Effects of High-Intensity Intermittent Exercise

Training on Appetite Regulation

AARON Y. SIM1, KAREN E. WALLMAN1, TIMOTHY J. FAIRCHILD2, and KYM J. GUELFI1
1
School of Sport Science, Exercise and Health, University of Western Australia, Perth, Western Australia, AUSTRALIA;
and 2School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, AUSTRALIA

ABSTRACT
SIM, A. Y., K. E. WALLMAN, T. J. FAIRCHILD, and K. J. GUELFI. Effects of High-Intensity Intermittent Exercise Training on
Appetite Regulation. Med. Sci. Sports Exerc., Vol. 47, No. 11, pp. 2441–2449, 2015. Objective: An acute bout of high-intensity
intermittent exercise suppresses ad libitum energy intake at the postexercise meal. The present study examined the effects of 12 wk of
high-intensity intermittent exercise training (HIIT) compared with moderate-intensity continuous exercise training (MICT) on appetite
regulation. Methods: Thirty overweight inactive men (body mass index, 27.2 T 1.3 kgImj2; V̇O2peak, 35.3 T 5.3 mLIkgj1Iminj1) were
randomized to either HIIT or MICT (involving 12 wk of training, three sessions per week) or a control group (CON) (n = 10 per group).
Ad libitum energy intake from a laboratory test meal was assessed after both a low-energy (847 kJ) and a high-energy preload (2438 kJ)
before and after the intervention. Perceived appetite and appetite-related blood variables were also measured. Results: There was no
significant effect of the intervention period on energy intake at the test meal after the two different preloads (P Q 0.05). However, the 95%
confidence interval indicated a clinically meaningful decrease in energy intake after the high-energy preload compared with the low-
energy preload in response to HIIT (516 T 395 kJ decrease), but not for MICT or CON, suggesting improved appetite regulation.
This was not associated with alterations in the perception of appetite or the circulating concentration of a number of appetite-related
peptides or metabolites, although insulin sensitivity was enhanced with HIIT only (P = 0.003). Conclusions: HIIT seems to benefit
appetite regulation in overweight men. The mechanisms for this remain to be elucidated. Key Words: ENERGY INTAKE, INSULIN
SENSITIVITY, APPETITE-RELATED HORMONES, PRELOAD, OVERWEIGHT, INACTIVE

A
growing body of research has demonstrated a link individuals by promoting more sensitive eating behav-
between exercise and the physiological mechanisms ior in response to previous energy intake. Similar im-

controlling appetite and energy intake, with inac-
tivity potentially contributing to a positive energy balance
and subsequent weight gain (18,22,31). Conversely, it is
widely acknowledged that exercise plays a prominent role in
weight management by 1) contributing to a negative energy
balance by increasing energy expenditure (3,4,27) and 2)
having a favorable influence on the sensitivity of appetite
regulation (25), the total amount of energy consumed (30),
feelings of hunger and fullness (3,9), and the circulating
levels of a number of appetite-related hormones (1,3).
More specifically, Martins et al. (25) demonstrated that 6 wk
of moderate-intensity aerobic exercise training (four ses-
sions per week at approximately 65%–75% of HRmax) im-
proved appetite regulation in previously inactive normal-weight
Address for correspondence: Aaron Sim, Ph.D., School of Sport Science,
Exercise and Health, University of Western Australia, 35 Stirling Highway,
Crawley, WA 6009, Australia; E-mail: aaron.sim@uwa.edu.au.
Submitted for publication November 2014.
Accepted for publication April 2015.
0195-9131/15/4711-2441/0
MEDICINE & SCIENCE IN SPORTS & EXERCISEÒ
Copyright Ó 2015 by the American College of Sports Medicine
DOI: 10.1249/MSS.0000000000000687
APPLIED SCIENCES
provements in appetite regulation have been reported in
inactive overweight participants in response to 12 wk of
aerobic exercise training (five sessions per week at approx-
imately 75% of HRmax) (24). However, there is evidence
that the benefits of exercise training for appetite regulation
may be optimized by manipulating the specific type of ex-
ercise used. For instance, Guelfi et al. (9) found that 12 wk
(three sessions per week) of aerobic-based exercise training
(stationary cycling and elliptical cross training at approxi-
mately 70%–80% of HRmax) increased both fasting and
postprandial ratings of perceived fullness whereas an
equivalent period of resistance training (machine and free
weights) did not.
Another important aspect of exercise prescription that
may influence appetite regulation is the intensity of training.
Support for this notion comes from a recent study by our
laboratory showing that an acute bout of intermittent high-
intensity exercise (consisting of repeated bouts of 15 s at
approximately 170% V̇O2peak with an active recovery period
of 60 s at approximately 32% V̇O2peak) attenuated energy
intake in the postexercise meal compared with a bout of
continuous moderate-intensity exercise (approximately 60%
V̇O2peak) of matched total work and a resting control in
overweight and inactive men (30). The lower energy intake
after intermittent exercise was associated with reduced active

