High Intensity Interval Training (HIIT) and Health

Critical Questions

Key Recommended Reading

Biddle, S. J., & Batterham, A. M. (2015). High-intensity interval exercise training for public health: a big HIT or shall we HIT it on the head?. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 95 [full text]  

Campbell, W.W., Kraus, W.E., Powell, K.E., Haskell, W.L., Janz, K.F., Jakicic, J.M., Troiano, R.P., Sprow K, Torres, A., Piercy, K.L., Bartlett, D.B. and 2018 Physical Activity Guidelines Advisory Committee. (2019) High-Intensity Interval Training for Cardiometabolic Disease Prevention. Med Sci Sports Exerc. 51(6):1220-1226. DOI: 10.1249/MSS.0000000000001934

Edwards, J. J., Griffiths, M., Deenmamode, A. H., & O’Driscoll, J. M. (2023). High-Intensity Interval Training and Cardiometabolic Health in the General Population: A Systematic Review and Meta-analysis of Randomised Controlled Trials. Sports Medicine, 53, 1753–1763. https://doi.org/10.1007/s40279-023-01863-8

Gibala, M. J., & Hawley, J. A. (2017). Sprinting toward fitness. Cell Metabolism, 25(5), 988-990. https://doi.org/10.1016/j.cmet.2017.04.030 

Hough, P. (2021). High-intensity interval training. In P. Hough and B. J. Schoenfeld (Eds) Advanced Personal Training (pp. 171-203). Routledge.

Taylor, J. L., Holland, D. J., Spathis, J. G., Beetham, K. S., Wisløff, U., Keating, S. E., & Coombes, J. S. (2019). Guidelines for the Delivery and Monitoring of High Intensity Interval Training in Clinical Populations. Progress in Cardiovascular Diseases. https://doi.org/10.1016/j.pcad.2019.01.004  

Watch a Video/Lecture

Prof Martin Gibala at ECSS, 2017 - HIIT - Mechanisms of AdaptationLinked paper: MacInnis, & Gibala, (2017). Physiological adaptations to interval training and the role of exercise intensity. The Journal of Physiology, 595(9), 2915-2930. https://doi.org/10.1113/JP273196

Full Reading List

Bartlett, J. D., Close, G. L., MacLaren, D. P., Gregson, W., Drust, B., & Morton, J. P. (2011). High-intensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise: implications for exercise adherence. Journal of Sports Sciences, 29(6), 547-553. https://doi.org/10.1152/japplphysiol.01040.2011  

Batacan, R. B., Duncan, M. J., Dalbo, V. J., Tucker, P. S., & Fenning, A. S. (2016). Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies. British Journal of Sports Medicine, http://bjsm.bmj.com/content/51/6/494  

Biddle, S. J., & Batterham, A. M. (2015). High-intensity interval exercise training for public health: a big HIT or shall we HIT it on the head?. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 95 [full text]  

Bishop, D. J., Botella, J., Genders, A. J., Lee, M. J., Saner, N. J., Kuang, J., ... & Granata, C. (2019). High-intensity exercise and mitochondrial biogenesis: current controversies and future research directions. Physiology, 34(1), 56-70. https://doi.org/10.1152/physiol.00038.2018  

Blackwell, J. E., Gharahdaghi, N., Brook, M. S., Watanabe, S., Boereboom, C. L., Doleman, B., ... & Phillips, B. E. (2021) The physiological impact of high intensity interval training in octogenarians with comorbidities. Journal of Cachexia, Sarcopenia and Muscle. https://doi.org/10.1002/jcsm.12724 

Bucheit, M. (2018) Heart rate recovery during repeated high-intensity efforts is not related to the recovery of systemic oxygen uptake and muscle oxygenation, and can’t be used to predict performance decrement. Sport Performance and Science Reports [full text]

Decision process for selecting an HIT format based on the expected acute physiological response/strain.  Taken from: Buchheit, M., & Laursen, P. B. (2013). High-intensity interval training, solutions to the programming puzzle. Part I: Cardiopulmonary Emphasis. Sports Medicine, 43(5), 313-338. https://doi.org/10.1007/s40279-013-0029-x 

Buchheit, M., & Laursen, P. B. (2013). High-intensity interval training, solutions to the programming puzzle. Part I: Cardiopulmonary Emphasis. Sports Medicine, 43(5), 313-338. https://doi.org/10.1007/s40279-013-0029-x 

Buchheit, M., & Laursen, P. B. (2013). High-intensity interval training, solutions to the programming puzzle. Part II: Anaerobic Energy, Neuromuscular Load and Practical Applications . Sports Medicine, 43(10), 927-954. https://doi.org/10.1007/s40279-013-0066-5 

