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Effectiveness of high-intensity interval training for weight loss in adults with obesity: a randomised controlled non-inferiority trial [with consumer summary]
d'Amuri A, Sanz JM, Capatti E, di Vece F, Vaccari F, Lazzer S, Zuliani G, dalla Nora E, Passaro A
BMJ Open Sport & Exercise Medicine 2021;7(3):e001021
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: Obesity treatment guidelines suggest moderate-intensity continuous training (MICT), but the patient's compliance to this indication remains low. High-intensity interval training (HIIT) is a time sparing training mode whose metabolic effects are not clear. This study aimed to determine whether a 12-week HIIT was more effective than MICT for weight loss in obese adults. METHODS: 44 obese subjects were randomised and trained with isoenergetic treadmill exercises for 12 weeks: MICT (60% of maximal oxygen peak, VO2peak) or HIIT (3 to 7 repetition of 3 min 100% of VO2peak interspersed by 1.5 min 50% of VO2peak). The primary outcome was a change in body weight; the secondary outcomes were changes in body composition, blood pressure, lipid profile, glycaemia, insulin and VO2peak. RESULTS: 32 subjects (53% male, mean age: 38.5 years, mean body mass index: 35.5 kg/m2) completed the trial. MICT and HIIT showed comparable effect within groups in weight loss (-6.0 kg (-9.0 kg to -3.0 kg) versus -5.7 kg (-8.3 kg to -3.1 kg)), changes in fat mass (-2.9% (-4.4% to -1.4%) versus -3.6% (-5.9% to -1.2%)), fat free mass (-5.3% (-7.8% to -2.8%) versus -5.5% (-8.3% to -2.6%)), diastolic blood pressure (-5.5 mmHg (-10.6 mmHg to -0.3 mmHg) versus -5.8 mmHg (-11.3 mmHg to -0.3 mmHg)) and low-density lipoprotein cholesterol (-16.4 mg/dL (-30.8 mg/dL to -2.0 mg/dL) versus -14.7 mg/dL (-25.6 mg/dL to -3.8 mg/dL)). There was a significant change between groups in VO2peak (HIIT +461.6 mL (329.3 to 593.8 mL); MICT +170.5 mL (86.7 to 254.4 mL); p < 0.001) and duration of sessions (HIIT 35.0 min (31.7 to 35.6 min); MICT 46.5 min (40.2 to 48.3 min); p < 0.001). No significant changes in systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, glycaemia or plasma insulin were observed. CONCLUSIONS: In healthy adults with obesity, HIIT compared with MICT induced similar weight loss and cardiovascular risk factors improvement but resulted in a larger increase in cardiorespiratory fitness over a shorter period.

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