of relatively intense effort interspersed with periods of rest or lower-intensity exercise for recovery. Low-volume high-intensity interval training (HIIT) and sprint interval training (SIT) induce physiological and health-related adaptations comparable to traditional moderate-intensity continuous training (MICT) in healthy adults and those with chronic disease despite a lower time commitment. However, most studies within the field have been conducted in men, with a relatively limited number of studies conducted in women cohorts across the lifespan. This review summarizes our understanding of physiological responses to low-volume interval training in women, including those with overweight/obesity or type 2 diabetes, with a focus on cardiorespiratory fitness, glycemic control, and skeletal muscle mitochondrial content. We also describe emerging evidence demonstrating similarities and differences in the adaptive response between women and men. Collectively, HIIT and SIT have consistently been demonstrated to improve cardiorespiratory fitness in women, and most sex-based comparisons demonstrate similar improvements in men and women. However, research examining insulin sensitivity and skeletal muscle mitochondrial responses to HIIT and SIT in women is limited and conflicting, with some evidence of blunted improvements in women relative to men. There is a need for additional research that examines physiological adaptations to low-volume interval training in women across the lifespan, including studies that directly compare responses to MICT, evaluate potential mechanisms, and/or assess the influence of sex on the adaptive response. Future work in this area will strengthen the evidence-base for physical activity recommendations in women.
After menopause, bones decline in structure and can break more easily. Physical activity can strengthen bones. This study investigated how activity and body composition can impact bone structure in post-menopausal women. Higher levels of physical activity were positively associated with bone structure at the lower leg.PurposeThe menopausal transition is characterized by dramatic bone loss, leading to an increased risk of fracture. Few studies have examined how modifiable risk factors influence bone structure. Thus, the objective of this cross-sectional study was to examine the relationship between habitual physical activity (PA), body composition, and bone structure in post-menopausal women with low bone mass.Methods Data was analyzed from 276 post-menopausal women with low bone mass enrolled in the Heartland Osteoporosis Prevention Study. Body composition and bone structure measures were collected using dual X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) at the tibia. Habitual PA was collected using the Human Activity Profile questionnaire. Multiple regression analysis was used to determine the relative impact of habitual PA and body composition on bone structure measures (density, area, and strength). Direct and/or indirect effects of PA on bone outcomes were assessed by path analysis.ResultsMean (± SD) age of participants was 54.5 (± 3.2) years and average BMI was 25.7 (± 4.7). Mean T-score of the total lumber spine and hip were − 1.5 (± .6) and − 0.8 (± .59), respectively, with all women classified with low bone mass. Habitual PA had a significant positive effect on bone area and strength measures at the 66% site, and trend effects at the 4% site. Lean mass had a significant positive effect on area and strength at the 66% site and 4% site. Fat mass showed no effect at the 66% site, with a positive effect on density and strength at the 4% site.Conclusion Increased habitual activity was related to improved bone structure of the tibia. Our results in post-menopausal women emphasize that PA and lean mass preservation are important for maintaining bone structure in the years following menopause.
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Background: High-intensity interval training (HIIT) is an emerging exercise strategy and is considered to be a recipe for health promotion. This study aimed to systematically identify collaboration networks, track research trends, highlight current hotspots, and predict future frontiers in HIIT and its applications in health promotion since the start of the new century. Methods: Relevant original publications were obtained from the Science Citation Index Expanded of the Web of Science Core Collection (WoSCC) database between 2001 and 2020. CiteSpace and VOSviewer software were used to perform bibliometric visualization and comparative analysis of involved indexes that included countries, institutions, journals, authors, references, and keywords. Results: A total of 572 papers were included, and the trend of annual publications showed a remarkable growth. The United States and the University of Exeter were the most productive country and institutions, respectively, with 107 and 18 publications, respectively. European Journal of Applied Physiology took the lead in the number of published articles, and Medicine and Science in Sports and Exercise ranked first in the cocitation counts. Barker AR and Gibala MJ were considered as the most productive and the most highly-cited authors. Conclusions: “Health risks,” “adolescent,” and “aging” are the three noteworthy topics during the evolution of HIIT-health promotion (HIIT-HP) research. The current research hotspots of HIIT and its practices in the health promotion domain lies in “metabolic diseases,” “cardiovascular diseases,” “neurological diseases,” and “musculoskeletal diseases.” The authors summarize that “prevention and rehabilitation,” “micro and molecular level,” and “cognition and mental health” are becoming frontiers and focus on the health topics related to HIIT in the upcoming years, which are worthy of further exploration.