2441

Copyright © 2015 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
 ghrelin, together with elevated blood lactate and glucose. In
addition, free-living energy intake in the 48 h after leaving
the laboratory remained lower after the intermittent exercise
compared with moderate continuous exercise and control.
Whether these acute benefits of intermittent high-intensity
exercise translate to differences in long-term appetite regula-
tion and weight loss remains to be determined. Therefore,
the purpose of this study was to examine the effect of 12 wk
of supervised exercise (high-intensity intermittent exercise
training (HIIT) compared with continuous moderate-intensity
training (MICT) and a no-exercise control) on appetite regula-
tion (using the high-energy vs low-energy preload test meal
paradigm), perceptions of appetite and the circulating con-
centrations of appetite-related hormones (particularly active
ghrelin, leptin, insulin, pancreatic peptide (PP), and peptide
tyrosine tyrosine (PYY)) in the fasted state and in response to
caloric consumption in previously inactive overweight men. It
was hypothesized that 12 wk of supervised exercise would
improve appetite regulation (i.e., promote more sensitive eat-
ing behavior) compared with a no-exercise control but that the
improvement would be to a greater extent in response to HIIT
compared with MICT.
METHODS
Participants
Thirty overweight, physically inactive men (age, 31T 8 yr;
body mass index (BMI), 27.2 T 1.3 kgImj2; V̇O2peak, 35.3 T
5.3 mLIkgj1Iminj1) were recruited from the local commu-
nity. Physical inactivity was defined as not engaging in
APPLIED SCIENCES
moderate-intensity exercise for more than 75 minIwkj1 (35).
To minimize any influence of dietary restraint on the results,
participants were excluded if they scored Q3.5 on the re-
straint scale of the Dutch Eating Behavior Questionnaire
(33). Ethics approval was granted by the human research
ethics committee at the University of Western Australia, and
a written consent was obtained from all participants.
Study Design
Participants were randomly allocated (using a random
number generator software (32) into one of the following
three experimental groups: 1) HIIT, 2) MICT, or 3) no ex-
ercise training control (CON). Appetite regulation was assessed
before and after the intervention on the basis of a preload-test
meal paradigm, originally introduced by Schachter et al. (29)
(involving the assessment of ad libitum energy intake in
response to previous energy intake of differing caloric con-
tents). The effect of the intervention period on perceived
appetite, appetite-related blood variables, free-living energy
intake, physical activity levels, anthropometric measures,
aerobic fitness, dietary restraint, and physical activity en-
joyment were also assessed.
Baseline testing and familiarization. Participants
completed an initial baseline testing and familiarization ses-
sion. This included the assessment of 1) body composition
2442 Official Journal of the American College of Sports Medicine
Copyright © 2015 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
using dual-energy x-ray absorptiometry (GE Lunar Prodigy
Vision; GE Medical Systems, Madison, WI), 2) peak aero-
bic capacity (V̇O2peak) using a continuous incremental
exercise test performed on an air-braked cycle ergometer
as previously described (30), 3) dietary restraint via the
Dutch Eating Behavior Questionnaire (33), and 4) whether
they were regular breakfast consumers (Q5 times per week).
Familiarization with the questionnaires and protocols
to be used for the subsequent assessment of pre- and
postintervention outcome measures (i.e., blood sampling,
laboratory test meal) was also performed during this ses-
sion to minimize the novelty of these tasks. Body compo-
sition, V̇O2peak, and dietary restraint were reassessed at the
end of the study period.
Pre- and postintervention testing. Participants attended
the laboratory at approximately 0700 h, having fasted for
10–12 h, on two separate occasions both before and after
intervention (i.e., four visits in total) for the assessment
of outcomes measures. In the 24 h before the first visit,
participants were required to document their food and
drink consumption and to refrain from vigorous physical
activity. The documented dietary information was reviewed by
the investigator upon arrival at the laboratory, and participants
were instructed to replicate their food and drink intake before
each subsequent visit, with compliance confirmed by the
inspection of the records upon arrival to the laboratory
and later nutritional analyses. All postintervention testing
was conducted within the week and at least 48 h after the
last training session. Enjoyment of physical activity was
assessed before and after intervention (i.e., first and final
exercise training session) via the Physical Activity Enjoy-
ment Scale (16).
Preload test meal. Upon arrival at the laboratory,
participants were provided with either a high-energy preload
(HEP, 2438 kJ) or low-energy preload (LEP, 847 kJ) in a
counterbalanced, single-blind design (preloads were of
similar volume and sensory properties for consumption).
The HEP consisted of 250 mL of UP&GOÒ liquid breakfast
(Sanitariumi; Berkeley Vale, New South Wales, Australia),
100 g of maltodextrin (Poly-JouleÒ; Nutricia, Macquarie
Park, New South Wales, Australia), and approximately 100 mL
of water to make a total volume of 450 mL, whereas the LEP
consisted of 250-mL UP&GOÒ liquid breakfast, 2 g of
ResourceÒ ThickenUpi Clear (Nestlé, Notting Hill, Victoria,
Australia), 5-mL SugarlessÒ Liquid Sweetener, (Sugarlessi,
Chipping Norton, New South Wales, Australia), and approxi-
mately 193-mL water to make a total volume of 450 mL.
Participants remained seated for 70 min after consuming
the preload, at which point they were given access to a
laboratory test meal for 20 min, during which time they were
instructed to consume ad libitum until they felt ‘‘comfort-
ably full.’’ The test meal consisted of porridge made from a
mixture of instant oats (Oats Quick Sachet—Creamy Honey;
Uncle TobysÒ, Nestlé, Rhodes, New South Wales, Australia)
and milk (HiLo Milk; PuraÒ, Melbourne, Victoria, Australia)
of known quantity and nutrition content. In favor of external
http://www.acsm-msse.org
validity (i.e., there is typically free access to water intake
when consuming a meal), a standardized bottle of plain
drinking water (approximately 1000 mL) was also available
for ad libitum consumption. The porridge and drinking water
were weighed before and after consumption. Measures were
taken to minimize the influence of environmental factors on
eating behavior as previously described (30).
