Sports Med

https://doi.org/10.1007/s40279-018-0925-1

CURRENT OPINION

Can We Draw General Conclusions from Interval Training

Studies?
Ricardo Borges Viana1 • Claudio Andre Barbosa de Lira1 • João Pedro Araújo Naves1 •
Victor Silveira Coswig2 • Fabrı́cio Boscolo Del Vecchio3 • Rodrigo Ramirez-Campillo4 •
Carlos Alexandre Vieira1 • Paulo Gentil1

Ó Springer International Publishing AG, part of Springer Nature 2018

Abstract Interval training (IT) has been used for many examples of the complexity involved in IT prescription,
decades with the purpose of increasing performance and and are discussed to illustrate some problems with the
promoting health benefits while demanding a relatively current literature regarding IT. Therefore, it is our opinion
small amount of time. IT can be defined as intermittent that it is not possible to draw general conclusions about IT
periods of intense exercise separated by periods of recov- without considering all variables used in IT prescription,
ery and has been divided into high-intensity interval such as exercise modality, intensity, effort and rest times,
training (HIIT), sprint interval training (SIT), and repeated and participants’ characteristics. In order to help guide
sprint training (RST). IT use has resulted in the publication researchers and health professionals in their practices it is
of many studies and many of them with conflicting results important that experimental studies report their methods in
and positions. The aim of this article was to move forward as much detail as possible and future reviews and meta-
and understand the studies’ protocols in order to draw analyses should critically discuss the articles included in
accurate conclusions, as well as to avoid previous mistakes the light of their methods to avoid inappropriate
and effectively reproduce previous protocols. When ana- generalizations.
lyzing the literature, we found many inconsistencies, such
as the controversial concept of ‘supramaximal’ effort, a
misunderstanding with regard to the term ‘high intensity,’
Key Points
and the use of different strategies to control intensity. The
adequate definition and interpretation of training intensity
Researchers, health professionals, and exercise
seems to be vital, since the results of IT are largely
practitioners must be aware that different responses
dependent on it. These observations are only a few
are to be expected from different IT protocols.
Interval training efficiency does not follow the rule
& Paulo Gentil
‘the more the better’ with regard to intensity; rather,
paulogentil@hotmail.com
it seems to be a matter of choosing the right
1
Department of Physical Education, FEFD-Faculdade de intensity.
Educação Fı́sica e Dança, Universidade Federal de Goiás-
UFG, Avenida Esperança s/n, Campus Samambaia, Goiânia, It is important that experimental studies report their
Goiás CEP: 74.690-900, Brazil methods in as much detail as possible to help guide
2
Department of Physical Education, Faculty of Physical researchers and health professionals in their
Education, Federal University of Pará, Castanhal, Brazil practices.
3
Department of Physical Education, Superior School of
Physical Education, Federal University of Pelotas, Pelotas,
Brazil
4
Department of Physical Activity Sciences, Research Nucleus
in Health, Physical Activity and Sport, Universidad de Los
Lagos, Osorno, Chile

123

1 Introduction
Interval training (IT) has been used for many decades with
the purpose of increasing performance and promoting
health benefits [1–4]. Its popularity has increased sharply in
recent years, in particular because of its potential to pro-
mote a wide range of benefits (e.g., improve glucose reg-
ulation, insulin resistance, aerobic power, and fat loss)
while demanding a relatively small amount of time [5–11].
This resulted in the publication of many studies, many of
them with conflicting results [12–16]. Such heterogeneity
created a polarization of views, with some advocating for
and others against the use of IT [16–22]. However, it is our
opinion that the discussion should go beyond the dichot-
omy of whether IT is good or bad. In this review, the aim
was to move forward and understand the studies’ results in
light of their methods in order to draw accurate conclu-
sions, as well as to avoid previous mistakes and effectively
reproduce previous protocols.
2 Definitions and Concepts
IT can be defined as intermittent periods of intense exercise
separated by periods of recovery [23] and has been divided
into high-intensity interval training (HIIT), sprint interval
training (SIT), and repeated sprint training (RST)
[8, 24, 25]. According to Buchheit and Laursen [24], IT
prescription involves ‘‘the manipulation of up to nine
variables, which include the work interval intensity and
duration, relief interval intensity and duration, exercise
modality, number of repetitions, number of series, as well
as the between-series recovery duration and intensity’’
(Fig. 1). As a consequence, the manipulation of any of
these variables can affect the acute and chronic physio-
logical effects.
Briefly, HIIT is defined as repeated short-to-long bouts
at ‘near maximal’ efforts often performed at an intensity
that elicits a heart rate (HR) C 80% of maximal heart rate
(HRmax) or the same maximum oxygen consumption
_ 2max). On the other hand, SIT is defined as efforts
(VO
_ 2peak/max (i VO_ 2peak/max),
performed at intensities * VO
including ‘all-out’ or ‘supramaximal’ efforts [8, 26], usu-
ally consisting of 20- to 30-s ‘all-out’ efforts interspersed
with 2- to 4-min passive recovery periods [25]. RST is
defined as sprints lasting from 3 to 7 s, interspersed with
recovery periods lasting generally less than 60 s [25].
In this context, two points are noteworthy. First, some
studies that used IT protocols (e.g., SIT, and RST), adopted
the concept of ‘supramaximal’ effort. However, this con-
cept is very controversial. Because 100% refers to the
maximal power of a given system, it is not possible to
123
R. B. Viana et al.
overcome this value (e.g., 100% of the HRmax or VO _ 2max).
