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Effect of high-intensity interval training on visceral and liver fat in cardiac rehabilitation: a randomized controlled trial [with consumer summary]
Taylor JL, Holland DJ, Mielke GI, Bailey TG, Johnson NA, Leveritt MD, Gomersall SR, Rowlands AV, Coombes JS, Keating SE
Obesity 2020 Jul;28(7):1245-1253
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: This study aimed to investigate the effect of exercise intensity on visceral adipose tissue (VAT) and liver fat reduction in patients with coronary artery disease (CAD) over 3 months and the maintenance of improvements over 12 months. METHODS: Forty-two participants with CAD were randomized to three sessions/week of either 4 x 4-minute high-intensity interval training (HIIT) or 40 minutes of usual care moderate-intensity continuous training (MICT) for a 4-week supervised cardiac rehabilitation program, followed by three home-based sessions/week for 11 months. Liver fat (as intrahepatic lipid) and VAT were measured via magnetic resonance techniques. Data are mean change (95% CI). RESULTS: HIIT and MICT significantly reduced VAT over 3 months (-350 (-548 to -153) cm3 versus -456 (-634 to -278) cm3; time x group effect p = 0.421), with further improvement over 12 months (-545 (-818 to -271) cm3 versus -521 (-784 to -258) cm3; time x group effect p = 0.577) and no differences between groups. Both groups improved liver fat over 3 months, with HIIT tending to show greater reduction than MICT (-2.8% (-4.0% to -1.6%) versus -1.4% (-2.4% to -0.4%); time x group effect p = 0.077). After 12 months, improvements were maintained to a similar degree. Higher exercise intensity predicted liver fat reduction (beta = -0.3 (-0.7 to 0.0); p = 0.042). CONCLUSIONS: HIIT and MICT reduced VAT over 3 and 12 months. For liver fat, HIIT tended to provide a slightly greater reduction compared with MICT. These findings support HIIT as a beneficial adjunct or alternative to MICT for reducing visceral and liver fat in patients with CAD.

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