Assessment of perceptions of appetite. Subjective
perceptions of appetite (fullness, hunger, satiation, desire
to eat, and prospective food consumption) were assessed
using a 100-mm visual analog scale (13) in the fasted
state (before preload consumption) and in response to ca-
loric consumption (immediately and 30, 60, and 90 min
after preload).
Assessment of appetite-related blood variables.
Blood was sampled in the fasted state (before preload con-
sumption) and in response to caloric consumption (30 and
60 min after preload). To prepare the sampling site, the
entire hand was placed into a box heated with warm air
(approximately 60-C). Capillary blood (535 KL) was then
collected from the warmed fingertip using a sterile lancet
(Unistik 2 Normal; Owen Mumford, Oxford, United Kingdom).
Blood glucose concentration was measured using a blood
gas analyzer (35-KL ABL 735; Radiometer, Copenhagen,
Denmark). The remaining blood was treated with EDTA
(Microtainer Tubes with K2E (K2EDTA); BD Microtainer,
Franklin Lakes, NJ) and serine protease inhibitor (20 KL
per 500 KL of blood; Pefabloc SC, Roche Diagnostics,
Sydney, New South Wales, Australia) before being centri-
fuged at 1020g for 10 min. Plasma obtained was stored
at approximately j80-C, and samples from the HEP con-
dition only were later analyzed for a range of appetite-
related hormones leptin, insulin, active ghrelin, PP, and
PYY using a commercially available assay kit (Milliplex
Map Human Metabolic Hormone Magnetic Bead Panel;
Millipore Corporation, Billerica, MA). The minimum de-
tectable concentrations of the respective peptides are as
follows: ghrelin, 1.8 pgImLj1; leptin, 157.2 pgImLj1; PP,
2.4 pgImLj1; PYY, 8.4 pgImLj1; insulin, 44.5 pgImLj1.
The intraassay variation (%coefficient of variation) of the
Milliplex multiplex assay is G11%.
Assessment of free-living energy intake and
physical activity levels. Free-living energy intake and
physical activity levels in the 24 h before and for the re-
mainder of the day after leaving the laboratory sessions were
assessed using a self-recorded food diary and accelerometry
(GT1M Activity Monitor; ActiGraph, Pensacola, FL), re-
spectively. The food diary required participants to record the
portion size (weighing scales were provided to assist) and
describe the food consumed. Detailed instructions on the use
of the food diary and the necessity for timely and accurate
recordings after food and drink consumption were empha-
sized. Energy intake from food records was calculated using
a commercially available software program (Foodworks;
Xyris Software, Queensland, Australia). The total number
of steps and estimated energy expenditure from physical
EXERCISE TRAINING AND APPETITE REGULATION
Copyright © 2015 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
activity based on accelerometry were determined using
ActiLife software (ActiGraph, Pensacola, FL).
Exercise intervention. Both exercise training groups
(HIIT and MICT) were required to participate in three
training sessions each week over 12 wk. All training
was conducted on calibrated front-access air-braked cycle
ergometers (model EX-10; Repco Cycle, Huntingdale,
Victoria, Australia) that were interfaced with a customized
software program (Cyclemax; School of Sport Science, Ex-
ercise and Health, University of Western Australia, Perth,
Western Australia, Australia). Participants randomized to HIIT
were required to complete repeated bouts of high-intensity ex-
ercise (15 s at a power output equivalent to approximately
170% V̇O2peak) with an active recovery period (60 s at a power
output approximately 32% V̇O2peak) between efforts. This
protocol was intended to replicate the intensity and dura-
tion of intervals (and corresponding work-to-recovery ratio)
shown to attenuate short-term ad libitum energy intake in our
previous study (30). Participants allocated to MICT exercised
at a power output equivalent to 60% V̇O2peak continuously for
the duration of each training session. Relative total work was
matched between exercise protocols, and the workload for
each participant was determined using their individual base-
line V̇O2peak results.
All training sessions were fully supervised by an exercise
physiologist (A.Y.S.). Training sessions commenced with a
5-min warm-up that involved easy pedaling followed by
light static/dynamic stretching of the lower limbs. Heart rate
(HR) and rating of perceived exertion (RPE) were measured
during each exercise session. To accommodate for an in-
crease in fitness throughout the intervention period, the
APPLIED SCIENCES
workload and duration of the training sessions were pro-
gressively increased. Training workloads were adjusted on
the basis of a conservative 1% improvement in aerobic ca-
pacity per week, whereas duration progressed as follows:
weeks 1–3 (30 min), weeks 4–6 (35 min), weeks 7–9
(40 min), and weeks 10–12 (45 min). In addition, the V̇O2peak
test was repeated during week 6 of the intervention and
training workloads were further adjusted accordingly.
Statistical Analysis
Insulin sensitivity was calculated using the homeostatic
model assessment (HOMA-IR) index (based on fasting blood
glucose and insulin concentration) (34). Repeated-measures
ANOVA were used to compare the estimated energy intake
and energy expenditure for the 24 h before each laboratory
visit for the assessment of outcome measures to confirm that
these factors were well matched. Mixed-model ANOVA was
applied to determine treatment effects for each outcome var-
iable, as follows: 1) two-way (pre- vs postintervention 
condition (HIIT, MICT, and CON)) for aerobic fitness, an-
thropometric measures, physical activity enjoyment, and di-
etary restraint, 2) three-way (pre- vs postintervention 
preload (HEP vs LEP)  condition) for energy intake at the
laboratory test meal and 24-h cumulative energy intake, 3)
Medicine & Science in Sports & Exercised 2443
 TABLE 1. Aerobic fitness and body composition before and after 12 wk of HIIT (n = 10), MICT (n = 10), or no exercise training control (CON, n = 10).
HIIT MICT CON
V̇O2peak (mLIkgj1Iminj1) Preintervention 34.8 T 4.5 34.8 T 6.2 36.3 T 5.6
Postintervention 40.4 T 4.4*,** 39.7 T 6.9*,** 35.8 T 5.5
Body mass (kg) Preintervention 87.4 T 7.7 86.5 T 8.6 85.6 T 6.4
Postintervention 86.6 T 7.5 85.9 T 8.5 87.1 T 6.7
BMI (kgImj2) Preintervention 27.4 T 1.6 27.2 T 1.5 27.0 T 0.9
Postintervention 27.1 T 1.4 27.0 T 2.3 27.5 T 0.9**
Body fat percentage (%) Preintervention 32.0 T 2.9 31.1 T 5.0 32.2 T 3.9
Postintervention 30.9 T 2.7 30.2 T 6.5 32.5 T 3.9
Values are presented as mean T SD.
*Indicates significant difference from preintervention (P e 0.050).
**Indicates moderate-to-large Cohen d effect size from preintervention.