Therefore, using the term supramaximal on the basis of
physiological parameters such as HRmax or VO _ 2max might
not be appropriate. It only makes sense to use the term
supramaximal in a specific context; for example, when
referring to absolute intensity (speed or power) in which an
individual reached maximum oxygen consumption (i
_ 2max). Therefore, it would be more appropriate to state
VO
that the exercise is performed above the i VO _ 2max and use
the term ‘maximal efforts’ to characterize an all-out pro-
tocol. It is also important to note that it is possible to
_ 2max before reaching
exercise for 4–6 min at the i VO
exhaustion [27]; therefore, exercising above the i VO _ 2max
does not necessarily result in a maximum effort, especially
if the effort is of short duration.
Second, a common misunderstanding regarding HIIT
derives from the term ‘high intensity.’ It is usually sug-
gested that HIIT necessarily involves a highly demanding
protocol. However, the absolute intensity at which the
exercise is performed might not reflect a very intense
effort. As noted in the previous paragraph, fatigue will
ensue after 4–6 min at i VO _ 2max; therefore, if one exercises
at this intensity for 30 s, it may be debatable if the effort is
truly ‘high.’ Indeed, previous studies reported that HIIT
might result in low ratings of perceived exertion (RPE)
[28] and high levels of enjoyment [28–32] and high
adherence [29] when training involved short bouts (B 60 s)
performed at intensities equal or close to i VO _ 2max.
3 Intensity Control
A methodological concern arises from the use of a target
HR to control exercise intensity. A popular protocol rec-
ommends exercising at 90–95% of HRmax and rest at 70%
[7]. This protocol obtained impressive results and became a
reference for cardiac rehabilitation. However, the results
obtained in the original study [7] were not reproduced in a
larger sample [33], which could have been caused by the
low compliance with the prescribed intensity, since less
than 50% of the participants reached the target intensity.
This suggests that working at the prescribed intensity might
be vital to training effectiveness. Notwithstanding, many
strategies can be used to reach the prescribed HR, and this
can greatly influence the effective time spent at the target
intensity. For example, one can start the bout at high
intensity to assure a sharp increase in HR, while others can
maintain a constant intensity and wait for the HR to
increase. The same holds true for the rest periods. For
example, in a previous study, Ramos et al. [34] used a
protocol that supposedly involved 4 bouts of 4 min at
85–95% of peak HR interspaced with 3-min intervals;
Meta-Analysis in Interval Training
Fig. 1 Variables related to
interval training (IT) protocols
however, the authors reported that participants (individuals
with metabolic syndrome) took 2 min to reach the targeted
intensity. Therefore, the protocol seems to have involved
only 2 min at target intensity rather than 4-min intervals
and 5 min of rest (at least when the time that the participant
effectively remained in target HR is considered), resulting
in a lower effort:rest ratio than intended. In another study,
Helgerud et al. [35] reported that moderately trained males
performed IT consisting of 15:15 interval running (15 s of
running at 90–95% HRmax followed by 15 s of active
resting at 70% HRmax). Although we acknowledge that the
target intensity in subsequent interval bouts is usually
achieved faster, it is very improbable that 15 s would be
enough to reach the target intensity. Moreover, indepen-
dent of the strategy used and number of bouts performed, it
is important to report the time taken to reach the target
intensity, since this might influence physiological respon-
ses to training. This might be especially valid when ana-
lyzing different populations, since people with metabolic
syndrome [36] as well as older people [37], for example,
might have a delayed response in HR increase during
exercise and also a lower decrease in HR after effort.
Another point of concern is the methods employed for
controlling intensity. It is possible to find studies using HR
[7, 34], power output [38], i VO_ 2max [39, 40], RPE [41],
and maximum anaerobic power [13], among others.
However, each mode of controlling for intensity may result
in different responses and should not be used inter-
changeably, especially considering the effect of interindi-
vidual variability under different training approaches
[42–45]. For example, when adapting the HIIT protocol
used by Wisløff et al. [7] to be performed at 90–95% of i
_ 2max, we noted that the participants only reached the
VO
target HR in the third bout. Therefore, the same percentage
of HRmax and i VO _ 2max can result in different intensities,
and studies involving different methods for controlling
intensity could lead to different results, even when adopt-
ing the same number of bouts and the same effort and
pause times. The adequate definition and interpretation of
training intensity seems to be vital, since the results of IT
are largely dependent on it [46]. For example, Racil et al.
[47] compared the effects of IT intensity in groups of obese
young females performing the same number of bouts with
the same total time and time:effort ratios (6–8 9 30:30 s).
The difference was that one group exercised at an intensity
_ 2max and the other at an
corresponding to 80–90% i VO
_ 2max. Increases
intensity corresponding to 100–110% i VO
_
in VO2max as well as decreases in waist circumference,
123

triglycerides, and total cholesterol were significant only in
the higher intensity group. Moreover, increases in maximal
aerobic speed, decreases in percentage of body fat,
triglycerides, low-density lipoprotein cholesterol, and
insulin were higher in the higher intensity group.