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This pilot study compared the effects of acute high‐intensity intermittent exercise (HIIE) and moderate‐intensity continuous exercise (MICE) on post‐exercise VO2, fat utilization, and 24h‐energy balance to understand the mechanism of higher fat mass reduction observed after high‐intensity interval training in postmenopausal women with overweight/obesity. 12 fasted women (59.5±5.8 years; BMI: 28.9±3.9 kg.m‐2) completed three isoenergetic cycling exercise sessions in a counterbalanced, randomized order: i) MICE [35min at 60‐65% of peak heart rate, HRmax], ii) HIIE 1 [60 × (8s cycling‐12s recovery) at 80‐90% of HRmax] and iii) HIIE 2 [10 × 1min at 80‐90% of HRmax ‐ 1min recovery]. Then, VO2 and fat utilization measured at rest and during the 2h post‐exercise, enjoyment, perceived exertion and appetite recorded during the session and energy intake (EI) and energy expenditure (EE) assessed over the next 24h were compared for the three modalities. Overall, fat utilization increased after exercise. No modality effect or time‐modality interaction were observed concerning VO2 and fat oxidation rate during the 2h post‐exercise. The two exercise modalities did not induce specific EI and EE adaptations, but perceived appetite scores at 1h post‐exercise were lower after HIIE 1 & 2 than MICE. Perceived exertion was higher during HIIE 1 & 2 than MICE, but enjoyment did not differ among modalities. The acute HIIE responses did not allow explaining the greater fat mass loss observed after regular high‐intensity interval training in postmenopausal women with overweight/obesity. More studies are needed to understand the mechanisms involved in such adaptations.
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Muscle oxygenation (MO) status is the dynamic balance between O2 utilization and O2 delivery. Low-impact high-intensity interval exercise MO responses in the exercise and recovery stage are still unclear. We compared the differences in MO and physiological parameters between high-intensity interval water-based exercise (WHIIE) and high-intensity interval land bike ergonomic exercise (LBEHIIE) in postmenopausal women. Eleven postmenopausal women completed WHIIE or LBEHIIE in counter-balanced order. Eight sets were performed and each exercise set included high intensity with 80% heart rate reserve (HRR) in 30 s and dynamic recovery with 50% HRR in 90 s. Muscle tissue oxygen saturation index (TSI), total hemoglobin (tHb), oxy-hemoglobin (O2Hb), and deoxy-hemoglobin (HHb) were recorded. Blood lactate, heart rate and rating of perceived exertion (RPE) were measured at pre and post-exercise. Under similar exercise intensity, RPE in WHIIE was lower than that in LBEHIIE. The heart rate in WHIIE was lower than that in LBEHIIE at 1 and 2 min post-exercise. During the dynamic recovery, TSI, tHb, and O2Hb in water were higher than on land. A negative correlation was found between the change in TSI and lactate concentration (r = − 0.664). WHIIE produced greater muscle oxygenation during dynamic recovery. Muscle TSI% was inversely related to blood lactate concentration during exercise in water.