Callahan, M. J., Parr, E. B., Hawley, J. A., & Camera, D. M. (2021). Can High-Intensity Interval Training Promote Skeletal Muscle Anabolism?. Sports Medicine, 1-17. https://doi.org/10.1007/s40279-020-01397-3 

Callahan, M. J., Parr, E. B., Snijders, T., Conceição, M. S., Radford, B. E., Timmins, R. G., ... & Camera, D. M. (2021). Skeletal Muscle Adaptive Responses to Different Types of Short-Term Exercise Training and Detraining in Middle-Age Men. Medicine and Science in Sports and Exercise. doi: 10.1249/MSS.0000000000002684 

Campbell, W.W., Kraus, W.E., Powell, K.E., Haskell, W.L., Janz, K.F., Jakicic, J.M., Troiano, R.P., Sprow K, Torres, A., Piercy, K.L., Bartlett, D.B. and 2018 Physical Activity Guidelines Advisory Committee. (2019) High-Intensity Interval Training for Cardiometabolic Disease Prevention. Med Sci Sports Exerc. 51(6):1220-1226. DOI: 10.1249/MSS.0000000000001934

Chrøis, K. M., Dohlmann, T. L., Søgaard, D., Hansen, C. V., Dela, F., Helge, J. W., & Larsen, S. (2020). Mitochondrial adaptations to high intensity interval training in older females and males. European journal of sport science, 20(1), 135-145. https://doi.org/10.1080/17461391.2019.1615556 

Cocks, M., Shaw, C. S., Shepherd, S. O., Fisher, J. P., Ranasinghe, A. M., Barker, T. A., Tipton, K. D. and Wagenmakers, A. J. M. (2013) Sprint interval and endurance training are equally effective in increasing muscle microvascular density and eNOS content in sedentary males. Journal of Physiology. Vol. 591, No. 3: 641–656. [Online]. Available from: doi:10.1113/jphysiol.2012.239566. [full text]

Crozier, J., Roig, M., Eng, J. J., MacKay-Lyons, M., Fung, J., Ploughman, M., ... & Trivino, M. (2018). High-intensity interval training after stroke: an opportunity to promote functional recovery, cardiovascular health, and neuroplasticity. Neurorehabilitation and neural repair, 32(6-7), 543-556. https://doi.org/10.1177/1545968318766663 

Decker, E. S., & Ekkekakis, P. (2017). More efficient, perhaps, but at what price? Pleasure and enjoyment responses to high-intensity interval exercise in low-active women with obesity. Psychology of Sport and Exercise, 28, 1-10. http://www.sciencedirect.com/science/article/pii/S1469029216301285   

Image from: Edwards, J. J., Griffiths, M., Deenmamode, A. H., & O’Driscoll, J. M. (2023). High-Intensity Interval Training and Cardiometabolic Health in the General Population: A Systematic Review and Meta-analysis of Randomised Controlled Trials. Sports Medicine, 53, 1753–1763. https://doi.org/10.1007/s40279-023-01863-8  

Edwards, J. J., Griffiths, M., Deenmamode, A. H., & O’Driscoll, J. M. (2023). High-Intensity Interval Training and Cardiometabolic Health in the General Population: A Systematic Review and Meta-analysis of Randomised Controlled Trials. Sports Medicine, 53, 1753–1763. https://doi.org/10.1007/s40279-023-01863-8   

Ekkekakis, P., & Tiller, N. B. (2022). Extraordinary Claims in the Literature on High-Intensity Interval Training: II. Are the Extraordinary Claims Supported by Extraordinary Evidence?. Kinesiology Review, 1(aop), 1-14. https://doi.org/10.1123/kr.2022-0003 

Ekkekakis, P., & Biddle, S.J.H. (2022). Extraordinary claims in the literature on high-intensity interval training (HIIT): IV. Is HIIT associated with higher long-term exercise adherence? Psychology of Sport and Exercise https://doi.org/10.1016/j.psychsport.2022.102295 

Foster, C., Farland, C. V., Guidotti, F., Harbin, M., Roberts, B., Schuette, J., ... & Porcari, J. P. (2015). The effects of high intensity interval training vs steady state training on aerobic and anaerobic capacity. Journal of sports science & medicine, 14(4), 747.  

