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)
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 with clinical populations (see Taylor et al, 2019)
How do people feel during and after completing HIIT compared to other forms of exercise (Jung et al, 2014; Martinez, 2015; Oliveira et al, 2018; Niven et al, 2020)
Is Interval Training effective for fat loss? (e.g. Steele et al, 2021; CAUTION USING Viana et al, 2019 notes next to it below)
Is HIIT effective for hypertrophy? (See Callahan et al, 2021)
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
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
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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]
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
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
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
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
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
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Richard Metcalfe - @richmetcalfe
Paul Laursen - @PaulBLaursen
Martin Bucheitt - @mart1buch
Panteleimon ("Paddy") Ekkekakis - @Ekkekakis
Stuart Biddle - @stuart_biddle