We compared 3 months of eucaloric (12 kcal/kg/wk) steady state aerobic training (AER) to interval training (INT) in men at risk for insulin resistance. Primary outcomes included oral glucose tolerance testing (OGTT) and HOMA-IR 24 h and 72 h after each participants last exercise session. Secondary outcomes were VO2max, anthropometry, and metabolic syndrome expressed as a summed z-score (zMS). We also performed a sub-analysis for participants entering the trial above and below the HOMA-IR study median. Mean (95% CI) AER (-12.81 mg/dl; -24.7 to -1.0) and INT (-14.26 mg/dl; -24.9 to -3.6) significantly improved 24 h OGTT. HOMA-IR did not improve for AER, but did for INT 24 h and 72 h post-exercise. VO2max improved similarly for both groups. Changes in body mass for INT (-2.29 kg; -3.51 to -1.14), AER (-1.32 kg; -2.62 to 0.58)) and percent body fat (INT -0.83%; -1.62 to -0.03, AER -0.17%; -1.07 to 0.06) were only significant for INT. When examined as a full cohort, zMS improved for both groups. Upon HOMA-IR stratification, only high HOMA-IR AER showed significant improvements, while both low and high INT HOMA-IR participants demonstrated significant reductions (p < 0.05). Eucaloric AER and INT appear to affect fasting glucose, OGTT and VO2max similarly, while INT may have a greater impact on HOMA-IR and zMS.

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