4 Different Protocol Designs
Previous studies reported that IT might result in lower RPE
[28], higher levels of enjoyment [28–32], and higher
adherence [29] than continuous protocols, depending on
how it is designed. Kilpatrick et al. [28] compared RPE and
HR responses in healthy physically active students before,
during, and after continuous and IT exercise trials equated
by total load. IT lasted 24 min, with bouts and recovery
performed at the same intensity (60% of the difference
between ventilatory threshold and maximal capacity; and
10–20% of maximal capacity, respectively). Each interval
utilized a 1:1 work-to-recovery ratio and varied only in
number of bouts and time of effort and rest: 24 9 30:30 s,
12 9 60:60 s, and 6 9 120:120 s. According to the results,
higher RPE and HR occurred during the 120:120 s proto-
col, while the lower values were reported during the
30:30 s protocol. Jung et al. [29] reported that individuals
with prediabetes adhered to IT (4 9 60:60 s at * 90%
HRpeak and low intensity recovery and increased to
10 9 60:60 s) to a greater extent than to moderate intensity
continuous training (MICT; 20 min at * 65% HRpeak and
gradually increased to 50 min). Interestingly, Jung et al.
[30] had previously compared enjoyment after IT
(10 9 60:60 s at 100%:20% i VO _ 2peak), MICT (40% i
_ 2peak for 40 min), and continuous vigorous-intensity
VO
exercise (CVI; 80% i VO _ 2peak for 20 min). According to
the results, participants reported greater enjoyment for IT
as compared to MICT and CVI, with over 50% of partic-
ipants reporting a preference to engage in IT. Similar
results were reported by Thum et al. [31] when comparing
IT (8 9 60:60 s cycling at 85% i VO _ 2max with active
recovery between bouts) with MICT (20 min of cycling at
_ 2max) performed by physically active men and
45% i VO
women. Astorino and Thum [32] compared MICT (25 min
of arm cranking at 45% i VO _ 2peak) with submaximal
_ 2peak and active recovery at 10%
(8 9 60:90 s at 70% i VO
_
i VO2peak) or maximal IT (8 9 30:120 s ‘all-out’ efforts at
105% i VO _ 2peak and active recovery at 10% i VO_ 2peak) and
reported that IT elicited higher enjoyment despite higher
metabolic strain in people with spinal cord injury. These
results suggest that IT protocols using bouts of 60 s or less
at intensities equal to or less than i VO_ 2max, i VO
_ 2peak or
HRpeak appear to be more enjoyable and result in less RPE
123
R. B. Viana et al.
and HR than continuous protocols, which might result in
higher adherence. However, the same might not be true for
protocols that involve longer bouts.
Even if the same intensity is used, physiological
responses to an IT protocol can greatly vary, and one
aspect that may influence this response is the duration of
effort and rest. When intensity and total work are equated,
previous studies reported that longer bouts (i.e., six bouts
of 120:120 s) resulted in higher levels of RPE, HR, and
lower levels of enjoyment in overweight-to-obese adults
when compared to shorter bouts (24 bouts of 30:30 s)
[48, 49]. In addition, shorter bouts (15:15 and 30:30 s)
were shown to result in less effort and physiological stress
in overweight-to-obese adults and coronary heart disease
patients than MICT [48–50].
The conflicting effects of IT on body composition are
also apparently associated with different protocol designs
[5, 17]. Previous studies suggested that the increases in
post-exercise fat oxidation seem to be influenced by
glycogen depletion [51] and protocols that rely more on the
glycolytic system might be more advantageous in this
respect [52, 53]. In agreement with this, many of the pre-
vious articles that showed advantages of IT over moderate
intensity protocols were performed with all-out efforts
coupled with insufficient recovery time [9, 54, 55]. On the
other hand, protocols with lower submaximal bouts cou-
pled with longer rest intervals were not efficient in reduc-
ing body fat of overweight adults or individuals with
metabolic syndrome when compared to traditional proto-
cols [16, 34]. For example, Keating et al. [16] evaluated
efforts of 30 s at 115% of i VO _ 2max coupled with up to
3 min of rest and found no positive results for IT on body
composition. However, Matsuo et al. [3] studied efforts of
the same duration and intensity coupled with just 15 s of
recovery, which suggests that the intensity used in the IT
protocol applied by Matsuo et al. [3] was higher than the
intensity used by Keating et al. [16].
We must remind the reader, however, that IT efficiency
does not follow the rule ‘the more the better’ with regard to
intensity; rather, it seems to be a matter of choosing the
right intensity. In this regard, Raleigh et al. [56] investi-
gated the effect of HIIT intensity on training-induced
adaptations in VO_ 2peak and VO_ 2 kinetics of healthy men
and women. The authors compared the effects of HIIT
(1 min of effort per 1 min of rest) targeting 80, 115, or
150% of the i VO _ 2peak, with total work matched across
groups. According to their results, the increase in VO_ 2peak
was greater in the group that trained at 115% compared to
the 80%-intensity group; however, the group that trained at
150% achieved similar adaptations compared to the groups
trained at 115 or 80%. Moreover, the greatest proportion of
non-responders was observed in the group that trained at
Meta-Analysis in Interval Training
lower intensity and the highest proportion of responders
was in the group that trained at 115%.