four-way (pre- vs postintervention  preload  time (0 min,
immediately after preload, 30 min after preload, 60 min after
preload, and 90 min post-preload)  condition) for perceived
appetite, and 4) three-way (pre-vs postintervention  time
(0 min, 30 min after preload, and 60 min after preload)  con-
dition) for appetite-related hormone concentration in response
to caloric intake. The effect of the intervention and condition
(HIIT, MICT, and CON) on HR and RPE was assessed using
a mixed-model ANOVA. Post hoc comparisons were con-
ducted where appropriate. Statistical significance was ac-
cepted at P e 0.050 (SPSS version 20; IBM Corporation,
Armonk, NY). In addition, 95% confidence intervals (CI)
were presented as follows: lower bound value–upper bound
value. Furthermore, Cohen d effect sizes (d) were also cal-
culated for pairwise comparisons; only moderate (0.50–0.79)
and large (90.80) effect sizes are reported. All results are
presented as mean T SD, unless otherwise indicated.
RESULTS
APPLIED SCIENCES
RPE (P G 0.001) increased through the course of both
training interventions.
After the 12-wk study period, V̇O2peak was improved in
both the HIIT and MICT groups (P G 0.001) (Table 1) to a
similar extent but remained unchanged in the CON group.
There were no significant changes in anthropometric mea-
sures (body mass, P = 0.234; BMI, P = 0.204; body fat, P =
0.187) in response to the interventions (Table 1). With re-
spect to the enjoyment of exercise, there was a main effect of
the exercise intervention period (P = 0.006), with an in-
crease in enjoyment after intervention compared with base-
line (preintervention, 93 T 15; postintervention, 102 T 13;
d = 0.64); however, there was no difference between HIIT
and MICT (P = 0.172). Furthermore, there was no interac-
tion effect of pre- vs postintervention  condition on dietary
restraint (pre- vs postintervention, HIIT: 2.7 T 0.4 vs 2.6 T
0.5; MICT, 2.4 T 0.6 vs. 2.5 T 0.8; CON, 2.2 T 0.5 vs 2.4 T
0.5; P = 0.829).
Ad libitum energy intake at the laboratory test
meal. Energy intake and energy expenditure from physical