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New findings: What is the topic of this review? A meta-analysis of the efficacy of high intensity interval training (HIIT) in reducing weight, total fat mass (FM) and (intra)-abdominal FM in normal-weight and overweight/obese women before and after menopause. What advances does it highlight? HIIT programmes in women significantly decrease body weight and total and abdominal FM. Their effects are more evident in pre- than in postmenopausal women. Cycling HIIT seems more effective than running, especially in postmenopausal women, and training interventions longer than 8 weeks comprising three sessions a week should be promoted. Abstract: High-intensity interval training (HIIT) is a stimulating modality for reducing body weight and adipose tissue. The purpose of this meta-analysis was to assess the efficacy of HIIT in reducing weight, total fat mass (FM) and (intra)-abdominal FM in normal-weight and overweight/obese women before and after menopause. A structured electronic search was performed to find all publications relevant to our review. Stratified analyses were made of hormonal status (pre- vs. postmenopausal state), weight, HIIT modalities (cycling vs. running), programme duration (< or ≥8 weeks) and the methods used to measure body composition (dual-energy X-ray absorptiometry vs. computed tomography, Magnetic Resonance Imaging and others). A total of 38 studies involving 959 subjects were included. Our meta-analysis showed that overall HIIT programmes significantly decrease weight, total and abdominal FM in women. Both normal weight and overweight/obese women lost total FM after HIIT protocols whereas HIIT was only effective in decreasing abdominal FM in women with excess adiposity. When pre- and postmenopausal women were considered separately, the effect of HIIT on weight, total and abdominal FM were only significant before menopause. Cycling HIIT seemed more effective than running, especially in postmenopausal women, and training interventions longer than 8 weeks comprising three sessions were more efficient. HIIT is a successful strategy to lose weight and FM in normal weight and overweight/obese women. However, further studies are still needed to draw meaningful conclusions about the real effectiveness of HIIT protocols in postmenopausal women.
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Bariatric surgery (BS) is considered the most effective treatment for morbid obesity. Preoperative body weight is directly associated with a higher surgical morbimortality and physical activity could be effective in the preparation of patients. The aim of this study is to determine the effects of a six-month exercise training program (ETP), combining high-intensity interval training (HIIT) and resistance training in patients awaiting BS. Six candidates awaiting BS (38.78 ± 1.18 kg·m−2; 38.17 ± 12.06 years) were distributed into two groups: the ETP group (experimental group (EG), n = 3) and a control group (CG, n = 3). Anthropometrical and blood pressure (BP), cardiorespiratory fitness and maximal strength were registered before and after the ETP. The EG participated in 93.25% of the sessions, showing reductions in body mass index (BMI) compared to the CG (34.61 ± 1.56 vs. 39.75 ± 0.65, p = 0.006, ANOVA). The inferential analysis showed larger effects on BMI, excess body weight percentage and fat mass, in addition to small to moderate effects in BP and the anthropometric measurements. Peak oxygen uptake normalized to fat-free mass showed likely positive effects with a probability of >95–99%. A six-month ETP seems to be a positive tool to improve body composition, cardiometabolic health, and fitness level in patients awaiting BS, but a larger sample size is needed to confirm these findings.
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The majority of sports rely on concurrent training (CT; e.g., the simultaneous training of strength and endurance). However, a phenomenon called “Concurrent training effect” (CTE), which is a compromise in adaptation resulting from concurrent training, appears to be mostly affected by the interference of the molecular pathways of the underlying adaptations from each type of training segments. Until now, it seems that the volume, intensity, type, frequency of endurance training, as well as the training history and background strongly affect the CTE. High volume, moderate, continuous and frequent endurance training, are thought to negatively affect the resistance training-induced adaptations, probably by inhibition of the Protein kinase B—mammalian target of rapamycin pathway activation, of the adenosine monophosphate-activated protein kinase (AMPK). In contrast, it seems that short bouts of high-intensity interval training (HIIT) or sprint interval training (SIT) minimize the negative effects of concurrent training. This is particularly the case when HIIT and SIT incorporated in cycling have even lower or even no negative effects, while they provide at least the same metabolic adaptations, probably through the peroxisome proliferator-activated receptor-γ coactivator (PGC-1a) pathway. However, significant questions about the molecular events underlying the CTE remain unanswered.