5 Different Types of Exercise
It is important to note that different types of exercise (e.g.,
cycling, running, calisthenics, kettlebell) evoke different
physiological demands [57–67]. Ozkaya et al. [57] com-
pared the contribution of the three main energy pathways
during a 30-s elliptical ‘all-out’ test (EAT) compared with
the Wingate all-out test and reported that EAT was char-
acterized by lower contributions of the oxidative system
and greater contributions of the phospholytic and gly-
colytic systems. Medelli et al. [58] evaluated VO _ 2max and
the aerobic-anaerobic transition in 14 triathletes perform-
ing an incremental test on a bicycle ergometer and on
horizontal or inclined treadmills. Whilst VO _ 2max did not
differ between the two types, pulmonary ventilation, HR
and VO _ 2 recorded at ventilatory threshold 1 (VT-1) and II
(VT-2) reached the highest values on the treadmill. Miles
et al. [59] investigated the relationships between car-
diorespiratory and metabolic adjustments during cycle
ergometer and treadmill exercise in young females and
reported that treadmill walking resulted in greater VO _ 2max
than cycle ergometer training. The higher blood lactate
concentrations, plasma bicarbonate, respiratory exchange
ratios, lower HR, and pH found during the cycle ergometer
test suggested the occurrence of higher localized fatigue
from anaerobic metabolism.
Smith et al. [60] compared the responses of recreational
exercisers to six modes of incremental maximal tests
(treadmill, stationary skier, shuffle skier, stepper, stationary
cycle, and row) for VO _ 2peak, VT-1, and VT-2. The tread-
_ 2peak than did the
mill test elicited a significantly higher VO
other modes, while the VT-1 and VT-2 responses (%
_ 2peak) were similar among exercises. Similarly, Lafor-
VO
tuna et al. [64] compared the metabolic responses to
treadmill and cycle ergometer exercise at different intensity
levels (up to about 85% of maximal oxygen uptake) in
obese people and reported higher HR, O2, energy expen-
diture, and fat oxidation together with lower blood lactate
during treadmill exercise. In the study by Schneider and
Pollack [63], highly trained male triathletes achieved a
significantly higher VO _ 2max with treadmill running than
with cycle ergometry.
Exploring the differences in responses of individuals to
different exercise modes, Lafortuna et al. [65] compared
the energetic and cardiovascular responses to walking and
cycling in 15 obese and six normal weight women. They
found a higher metabolic rate in obese compared with
normal weight individuals during both exercise modes,
which correlated with body mass. In both groups, HR was
higher during cycle ergometer than treadmill exercise at the
same VO_ 2, but in obese individuals the HR increment over
_ 2 was greater for cycle ergometer than for treadmill
VO
exercise. Verstappen et al. [61] compared the physiological
responses of competitive athletes in long-distance running
_ 2 was
and cyclists on the treadmill and cycle ergometer. VO
14% higher on the treadmill in the long-distance runners,
but equal in the cycle racers. Similarly, HR and minute
ventilation reached similar values in cyclists on both
ergometers, but runners had higher values on the treadmill.
On the other hand, lactate concentrations reached similar
values in runners on both ergometers, but cycling induced
higher lactate concentrations in cyclists. Confirming these
findings, Millet et al. [62] reviewed the literature con-
cerning the physiological differences between cycling and
running and reported that the majority of studies indicate
that runners achieve a higher VO _ 2max and HR on the
treadmill whereas cyclists can achieve a VO _ 2max value in
cycle ergometry similar to that seen with treadmill running.
Muscles seem to specifically adapt to a given exercise,
such that training history seems to influence physiological
responses to a given exercise.
Therefore, similar IT protocols using different exercise
modes might result in different physiological responses
and, therefore, divergent outcomes, as has been recently
discussed with a variation of IT known as the Tabata
Protocol [68]. For example, McRae et al. [69] used calis-
thenic exercises and found no differences in anaerobic
capacity between IT and MICT, contradicting the results
obtained by Tabata et al. [70] when using a cycle
ergometer. Fortner et al. [67] conducted a study with 14
non-obese young participants in order to investigate car-
diovascular and metabolic demands of a Tabata Protocol
performed with kettlebell swings and reported higher RPE,
average VO_ 2 value, percent of VO_ 2peak, maximal HR, and
post-exercise blood lactate than in traditional resistance
protocols. However, the lactate values (6.4 ± 1.1 mmol/L)
reported by Fortner et al. [67] were lower than the value
(* 12 mmol/L) reported by Foster et al. [71] when using a
cycle ergometer. On the other hand, Amtmann et al. [72]
used the Tabata Protocol with mixed martial arts move-
ments and reported blood lactate concentrations of up to
19.7 mmol/L, which were higher than the values obtained
by Foster et al. [71].
At the same relative intensity, IT involving running
induced greater VO_ 2 than cycling, with lower lactate levels
in untrained males [73]. Moreover, running and calisthen-
ics exercises can result in less peripheral fatigue when
compared to cycling [74], which might result in a lower
glycogen depletion and influence subsequent power outputs
[75]. Although McRae et al. [69] suggested that the choice
123

and variability of exercise modality could enhance moti-
vation and long-term adherence, this issue was not yet
tested and one must take into account that changing exer-
cise might change the results obtained from an IT protocol.
In addition, considering the complexity involved with
IT prescription and the large inconsistency in the liter-
ature, we follow previous philosophical objections
[76, 77] that suggest great caution should be exercised
when using meta-analysis to evaluate the effects of IT. A
brief PubMed search for IT and meta-analysis resulted in
nine articles and none considered the effects of different
configurations of IT [8, 10, 17, 78–83], thereby not
taking into account that different responses should be
expected from different IT protocols [25]. Even the type
of exercise performed should be considered, since dif-
ferent exercises result in different responses in the
energy systems and cardiorespiratory demands [57–67].
