High Intensity Interval Training (HIIT) and Health

Critical Questions

  • What role might high intensity interval training play in population level physical activity guidelines? (also see Physical Activity Guidelines: Key Issues)
  • What type of interval training sessions have been evaluated?
  • Define the various terminology used (e.g. HIIT, SIT)
  • What physiological adaptations is interval training associated with? (also see Chronic Exercise Induced Cardio-Respiratory Adaptations)
  • Is Interval Training any use for fat loss? (see Viana et al, 2019)
  • Why is interval training an attractive health-based recommendation?
  • What are the limitations of recommending high intensity interval training to the general population?
  • What is the minimal dose required to achieve the benefits of high intensity interval training?
  • How can changing the variables (Intensity, work duration, rest duration, number of repetitions, frequency of training) affect the adaptations?
  • What evidence is there for the use of HIIT (or other interval protocols) in specific conditions?
  • What are the guidelines for using HIIT training with clinical populations (see Taylor et al, 2019)

Key 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

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

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

Full Reading List

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]

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

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

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

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

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

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

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]

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

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

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

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

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

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 [also see this commentary in JAMA] [

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

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