There were no dropouts in any of the treatment groups,
with every participant in the study completing all the re-
quired testing sessions. Furthermore, training attendance
was similar between groups (P = 0.712), with 98% T 3%
(mean, 35 of 36 sessions; minimum, 33 sessions) compli-
ance for HIIT and 97% T 4% (mean, 35 of 36; minimum, 33
sessions) for MICT.
Training intervention. A main effect of condition re-
vealed higher average HR (P G 0.001) and RPE (P = 0.034)
during HIIT (HR, 158 T 3 bpm; RPE, 14 T 1) compared with
MICT (HR, 133 T 5 bpm; RPE, 13 T 1). A main effect of
training time point showed that average HR (P G 0.001) and
activity in the 24 h before each preload test session were
well-matched (energy intake = 8327 T 2191 kJ, P = 0.416;
energy expenditure = 1905 T 573 kJ, P = 0.768). Likewise,
the environmental conditions were consistent during the
preload test sessions (temperature = 21.3-C T 0.9-C, P =
0.996; humidity = 52.6% T 7.2 %, P = 0.700).
Absolute ad libitum energy intake during the laboratory
test meal after the HEP and LEP assessed pre- and post-
intervention is shown in Figure 1, with differences in energy
intake pre- and postintervention displayed in Table 2. En-
ergy intake during the test meal after the two different
preloads was similar at baseline in all groups (P = 0.396),

FIGURE 1—Mean (T SE) ad libitum energy intake at laboratory test meal after HEP and LEP before (preintervention) and after (postintervention)
12 wk of HIIT, MICT, or no exercise training (CON) (n = 10 in each group).