In this regard, moderate intensity protocols exhibit low
heterogeneity, since most protocols are based on cycling
and running, which might lead to results that are more
consistent. While we recognize many modes and meth-
ods can be classified as IT, we also believe that these
differences should not be ignored.
6 Conclusions
Researchers must be aware that IT prescription involves
the manipulation of many variables and the outcomes
depend on the combination used. Therefore, IT protocols
must be described in detail in order to allow their
reproduction by other researchers, health professionals,
and exercise practitioners. Other points of concern are the
misuse of the term supramaximal and the lack of strict
intensity control. These observations are only a few
examples of the complexity involved with IT prescription,
discussed to illustrate some problems with the current
literature regarding this exercise mode. Based on this, it is
our opinion that it is not possible to draw general con-
clusions about IT without considering such complexity
and one cannot affirm if IT is efficient, well tolerated, or
even safe without analyzing the protocols used. A possi-
ble alternative for assessing the quality and reporting of
studies involving IT might be the use of specific tools,
such as the Tool for the assEssment of Study qualiTy and
reporting in EXercise (TESTEX) scale [84]. Moreover, to
help guide researchers and health professionals in their
practices it is important that experimental studies report
their methods in as much detail as possible and future
reviews and meta-analyses critically discuss the articles
included in light of their methods to avoid inadequate
generalizations.
123
R. B. Viana et al.
Compliance with Ethical Standards
Funding No sources of funding were used to assist in the preparation
of this article.
Conflict of interest Ricardo Viana, Claudio de Lira, João Naves,
Victor Coswig, Fabrı́cio Del Vecchio, Rodrigo Ramirez-Campillo,
Carlos Vieira, and Paulo Gentil declare that they have no conflicts of
interest relevant to the content of this review.
Author contributions Ricardo Viana and Paulo Gentil conceived
and drafted the article. Ricardo Viana, Claudio de Lira, João Naves,
Victor Coswig, Fabrı́cio Del Vecchio, Rodrigo Ramirez-Campillo,
and Paulo Gentil corrected and critically revised the article, and
approved the final version for publication.
References
1. Laursen PB, Shing CM, Peake JM, Coombes JS, Jenkins DG.
Influence of high-intensity interval training on adaptations in
well-trained cyclists. J Strength Cond Res. 2005;19:527–33.
2. Gibala MJ, Little JP, Van Essen M, Wilkin GP, Burgomaster KA,
Safdar A, et al. Short-term sprint interval versus traditional
endurance training: similar initial adaptations in human skeletal
muscle and exercise performance. J Physiol. 2006;575:901–11.
3. Matsuo T, Saotome K, Seino S, Shimojo N, Matsushita A,
Iemitsu M, et al. Effects of a low-volume aerobic-type interval
exercise on VO2max and cardiac mass. Med Sci Sport Exerc.
2014;46:42–50.
4. Meyer K, Samek L, Schwaibold M, Westbrook S, Hajric R,
Beneke R, et al. Interval training in patients with severe chronic
heart failure: analysis and recommendations for exercise proce-
dures. Med Sci Sports Exerc. 1997;29:306–12.
5. Boutcher SH. High-intensity intermittent exercise and fat loss.
J Obes. 2011;2011:868305.
6. Meyer P, Gayda M, Juneau M, Nigam A. High-intensity aerobic
interval exercise in chronic heart failure. Curr Heart Fail Rep.
2013;10:130–8.
7. Wisløff U, Støylen A, Loennechen JP, Bruvold M, Rognmo Ø,
Haram PM, et al. Superior cardiovascular effect of aerobic
interval training versus moderate continuous training in heart
failure patients: a randomized study. Circulation.
2007;115:3086–94.
8. Weston KS, Wisløff U, Coombes JS. High-intensity interval
training in patients with lifestyle-induced cardiometabolic dis-
ease: a systematic review and meta-analysis. Br J Sports Med.
2014;48:1227–34.
9. Trapp EG, Chisholm DJ, Freund J, Boutcher SH. The effects of
high-intensity intermittent exercise training on fat loss and fasting
insulin levels of young women. Int J Obes (Lond).
2008;32:684–91.
10. Jelleyman C, Yates T, O’Donovan G, Gray LJ, King JA, Khunti
K, et al. The effects of high-intensity interval training on glucose
regulation and insulin resistance: a meta-analysis. Obes Rev.
2015;16:942–61.
11. Wisløff U, Ellingsen Ø, Kemi OJ. High-intensity interval training
to maximize cardiac benefits of exercise training? Exerc Sport Sci
Rev. 2009;37:139–46.
12. Nalcakan GR. The effects of sprint interval vs. continuous
endurance training on physiological and metabolic adaptations in
young healthy adults. J Hum Kinet. 2014;44:97–109.
13. Fisher G, Brown AW, Bohan Brown MM, Alcorn A, Noles C,
Winwood L, et al. High intensity interval- vs moderate intensity-
training for improving cardiometabolic health in overweight or
Meta-Analysis in Interval Training
obese males: a randomized controlled trial. PLoS One.
2015;10:e0138853.
14. Shepherd SO, Cocks M, Tipton KD, Ranasinghe AM, Barker TA,
Burniston JG, et al. Sprint interval and traditional endurance
training increase net intramuscular triglyceride breakdown and
expression of perilipin 2 and 5. J Physiol. 2013;591:657–75.