Gaesser, G. A., & Angadi, S. S. (2011). High-intensity interval training for health and fitness: Can less be more?. American Journal of Physiology-Heart and Circulatory Physiology, 111(6), 1540-1541. https://doi.org/10.1152/japplphysiol.01237.2011 

Gibala, M. J., & Hawley, J. A. (2017). Sprinting toward fitness. Cell Metabolism, 25(5), 988-990. https://doi.org/10.1016/j.cmet.2017.04.030 

Gibala, M. J., Little, J. P., Essen, M. Van, Wilkin, G. P., Burgomaster, K. A., Safdar, A., Raha, S. and Tarnopolsky, M. A. (2006) Short-term sprint interval versus traditional endurance training : similar initial adaptations in human skeletal muscle and exercise performance. Journal of Physiology. Vol. 575, No. 3: 901–911. [Online]. Available from: doi:10.1113/jphysiol.2006.112094.[full text]

Gibala, M. J., Little, J. P., Macdonald, M. J. and Hawley, J. A. (2012) Physiological adaptations to low-volume , high-intensity interval training in health and disease. Journal of Physiology. Vol. 5, No. March: 1077–1084. [Online]. Available from: doi:10.1113/jphysiol.2011.224725.[full text]

Gibala, M. J. and Mcgee, S. L. (2008) Metabolic Adaptations to Short-term High-Intensity Interval Training : A Little Pain for a Lot of Gain ? Exercise and Sport Science Reviews. Vol. 36, No. 2: 58–63.[full text]

Gibala, M. J., Gillen, J. B., & Percival, M. E. (2014). Physiological and health-related adaptations to low-volume interval training: influences of nutrition and sex. Sports Medicine, 44(2), 127-137. https://doi.org/10.1007/s40279-014-0259-6  

Gillen, J. B., & Gibala, M. J. (2018). Interval training: a time-efficient exercise strategy to improve cardiometabolic health. Applied Physiology, Nutrition, and Metabolism, 43(10), iii-iv. DOI: 10.1139/apnm-2018-0453

Guiraud, T., Nigam, A., Gremeaux, V., Meyer, P., Juneau, M., & Bosquet, L. (2012). High-intensity interval training in cardiac rehabilitation. Sports Medicine, 42(7), 587-605. https://doi.org/10.2165/11631910-000000000-00000 

Hannan, A. L., Hing, W., Simas, V., Climstein, M., Coombes, J. S., Jayasinghe, R., ... & Furness, J. (2018). High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open access journal of sports medicine, 1-17. https://doi.org/10.2147/OAJSM.S150596 

Hardcastle, S. J., Ray, H., Beale, L., & Hagger, M. S. (2014). Why sprint interval training is inappropriate for a largely sedentary population. Frontiers in Psychology, 5, 1505. https://doi.org/10.3389/fpsyg.2014.01505 

Jelleyman, C., Yates, T., O'Donovan, G., Gray, L. J., King, J. A., Khunti, K., & Davies, M. J. (2015). The effects of high‐intensity interval training on glucose regulation and insulin resistance: a meta‐analysis. Obesity reviews, 16(11), 942-961. https://doi.org/10.1111/obr.12317

Jung, M. E., Bourne, J. E., & Little, J. P. (2014). Where does HIT fit? An examination of the affective response to high-intensity intervals in comparison to continuous moderate-and continuous vigorous-intensity exercise in the exercise intensity-affect continuum. PloS one, 9(12), e114541.  https://doi.org/10.1371/journal.pone.0114541  

Kilpatrick, M. W., Jung, M. E., & Little, J. P. (2014). High-intensity interval training: A review of physiological and psychological responses. ACSM's Health & Fitness Journal, 18(5), 11-16. https://acsm.ideafit.com/files/resources/1160365.pdf 

Kinnafick, F. E., Thøgersen-Ntoumani, C., Shepherd, S. O., Wilson, O. J., Wagenmakers, A. J., & Shaw, C. S. (2018). In it together: A qualitative evaluation of participant experiences of a 10-week, group-based, workplace HIIT program for insufficiently active adults. Journal of Sport and Exercise Psychology, 40(1), 10-19. https://doi.org/10.1123/jsep.2017-0306 [pre-print

Lambrick, D., Stoner, L., Ewings, S., & Faulkner, J. (2016). Comment on: Is high-intensity interval training more effective on improving cardiometabolic risk and aerobic capacity than other forms of exercise in overweight and obese youth? A meta-analysis. Obesity Reviews, 17(10), 1012-1013. https://doi.org/10.1111/obr.12451 

Langan, S. P., & Grosicki, G. J. (2021). Exercise is medicine… and the dose matters. Frontiers in physiology, 664. https://doi.org/10.3389/fphys.2021.660818 

MacInnis, M. J., & Gibala, M. J. (2017). Physiological adaptations to interval training and the role of exercise intensity. The Journal of Physiology, 595(9), 2915-2930. https://doi.org/10.1113/JP273196