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TABLE 2. Difference in ad libitum energy intake from a laboratory test meal and cumulative 24-h energy intake (kJ) after HEP and LEP before and after 12 wk of HIIT, MICT, or no exercise
training (CON; n = 10 in each group).
Study Time
Point/Preload HIIT x̄ T SD (95% CI) MICT x̄ T SD (95% CI) CON x̄ T SD (95% CI)
$ Energy intake at test meal (i.e., HEP j LEP) Preintervention j43 T 585 (320, j406) 219 T 523 (544, j105) j88 T 494 (218, j394)
Postintervention j516 T 395 (j271, j762) j68 T 677 (351, j488) j66 T 688 (360, j493)
$ 24-h energy intake (i.e., HEP j LEP) Preintervention 402 T 1597 (1392, j588) 649 T 2103 (1953, j654) j204 T 1054 (449, j857)
Postintervention 186 T 1108 (873, j500) j617 T 2445 (898, j2133) 265 T 1345 (1099, j569)
$ Energy intake at test meal HEP 517 T 736 (61, 973) 199 T 1043 (j447, 845) j223 T 628 (j612, 166)
(i.e., preintervention j postintervention) LEP 43 T 640 (j354, 439) j89 T 783 (j574, 397) j202 T 736 (j658, 254)
$ 24-h energy intake HEP 928 T 1590 (j58, 1913) 758 T 1917 (j430, 1946) j199 T 648 (j601, 203)
(i.e., preintervention j postintervention) LEP 712 T 1241 (j57, 1481) j509 T 1265 (j1293, 275) 104 T 1354 (j735, 943)
Values are presented as mean (x̄) and 95% CI for preintervention energy intake minus postintervention energy intake (lower bound, upper bound). Where the 95% CI does not cross zero,
the value was set in bold.

suggesting a lack of appropriate compensation for previous
energy intake. With respect to the effect of the intervention
period on energy intake from the test meals, there was no
significant interaction of pre- versus postintervention 
preload  condition (P = 0.333); however, the 95% CI indi-
cated a decrease in energy intake after the HEP after 12 wk of
HIIT compared with the LEP postintervention (Table 2),
suggesting a tendency for enhanced appetite regulation based
on more appropriate adjustment for previous energy intake.
There was no difference in ad libitum water intake at the
laboratory test meal between trials (P = 0.601).
Cumulative 24-h energy intake. Cumulative energy
intake for the remainder of the day after the ad libitum lab-
oratory meal is shown in Figure 2, and the differences in
cumulative energy intake before to after intervention are
presented in Table 2. Cumulative energy intake values after
the two different preloads were similar at baseline in all
groups (P = 0.644). The interaction effect of pre- versus
postintervention  preload  condition on cumulative en-
Appetite-related blood variables. An interaction ef-
fect of pre- versus postintervention  time  condition was
observed for insulin (P = 0.050) (Fig. 3A), with post hoc
analysis revealing lower insulin concentration in a fasted
state after HIIT (P = 0.003, d = 0.60) and 60 min after ca-
loric consumption in MICT (P = 0.010, d = 0.77) compared
with preintervention. There was an interaction effect of pre-
versus postintervention  condition on leptin (P = 0.017)
(Fig. 3B), revealing lower leptin concentration after HIIT
but not after MICT and CON. There were no interaction
effects observed for active ghrelin (P = 0.736) (Fig. 4A), PP
(P = 0.060) (Fig. 4B), PYY (P = 0.077) (Fig. 4C), or blood
glucose (P = 0.926) (Fig. 4D). However, there was a main
effect of test session time (P e 0.001) for each of these blood
variables, with increased PP, PYY, insulin, and blood glu-
cose in response to caloric consumption, whereas active
ghrelin and leptin decreased over time.
HOMA-IR was similar between groups at baseline (P =
0.48). There was an interaction effect of pre- versus

ergy intake over 24 h was not significant (P = 0.082).
Perception of appetite. There were no significant
interactions of pre- versus postintervention  preload  time 
condition on perceived hunger (P = 0.691), fullness (P =
0.260), satiation (P = 0.352), desire to eat (P = 0.434), or
prospective food consumption (P = 0.657; results not
displayed). However, there was a main effect of time within
each test session for each of these variables (P G 0.001), with
increased feelings of fullness and satiation along with de-
creased hunger, desire to eat, and prospective food con-
sumption after the test meal.
APPLIED SCIENCES
postintervention  condition on HOMA-IR (P = 0.016), with
post hoc analysis revealing significantly lower HOMA-IR
after HIIT (pre, 3.8 T 1.9; post, 2.9 T 1.6; P = 0.018; d = 0.61)
but not for MICT and CON.
DISCUSSION
The main aim of the present study was to compare the
effects of 12 wk of HIIT with an equivalent period of MICT
or inactivity on appetite regulation in previously inactive
overweight men. There were no statistically significant

FIGURE 2—Mean (T SE) cumulative 24-h energy intake after HEP and LEP before (preintervention) and after (postintervention) 12 wk of HIIT,
MICT, or no exercise training (CON) (n = 10 in each group).