15. Mazurek K, Zmijewski P, Krawczyk K, Czajkowska A, Kȩska A,
Kapuściński P, et al. High intensity interval and moderate con-
tinuous cycle training in a physical education programme
improves health-related fitness in young females. Biol Sport.
2016;33:139–44.
16. Keating SE, Machan EA, O’Connor HT, Gerofi JA, Sainsbury A,
Caterson ID, et al. Continuous exercise but not high intensity
interval training improves fat distribution in overweight adults.
J Obes. 2014;2014:834865.
17. Keating SE, Johnson NA, Mielke GI, Coombes JS. A systematic
review and meta-analysis of interval training versus moderate-
intensity continuous training on body adiposity. Obes Rev.
2017;18:943–64.
18. Skelly LE, Andrews PC, Gillen JB, Martin BJ, Percival ME,
Gibala MJ. High-intensity interval exercise induces 24-h energy
expenditure similar to traditional endurance exercise despite
reduced time commitment. Appl Physiol Nutr Metab.
2014;39:845–8.
19. Cochran AJR, Percival ME, Tricarico S, Little JP, Cermak N,
Gillen JB, et al. Intermittent and continuous high-intensity
exercise training induce similar acute but different chronic
muscle adaptations. Exp Physiol. 2014;99:782–91.
20. Wewege M, van den Berg R, Ward RE, Keech A. The effects of
high-intensity interval training vs. moderate-intensity continuous
training on body composition in overweight and obese adults: a
systematic review and meta-analysis. Obes Rev. 2017;18:635–46.
21. Hardcastle SJ, Ray H, Beale L, Hagger MS. Why sprint interval
training is inappropriate for a largely sedentary population. Front
Psychol. 2014;5:1505.
22. Del Vecchio FB, Gentil P, Coswig VS, Fukuda DH. Commen-
tary: why sprint interval training is inappropriate for a largely
sedentary population. Front Psychol. 2015;6:1359.
23. Fox EL, Bartels RL, Billings CE, Mathews DK, Bason R, Webb
WM. Intensity and distance of interval training programs and
changes in aerobic power. Med Sci Sports. 1973;5:18–22.
24. Buchheit M, Laursen PB. High-intensity interval training, solu-
tions to the programming puzzle: part II: anaerobic energy,
neuromuscular load and practical applications. Sports Med.
2013;43:927–54.
25. Buchheit M, Laursen PB. High-intensity interval training, solu-
tions to the programming puzzle: part I: cardiopulmonary
emphasis. Sports Med. 2013;43:313–38.
26. MacInnis MJ, Gibala MJ. Physiological adaptations to interval
training and the role of exercise intensity. J Physiol.
2017;595:2915–30.
27. Demarie S, Koralsztein JP, Billat V. Time limit and time at
VO2max, during a continuous and an intermittent run. J Sport Med
Phys Fit. 2000;40:96–102.
28. Kilpatrick MW, Greeley SJ, Collins LH. The impact of contin-
uous and interval cycle exercise on affect and enjoyment. Res Q
Exerc Sport. 2015;86:244–51.
29. Jung ME, Bourne JE, Beauchamp MR, Robinson E, Little JP.
High-intensity interval training as an efficacious alternative to
moderate-intensity continuous training for adults with predia-
betes. J Diabetes Res. 2015;2015:191595.
30. Jung ME, Bourne JE, Little JP. Where does HIT fit? An exami-
nation 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. 2014;9:e114541.
31. Thum JS, Parsons G, Whittle T, Astorino TA. High-intensity
interval training elicits higher enjoyment than moderate intensity
continuous exercise. PLoS One. 2017;12:e0166299.
32. Astorino TA, Thum JS. Interval training elicits higher enjoyment
versus moderate exercise in persons with spinal cord injury.
J Spinal Cord Med. 2018;41(1):77–84. https://doi.org/10.1080/
10790268.2016.1235754.
33. Ellingsen Ø, Halle M, Conraads V, Støylen A, Dalen H, Dela-
gardelle C, et al. High-intensity interval training in patients with
heart failure with reduced ejection fraction. Circulation.
2017;135:839–49.
34. Ramos JS, Dalleck LC, Borrani F, Mallard AR, Clark B, Keating
SE, et al. The effect of different volumes of high-intensity
interval training on proinsulin in participants with the metabolic
syndrome: a randomised trial. Diabetologia. 2016;59:2308–20.
35. Helgerud J, Høydal K, Wang E, Karlsen T, Berg P, Bjerkaas M,
et al. Aerobic high-intensity intervals improve VO2max more than
moderate training. Med Sci Sport Exerc. 2007;39:665–71.
36. Silva LRBE, Zamunér AR, Gentil P, Alves FM, Leal AGF,
Soares V, et al. Cardiac autonomic modulation and the kinetics of
heart rate responses in the on- and off-transient during exercise in
women with metabolic syndrome. Front Physiol. 2017;8:542.
37. Simões RP, Bonjorno JC, Beltrame T, Catai AM, Arena R,
Borghi-Silva A. Slower heart rate and oxygen consumption
kinetic responses in the on- and off-transient during a discon-
tinuous incremental exercise: effects of aging. Braz J Phys Ther.
2013;17:69–76.
38. Smith-Ryan AE, Melvin MN, Wingfield HL. High-intensity
interval training: modulating interval duration in overweight/
obese men. Phys Sportsmed. 2015;43:107–13.