Martinez, N., Kilpatrick, M. W., Salomon, K., Jung, M. E., & Little, J. P. (2015). Affective and enjoyment responses to high-intensity interval training in overweight-to-obese and insufficiently active adults. Journal of Sport and Exercise Psychology, 37(2), 138-149. https://doi.org/10.1123/jsep.2014-0212 

Image from: MacInnis, M. J., & Gibala, M. J. (2017). Physiological adaptations to interval training and the role of exercise intensity. The Journal of Physiology, 595(9), 2915-2930. https://doi.org/10.1113/JP273196

Metcalfe, R. S., Babraj, J. A., Fawkner, S. G., & Vollaard, N. B. (2012). Towards the minimal amount of exercise for improving metabolic health: beneficial effects of reduced-exertion high-intensity interval training. European Journal of Applied Physiology, 112(7), 2767-2775. https://doi.org/10.1007/s00421-011-2254-z 

Metcalfe, R. S., Koumanov, F., Ruffino, J. S., Stokes, K. A., Holman, G. D., Thompson, D., & Vollaard, N. B. J. (2015). Physiological and molecular responses to an acute bout of reduced-exertion high-intensity interval training (REHIT). European Journal of Applied Physiology, 115(11), 2321-2334. https://doi.org/10.1007/s00421-015-3217-6   

Meyer, K., Lehmann, M., Sünder, G., Keul, J., & Weidemann, H. (1990). Interval versus continuous exercise training after coronary bypass surgery: A comparison of training‐induced acute reactions with respect to the effectiveness of the exercise methods. Clinical Cardiology, 13(12), 851-861. https://doi.org/10.1002/clc.4960131208   

Milanović, Z., Sporiš, G., & Weston, M. (2015). Effectiveness of high-intensity interval training (HIT) and continuous endurance training for VO 2max improvements: a systematic review and meta-analysis of controlled trials. Sports Medicine, 45(10), 1469-1481. https://doi.org/10.1007/s40279-015-0365-0

Niven, A., Laird, Y., Saunders, D. H., & Phillips, S. M. (2020). A Systematic Review and Meta-Analysis of Affective Responses to Acute High Intensity Interval Exercise Compared with Continuous Moderate-and High-Intensity Exercise. Health Psychology Review, 1-113. https://doi.org/10.1080/17437199.2020.1728564 

O'Brien, M. W., Johns, J. A., Robinson, S. A., Bungay, A., Mekary, S. A. I. D., & Kimmerly, D. S. (2020). Impact of high-intensity interval training, moderate-intensity continuous training, and resistance training on endothelial function in older adults. Medicine and science in sports and exercise, 52(5), 1057-1067. https://doi.org/10.1249/mss.0000000000002226 

Oliveira, B. R. R., Santos, T. M., Kilpatrick, M., Pires, F. O., & Deslandes, A. C. (2018). Affective and enjoyment responses in high intensity interval training and continuous training: A systematic review and meta-analysis. PLoS One, 13(6). doi: 10.1371/journal.pone.0197124 

Phillips, B. E., Kelly, B. M., Lilja, M., Ponce-González, J. G., Brogan, R. J., Morris, D. L., ... & Rooyackers, O. (2017). A Practical and Time-efficient high-intensity interval Training Program Modifies cardio-Metabolic risk Factors in adults with risk Factors for Type ii Diabetes. Frontiers in Endocrinology, 8, 229. https://doi.org/10.3389/fendo.2017.00229 

Quindry, J. C., Franklin, B. A., Chapman, M., Humphrey, R., & Mathis, S. (2019). Benefits and risks of high-intensity interval training in patients with coronary artery disease. The American journal of cardiology, 123(8), 1370-1377. https://doi.org/10.1016/j.amjcard.2019.01.008 

Roloff, Z. A., Dicks, N. D., Krynski, L. M., Hartman, M. E., Ekkekakis, P., & Pettitt, R. W. (2020). Ratings of affective valence closely track changes in oxygen uptake: Application to high-intensity interval exercise. Performance Enhancement & Health, 100158. https://doi.org/10.1016/j.peh.2020.100158 

Ross, L. M., Porter, R. R., & Durstine, J. L. (2016). High-intensity interval training (HIIT) for patients with chronic diseases. Journal of Sport and Health Science, 5(2), 139-144. 