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Purpose: An imbalance in the production of adipokines and myokines impairs the energy expenditure, increases adipocyte and develops metabolic pathologies. Physical exercise is able to regulate the secretion of myokines and adipokines. The present study considers the metabolic cross talk between skeletal muscle and adipose tissue in high-intensity interval training vs. moderate-intensity continuous training by regulation of PGC-1α. Methods: A sample of 32 male Wistar rats (8 weeks old with mean weight 250 ± 55 g) were divided into four groups randomly: control of base (CO), control of 8 weeks (CO8w), moderate-intensity continuous training (MICT), and high-intensity interval training (HIIT). The rats were fed with standard chow diet. The CO group was killed at the start of the study and the CO8w group was kept alive for the same time as the experimental groups, but did not participate in any exercise. MICT and HIIT groups for 8 weeks were placed under the moderate-intensity continuous training (15-60 min, with speed of 15-30 m/min) and high-intensity interval training (8-4 intense period for 1 min, with speed of 28-55 m/min, with 3-7 slow-intensity period for 1 min, with a speed of 12-30 m/min) for 8 weeks, respectively. To measure the levels of serum irisin, nesfatin, and resistin the ELISA method was used and real-time PCR method was used to evaluate the relative expression of soleus PGC-1α gene mRNA. Results: The levels of irisin and nesfatin significantly increased in the HIIT compared with control groups (p = 0.001). Resistin values in both training groups showed a significant decrease compared to the control groups (p = 0.005). The level of PGC-1α gene expression in both HIIT and MICT groups was significantly increased in comparison with the control groups (p = 0.001). Discussion: The results showed that HIIT and MICT increase the transcription of the PGC-1α gene and possibly the increased expression of this gene after HIIT and MICT plays a central role in the secretion of skeletal muscle myokines and adipokines of adipose tissue. Level of evidence: No Level of evidence: Animal study.
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This study investigate the effects of high-intensity interval training (HIIT) on systemic levels of inflammatory and hormonal markers in postmenopausal women with metabolic syndrome (MS). Fifteen postmenopausal women with MS completed the training on treadmills. Functional, body composition parameters, maximal oxygen uptake (VO2max), and lipid profile were assessed before and after HIIT. Serum or plasma levels of cytokines and hormonal markers were measured along the intervention. The analysis of messenger RNA (mRNA) expression of these cytokines was performed in peripheral blood mononuclear cells (PBMC). VO2max and some anthropometric parameters were improved after HIIT, while decreased levels of proinflammatory markers and increased levels of interleukin-10 (IL-10) were also found. Adipokines were also modulated after 12 weeks or training. The mRNA expression of the studied genes was unchanged after HIIT. In conclusion, HIIT benefits inflammatory and hormonal axis on serum or plasma samples, without changes on PBMC of postmenopausal MS patients.
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We investigated sex- and menopause-related differences in body composition and regional fat distribution, using dual-energy X-ray absorptiometry (DEXA) in nonobese healthy volunteers. Men (n = 103) had a 50% greater lean tissue mass (P < 0.001) but a 13% lower fat mass (P < 0.001) than the women (n = 131). Postmenopausal (n = 70) women had a 20% greater fat mass (P < 0.001) than premenopausal (n = 61) women. The proportion of android (upper body) fat was greatest in men (48.6%, P < 0.001) but was significantly lower in premenopausal (38.3%) than in postmenopausal (42.1%) women (P < 0.001). The reverse was found for gynoid (lower body) fat (P < 0.001 ). DEXA measurements thus clearly demonstrated that sex differences in total fat mass were opposite those of android fat, and that marked menopausal changes in fat mass and its distribution existed. Body mass indices did not demonstrate that men had less total fat than women whereas postmenopausal women had more total fat than did premenopausal women. Our findings suggest that DEXA measurements of fat distribution may be useful for studies related to obesity-associated disease risk.
Objectives: This study tested whether high-intensity interval training is a time-efficient strategy for improving visceral adiposity tissue and inflammatory markers in obese postmenopausal women when compared with combined training. Moreover, we tested whether change in visceral adiposity tissue is associated with alterations in these inflammatory markers. Methods: Postmenopausal women were randomized in two groups: combined training (n = 13) and high-intensity interval training (n = 13). The combined training group performed 60 minutes of walking at 70% of maximum heart rate and resistance exercises at 70% of one repetition maximum. The high-intensity interval training group performed 28 minutes of high-intensity exercises (> 80% of maximum heart rate). Both groups trained three times a week for 12 weeks. Body composition and inflammatory markers were analyzed with dual-energy x-ray absorptiometry scanning and enzyme-linked immunosorbent assay, respectively. Results: All groups reduced body fat percentage (P = 0.026), visceral adiposity tissue (P = 0.027), leptin (P = 0.043), and increased interleukin (IL)-1 receptor antagonist (P < 0.01). The high-intensity interval training group reduced visceral adiposity tissue (P = 0.021) in a greater magnitude and increased interleukin-6 (P = 0.037) level when compared with the combined training group. Moreover, the visceral adiposity tissue changes explained the changes in IL-6 (56%; P = 0.002) only in the high-intensity interval training group. Conclusions: These results suggest that high-intensity interval training is a time-efficient strategy for improving visceral adiposity tissue and inflammatory markers in obese postmenopausal women. Moreover, we observed that serum cytokine changes, at least in part, depend on visceral adiposity tissue alterations.