EXERCISE TRAINING AND APPETITE REGULATION Medicine & Science in Sports & Exercised 2445

Copyright © 2015 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
 FIGURE 3—Mean (T SE) concentrations of insulin (A) and leptin (B) in the fasted state (time, 0 min) and in response to caloric consumption (indicated
by an upward arrow, j) before (represented by black circles, ) and after (represented by white circles, )) 12 wk of HIIT, MICT, or no exercise training
control (CON) (n = 10 in each group). #Significantly different from preintervention. *Significant interaction effect of pre- vs postintervention, test
session time (0, 35, and 65 min), and condition (HIIT, MICT, and CON). †Significant main effect of test session time point (0, 35, and 65 min) is
different from preintervention (P e 0.050).

differences in energy intake at the laboratory test meal or
cumulative energy intake after leaving the laboratory as a
result of the intervention period. However, the 95% CI in-
dicated improved appetite regulation after HIIT on the basis
of a clinically meaningful decrease (14) in energy intake at
APPLIED SCIENCES
the test meal after the HEP compared with LEP in response
to HIIT but not for MICT or CON. The tendency for lower
energy intake after HEP compared with LEP in response
to HIIT suggests improved appetite regulation (based on a
more appropriate adjustment of energy intake in response to

FIGURE 4—Mean (T SE) concentrations of active ghrelin (A), PP (B), PYY (C), and glucose (D) in the fasted state (time, 0 min) and in response to
caloric consumption (indicated by upward arrow, j) before (represented by black circles, ) and after (represented by white circles, )) 12 wk of HIIT,
MICT, or no exercise training control (CON) (n = 10 in each group). †Significant main effect of test session time point (0, 35, and 65 min) is different
from preintervention (P e 0.050).