39. Ravier G, Dugué B, Grappe F, Rouillon JD. Impressive anaerobic
adaptations in elite karate athletes due to few intensive inter-
mittent sessions added to regular karate training. Scand J Med Sci
Sport. 2009;19:687–94.
40. Farney TM, McCarthy CG, Canale RE, Schilling BK, Whitehead
PN, Bloomer RJ. Absence of blood oxidative stress in trained
men after strenuous exercise. Med Sci Sports Exerc.
2012;44:1855–63.
41. Alvarez C, Ramirez-Campillo R, Martinez-Salazar C, Mancilla
R, Flores-Opazo M, Cano-Montoya J, et al. Low-volume high-
intensity interval training as a therapy for type 2 diabetes. Int J
Sports Med. 2016;37:723–9.
42. Álvarez C, Ramı́rez-Campillo R, Ramı́rez-Vélez R, Izquierdo M.
Prevalence of non-responders for glucose control markers after
10 weeks of high-intensity interval training in adult women with
higher and lower insulin resistance. Front Physiol. 2017;8:479.
43. Álvarez C, Ramı́rez-Campillo R, Ramı́rez-Vélez R, Izquierdo M.
Effects and prevalence of nonresponders after 12 weeks of high-
intensity interval or resistance training in women with insulin
resistance: a randomized trial. J Appl Physiol. 2017;122:985–96.
44. Álvarez C, Ramı́rez-Campillo R, Ramı́rez-Vélez R, Martı́nez C,
Castro-Sepúlveda M, Alonso-Martı́nez A, et al. Metabolic effects
of resistance or high-intensity interval training among glycemic
control-nonresponsive children with insulin resistance. Int J Obes
(Lond). 2018;42(1):79–87. https://doi.org/10.1038/ijo.2017.177.
45. Alvarez C, Ramı́rez-Campillo R, Ramı́rez-Vélez R, Izquierdo M.
Effects of 6-weeks high-intensity interval training in schoolchil-
dren with insulin resistance: influence of biological maturation on
metabolic, body composition, cardiovascular and performance
non-responses. Front Physiol. 2017;8:444.
46. Gentil P, Del Vecchio FB. Commentary: High-intensity inter-
mittent training vs. moderate-intensity intermittent training: is it a
matter of intensity or intermittent efforts? Front Physiol.
2017;8:370.
47. Racil G, Ben Ounis O, Hammouda O, Kallel A, Zouhal H,
Chamari K, et al. Effects of high vs. moderate exercise intensity
123

during interval training on lipids and adiponectin levels in obese
young females. Eur J Appl Physiol. 2013;113:2531–40.
48. Martinez N, Kilpatrick MW, Salomon K, Jung ME, Little JP.
Affective and enjoyment responses to high-intensity interval
training in overweight-to-obese and insufficiently active adults.
J Sport Exerc Psychol. 2015;37:138–49.
49. Kilpatrick MW, Martinez N, Little JP, Jung ME, Jones AM, Price
NW, et al. Impact of high-intensity interval duration on perceived
exertion. Med Sci Sport Exerc. 2015;47:1038–45.
50. Guiraud T, Nigam A, Juneau M, Meyer P, Gayda M, Bosquet L.
Acute responses to high-intensity intermittent exercise in CHD
patients. Med Sci Sport Exerc. 2011;43:211–7.
51. Kiens B, Richter EA. Utilization of skeletal muscle triacylglyc-
erol during postexercise recovery in humans. Am J Physiol.
1998;275:E332–7.
52. Tucker WJ, Angadi SS, Gaesser GA. Excess postexercise oxygen
consumption after high-intensity and sprint interval exercise, and
continuous steady-state exercise. J Strength Cond Res.
2016;30:3090–7.
53. Whyte LJ, Ferguson C, Wilson J, Scott RA, Gill JMR. Effects of
single bout of very high-intensity exercise on metabolic health
biomarkers in overweight/obese sedentary men. Metabolism.
2013;62:212–9.
54. Tremblay A, Simoneau JA, Bouchard C. Impact of exercise
intensity on body fatness and skeletal muscle metabolism.
Metabolism. 1994;43:814–8.
55. Higgins S, Fedewa MV, Hathaway ED, Schmidt MD, Evans EM.
Sprint interval and moderate-intensity cycling training differen-
tially affect adiposity and aerobic capacity in overweight young-
adult women. Appl Physiol Nutr Metab. 2016;41:1177–83.
56. Raleigh JP, Giles MD, Scribbans TD, Edgett BA, Sawula LJ,
Bonafiglia JT, et al. The impact of work-matched interval training
on VO _ 2 kinetics: diminishing returns with increasing
_ 2peak and VO
intensity. Appl Physiol Nutr Metab. 2016;41:706–13.
57. Ozkaya O, Colakoglu M, Kuzucu EO, Delextrat A. An elliptical
trainer may render the wingate all-out test more anaerobic.
J Strength Cond Res. 2014;28:643–50.
58. Medelli J, Maingourd Y, Bouferrache B, Bach V, Freville M,
Libert JP. Maximal oxygen uptake and aerobic-anaerobic tran-
sition on treadmill and bicycle in triathletes. Jpn J Physiol.
1993;43:347–60.
59. Miles DS, Critz JB, Knowlton RG. Cardiovascular, metabolic,
and ventilatory responses of women to equivalent cycle
ergometer and treadmill exercise. Med Sci Sports Exerc.
1980;12:14–9.