Reducing estrogen in women results in decreases in energy expenditure, but the mechanism(s) remain largely unknown. We postulate that the loss of estrogens in women is associated with increased accumulation of bone marrow (BM)-derived adipocytes in white adipose tissue, decreased activity of brown adipose tissue, and reduced levels of physical activity. Regular exercise may counteract the effects of estrogen deficiency.
The purpose of this systematic review and meta-analysis is to assess the effect of concurrent high intensity interval training (HIIT) and resistance training (RT) on strength and hypertrophy. Five electronic databases were searched using terms related to HIIT, RT, and concurrent training. Effect size (ES), calculated as standardised differences in the means, were used to examine the effect of concurrent HIIT and RT compared to RT alone on muscle strength and hypertrophy. Sub-analyses were performed to assess region-specific strength and hypertrophy, HIIT modality (cycling versus running), and inter-modal rest responses. Compared to RT alone, concurrent HIIT and RT led to similar changes in muscle hypertrophy and upper body strength. Concurrent HIIT and RT resulted in a lower increase in lower body strength compared to RT alone (ES = −0.248, p = 0.049). Sub analyses showed a trend for lower body strength to be negatively affected by cycling HIIT (ES = −0.377, p = 0.074) and not running (ES = −0.176, p = 0.261). Data suggests concurrent HIIT and RT does not negatively impact hypertrophy or upper body strength, and that any possible negative effect on lower body strength may be ameliorated by incorporating running based HIIT and longer inter-modal rest periods.
Metabolic and cardiovascular diseases are increasing worldwide due to the rise in the obesity epidemic. The metabolic consequences of obesity vary by distribution of adipose tissue. Visceral and ectopic adipose accumulation are associated with adverse cardiometabolic consequences, while gluteal-femoral adipose accumulation are negatively associated with these adverse complications and subcutaneous abdominal adipose accumulation is more neutral in its associations. Gender, race and ethnic differences in adipose tissue distribution have been described and could account for the observed differences in risk for cardiometabolic disease. The mechanisms behind the differential impact of adipose tissue on cardiometabolic risk have started to be unraveled and include differences in adipocyte biology, inflammatory profile, connection to systemic circulation and most importantly the inability of the subcutaneous adipose tissue to expand in response to positive energy balance.
Objective: This study compared the effects of 12 weeks of high-intensity interval body weight training (HIBWT) with combined training (COMT; aerobic and resistance exercises on body composition, a 6-minute walk test (6MWT; physical performance), insulin resistance (IR) and inflammatory markers in postmenopausal women (PW) at high risk of type 2 diabetes mellitus (TDM2). Methods: In this randomized controlled clinical study, 16 PW at high risk of TDM2 were randomly allocated into two groups: HIBWT (n = 8) and COMT (n = 8). The HIBWT group performed a training protocol (length time ~28 min) consisting of ten sets of 60 s of high intensity exercise interspersed by a recovery period of 60 s of low intensity exercise. The COMT group performed a training protocol (length time ~60 min) consisting of a 30 min walk of moderate intensity following by five resistance exercises. All training sessions were performed in the university gym facility three days a week (no consecutive days) for 12 weeks. All outcomes (body composition, muscle function, and IR and inflammatory markers) were assessed at the baseline and at the end of the study. Results: Both groups increased (P < 0.05) muscle mass index (MMI), 6MWT, and interleukin 1 receptor antagonist and decreased fasting glucose, glycated hemoglobin,Insulin, HOMA-IR, and monocyte chemoattractant protein-1 (trend, P = 0.056). HIBWT effects were indistinguishable (P > 0.05) from the effects of COMT. There was a significant (P < 0.05) interaction of time by the group in muscle strength, indicating that only the COMT increased the muscle strength. Conclusions: This study suggests that changes in HOMA, IL-1ra, 6MWT, and MMI with HITBW are similar when compared to COMT in PW at high risk of TDM2. Trial registration: The patients were part of a 12-week training study ( Identifier: NCT03200639).