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Copyright © 2015 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
previous caloric consumption). No significant changes in the
perception of appetite were noted as a result of the inter-
vention, and the circulating concentrations of glucose, active
ghrelin, PP, and PYY were not altered across the interven-
tion period. However, insulin was lower after both exercise
interventions (fasting—HIIT, postprandial—MICT) but un-
altered in CON, whereas leptin was reduced after HIIT only.
Both exercise interventions resulted in a significant increase
in aerobic fitness.
Previous research has demonstrated improved appetite
regulation in response to a period of aerobic exercise train-
ing (24,25). However, to our knowledge, this is the first
study that has compared the effect of different types of ex-
ercise training (specifically HIIT with MICT) on appetite
regulation. Despite no significant interaction effects being
observed in energy intake in response to the intervention,
the reported 95% CI suggests (i.e., lower and upper bound
values do not cross zero) that 12 wk of HIIT improved ap-
petite regulation in response to previous energy intake of
differing caloric content. Specifically, participants ate less at
the test meal after HEP compared with that after LEP (by
516 T 395 kJ) after the HIIT intervention, whereas intake
remained unaltered in the MICT and CON groups. When
comparing the preintervention and postintervention energy
intake at the test meals, it is evident that this compensation
was related to a reduction in energy intake after the post-
intervention HEP test meal compared with preintervention in
the HIIT group (517 T 736 kJ decrease). Considering that an
energy deficit of 419 kJIdj1 and 795 kJIdj1 has been calcu-
lated to prevent weight gain (maintain weight loss) and achieve
weight loss, respectively (14), the energy deficits presented
previously may be considered a clinically meaningful and im-
portant consideration for weight management. However, it is
important to note that despite the mentioned changes in en-
ergy intake in the meal directly after the HEP or LEP, there
were no significant differences in cumulative energy intake
for the remainder of the day between preloads or conditions.
This may be related to the level of accuracy of assessing en-
ergy intake at a laboratory test meal compared with that
obtained from self-reported food diaries, with the former be-
ing a more precise measure.
The lack of improvement in appetite regulation (based on
the similar energy intake after HEP vs LEP) observed after
MICT in the present study is in contrast with previous research
of similar duration (24,25). Martins et al. (24) reported a
significant within-group improvement in 24-h cumulative
energy compensation after 12 wk of MICT. This discrepancy
between studies may be explained by differences in the vol-
ume of exercise performed. The study of Martins et al. (23)
involved exercise training five times per week compared with
three times per week in the present study. Of note, exercise
intensities used in both studies were similar; Martins et al.
(24), 75% HRmax, versus present study, 60% V̇ ˙O
2peak (21). In
addition, it was surprising that the tendency for improved
appetite regulation in response to HIIT in the present study
was not accompanied by changes in perception of appetite.
EXERCISE TRAINING AND APPETITE REGULATION
Copyright © 2015 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
This is in contrast with the reported increases in fasting and
postprandial feelings of fullness in the study by Guelfi et al.
(9) after an aerobic exercise intervention of similar duration
and frequency to that used here.
With respect to the appetite-related blood variables, we
observed attenuated insulin concentration in a fasted state
after HIIT and in a postprandial state after MICT compared
with preintervention. However, improved insulin sensitivity
(based on the HOMA-IR index) was only noted after HIIT
but not after MICT. Given that insulin sensitivity has been
reported to have a negative relation with ad libitum energy
intake during a test meal in an overweight population (8,12),
the tendency for enhanced appetite regulation after HIIT
may be mediated by improved insulin sensitivity. Our find-
ings are in line with those of Matinhomaee et al. (26), who
also reported that 12 wk of HIIT improved insulin sensitivity
(HOMA-IR index). Importantly, the present study may lend
further support to the role of aerobic exercise training as a
first line of defense in the management of insulin resistance.
The decrease in leptin concentration after HIIT may be
associated with the fat loss (although not significant) ob-
served in the HIIT group (19). In contrast, active ghrelin, PP,
and PYY were not altered in response to the intervention
period. The lack of response of these appetite-related hor-
mones after aerobic exercise training is consistent with the
study of Guelfi et al. (9), who reported no change in active
ghrelin, PP, and PYY concentration in sedentary overweight/
obese men after 12 wk of aerobic exercise training (three times
weekly at 70%–80% of HRmax). In contrast, Martins et al.
(23) reported that 12 wk of aerobic training (five times per
week at 75% of HRmax) resulted in a significant increase in
APPLIED SCIENCES
fasting acylated ghrelin concentration, together with feelings
of hunger in sedentary overweight/obese men and women.
Reasons that may explain the discrepancy in outcomes be-
tween these studies include differences in the volume of ex-
ercise performed and the characteristics of the participants. For
instance, the study by Martins et al. (23) involved exercise
training five times per week compared with three times per
week in the study of Guelfi et al. (9) and the present study.
Furthermore, given that active ghrelin has been shown to re-
spond differently to aerobic exercise training in men and
women (higher active ghrelin concentration in women) (11),
the inclusion of women in the study by Martins et al. (23)
may partially explain the difference in findings.
Regardless, this raises the question of the potential mecha-
nisms besides appetite-related blood variables that may have
contributed to the tendency for enhanced appetite regulation
after HIIT. Firstly, it should be acknowledged that the range
of appetite-related peptides measured in this present study
was not exhaustive and other appetite-related hormones such
as glucagon-like peptide 1, cholecystokinin, and obestatin also
influence appetite regulation. Furthermore, a series of recent
studies have suggested that exercise may have a dampening
effect (attenuated neural activity) on the food reward path-
ways located in the brain, which is consistent with reduced
general palatability of food, reduced anticipation to eat, and
Medicine & Science in Sports & Exercised 2447
 reduced food consumption (5–7). Specifically, Crabtree et al.
(6) demonstrated that high-intensity exercise resulted in
suppressed neural responses during the viewing of high-
calorie foods. Another potential mechanism by which regular
exercise training may enhance appetite regulation is via
changes to substrate metabolism, particularly increased fatty
acid oxidation, which may reduce energy intake via alter-
ations to vagal afferent activity that report satiety signals to
appetite centers in the brain (2). Furthermore, changes in
psychological approaches to food may result from regular
exercise. However, the lack of change in dietary restraint
scores observed in the present study suggests minimal influ-
ence of eating attitudes on appetite regulation. Clearly, further
research is required to determine the mechanisms through
which exercise training may affect and improve appetite
regulation.
Average HR and RPE over the course of the intervention
were found to be higher during HIIT compared with those
during MICT. Considering the nature of the HIIT protocol
(i.e., repeated short bouts of supramaximal high-intensity
exercise), this was not unexpected. Despite this, physical
activity enjoyment was not different between HIIT and
MICT and enjoyment was greater after both training in-
terventions. These findings are of importance, given that
enjoyment of physical activity has been reported to be a key
factor in physical activity performance and exercise adher-
ence (10,28). The high attendance rate of study participants
in both exercise groups seems to reflect the levels of en-
joyment observed in the present study. Our study also
demonstrated that 12 wk of aerobic exercise, regardless of
exercise protocol, resulted in an increase in aerobic fitness.
APPLIED SCIENCES
This is significant, given that improvement in aerobic fit-
ness, independent of weight loss, has been associated with
decreased mortality (20).
Finally, it should be noted that even though HIIT may
have resulted in a tendency for improved appetite regulation,
the lack of significant alterations in anthropometric measures
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Medicine & Science in Sports & Exercised 2449