Stamatakis, E., Johnson, N.A., Powell, L. et al (2019) Short and sporadic bouts in the 2018 US physical activity guidelines: is high-intensity incidental physical activity the new HIIT? Br J Sports Med http://dx.doi.org/10.1136/bjsports-2018-100397 

Steele, J., Plotkin, D., Van Every, D., Rosa, A., Zambrano, H., Mendelovits, B., ... & Schoenfeld, B. J. (2021). Slow and steady, or hard and fast? A systematic review and meta-analysis of studies comparing body composition changes between interval training and moderate intensity continuous training. Sports, 9(11), 155. https://doi.org/10.3390/sports9110155 

Stensvold, D., Viken, H., Steinshamn, S. L., Dalen, H., Støylen, A., Loennechen, J. P., ... & Sandbakk, S. B. (2020). Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial. BMJ, 371. doi: https://doi.org/10.1136/bmj.m3485   [see thread for critique] 

Sultana, R. N., Sabag, A., Keating, S. E., & Johnson, N. A. (2019). The effect of low-volume high-intensity interval training on body composition and cardiorespiratory fitness: a systematic review and meta-analysis. Sports Medicine, 49(11), 1687-1721.  https://doi.org/10.1007/s40279-019-01167-w 

Image from: Taylor, J. L., Holland, D. J., Spathis, J. G., Beetham, K. S., Wisløff, U., Keating, S. E., & Coombes, J. S. (2019). Guidelines for the Delivery and Monitoring of High Intensity Interval Training in Clinical Populations. Progress in Cardiovascular Diseases. https://doi.org/10.1016/j.pcad.2019.01.004  

Taylor, J. L., Holland, D. J., Spathis, J. G., Beetham, K. S., Wisløff, U., Keating, S. E., & Coombes, J. S. (2019). Guidelines for the Delivery and Monitoring of High Intensity Interval Training in Clinical Populations. Progress in Cardiovascular Diseases. https://doi.org/10.1016/j.pcad.2019.01.004  

Tschakert, G., & Hofmann, P. (2013). High-intensity intermittent exercise: methodological and physiological aspects. International Journal of Sports Physiology and Performance, 8(6), 600-610. https://doi.org/10.1123/ijspp.8.6.600 

Viana, R. B., Naves, J. P. A., Coswig, V. S., de Lira, C. A. B., Steele, J., Fisher, J. P., & Gentil, P. (2019). Is interval training the magic bullet for fat loss? A systematic review and meta-analysis comparing moderate-intensity continuous training with high-intensity interval training (HIIT). Br J Sports Med, 53(10), 655-664. http://dx.doi.org/10.1136/bjsports-2018-099928 [paper retracted 15/12/20; see blog here http://www.weightymatters.ca/2019/02/guest-post-problems-with-balancing.html and also see this commentary in JAMA] [also see Steele et al, 2021 above]

Vollaard, N. B., & Metcalfe, R. S. (2017). Research into the health benefits of sprint interval training should focus on protocols with fewer and shorter sprints. Sports Medicine, 47(12), 2443-2451. https://doi.org/10.1007/s40279-017-0727-x   

Weston, K. S., Wisløff, U., & Coombes, J. S. (2014). High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med, 48(16), 1227-1234. http://dx.doi.org/10.1136/bjsports-2013-092576 

Weston, M., Taylor, K. L., Batterham, A. M., & Hopkins, W. G. (2014). Effects of low-volume high-intensity interval training (HIT) on fitness in adults: a meta-analysis of controlled and non-controlled trials. Sports Medicine, 44(7), 1005-1017. https://doi.org/10.1007/s40279-014-0180-z 

Wilke, J., Kaiser, S., Niederer, D., Kalo, K., Engeroff, T., Morath, C., ... & Banzer, W. (2019). Effects of high‐intensity functional circuit training on motor function and sport motivation in healthy, inactive adults. Scandinavian journal of medicine & science in sports, 29(1), 144-153. https://doi.org/10.1111/sms.13313 

Wisløff, U., Støylen, A., Loennechen, J. P., Bruvold, M., Rognmo, Ø., Haram, P. M., ... & Videm, V. (2007) Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: A randomized study. Circu. ; 115 (24): 3086-3094. https://doi.org/10.1161/CIRCULATIONAHA.106.675041 

Recommended books

Laursen, P. and Bucheit, M. (2018) Science and Application of High-Intensity Interval Training. Champaign, IL: Human Kinetics [Human Kinetics website]

(more focussed on sports performance training than health but contains a wealth of insight and research on the topic)

Follow on Twitter

Martin Gibala - @gibalam

Richard Metcalfe - @richmetcalfe

Paul Laursen - @PaulBLaursen

Martin Bucheitt - @mart1buch

@hiitscience

Panteleimon ("Paddy") Ekkekakis - @Ekkekakis

Stuart Biddle - @stuart_biddle