60. Smith TD, Thomas TR, Londeree BR, Zhang Q, Ziogas G. Peak
oxygen consumption and ventilatory thresholds on six modes of
exercise. Can J Appl Physiol. 1996;21:79–89.
61. Verstappen F, Huppertz R, Snoeckx LH. Effect of training
specificity on maximal treadmill and bicycle ergometer exercise.
Int J Sports Med. 1982;3:43–6.
62. Millet GP, Vleck VE, Bentley DJ. Physiological differences
between cycling and running: lessons from triathletes. Sports
Med. 2009;39:179–206.
63. Schneider DA, Pollack J. Ventilatory threshold and maximal
oxygen uptake during cycling and running in female triathletes.
Int J Sports Med. 1991;12:379–83.
64. Lafortuna CL, Lazzer S, Agosti F, Busti C, Galli R, Mazzilli G,
et al. Metabolic responses to submaximal treadmill walking and
cycle ergometer pedalling in obese adolescents. Scand J Med Sci
Sports. 2010;20:630–7.
65. Lafortuna CL, Agosti F, Galli R, Busti C, Lazzer S, Sartorio A.
The energetic and cardiovascular response to treadmill walking
and cycle ergometer exercise in obese women. Eur J Appl
Physiol. 2008;103:707–17.
123
R. B. Viana et al.
66. Koyal SN, Whipp BJ, Huntsman D, Bray GA, Wasserman K.
Ventilatory responses to the metabolic acidosis of treadmill and
cycle ergometry. J Appl Physiol. 1976;40:864–7.
67. Fortner HA, Salgado JM, Holmstrup AM, Holmstrup ME. Car-
diovascular and metabolic demands of the kettlebell swing using
Tabata interval versus a traditional resistance protocol. Int J
Exerc Sci. 2014;7:179–85.
68. Gentil P, Naves JPA, Viana RB, Coswig V, Dos Santos Vaz M,
Bartel C, et al. Revisiting Tabata’s protocol: does it even exist?
Med Sci Sports Exerc. 2016;48:2070–1.
69. McRae G, Payne A, Zelt JG, Scribbans TD, Jung ME, Little JP,
et al. Extremely low volume, whole-body aerobic-resistance
training improves aerobic fitness and muscular endurance in
females. Appl Physiol Nutr Metab. 2012;37:1124–31.
70. Tabata I, Nishimura K, Kouzaki M, Hirai Y, Ogita F, Miyachi M,
et al. Effects of moderate-intensity endurance and high-intensity
intermittent training on anaerobic capacity and VO2max. Med Sci
Sports Exerc. 1996;28:1327–30.
71. Foster C, Farland CV, Guidotti F, Harbin M, Roberts B, Schuette
J, et al. The effects of high intensity interval training vs steady
state training on aerobic and anaerobic capacity. J Sports Sci
Med. 2015;14:747–55.
72. Amtmann JA, Amtmann KA, Spath WK. Lactate and rate of
perceived exertion responses of athletes training for and com-
peting in a mixed martial arts event. J Strength Cond Res.
2008;22:645–7.
73. Matsui H, Kitamura K, Miyamura M. Oxygen uptake and blood
flow of the lower limb in maximal treadmill and bicycle exercise.
Eur J Appl Physiol Occup Physiol. 1978;40:57–62.
74. Fitzsimmons M, Dawson-Hughes B, Ware D, Wilkinson A,
Fitzsimons M. Cycling and running tests of repeated sprint
ability. Aust J Sci Med Sport. 1993;25:82–7.
75. Hulston CJ, Venables MC, Mann CH, Martin C, Philp A, Baar K,
et al. Training with low muscle glycogen enhances fat metabo-
lism in well-trained cyclists. Med Sci Sports Exerc.
2010;42:2046–55.
76. Field AP. Dread returns to mega-silly one. Health Psychol Rev.
2015;9:15–20.
77. Gentil P, Arruda A, Souza D, Giessing J, Paoli A, Steele J, et al.
Is there any practical application of meta-analytical results in
strength training? Front Physiol. 2017;8:1.
78. Weston KS, Wisløff U, Coombes JS, Ramos JS, Dalleck LC,
Tjonna AE, et al. High-intensity interval training for improving
health-related fitness in adolescents: a systematic review and
meta-analysis. Br J Sports Med. 2015;49:679–92.
79. Ramos JS, Dalleck LC, Tjonna AE, Beetham KS, Coombes JS.
The impact of high-intensity interval training versus moderate-
intensity continuous training on vascular function: a systematic
review and meta-analysis. Sports Med. 2015;45:679–92.
80. Costigan SA, Eather N, Plotnikoff RC, Taaffe DR, Lubans DR.
High-intensity interval training for improving health-related fit-
ness in adolescents: a systematic review and meta-analysis. Br J
Sports Med. 2015;49:1253–61.
81. Liou K, Ho S, Fildes J, Ooi S-Y. High intensity interval versus
moderate intensity continuous training in patients with coronary
artery disease: a meta-analysis of physiological and clinical
parameters. Heart Lung Circ. 2016;25:166–74.
82. Batacan RB, Duncan MJ, Dalbo VJ, Tucker PS, Fenning AS.
Effects of high-intensity interval training on cardiometabolic
health: a systematic review and meta-analysis of intervention
studies. Br J Sports Med. 2017;51:494–503.
83. Garcı́a-Hermoso A, Cerrillo-Urbina AJ, Herrera-Valenzuela T,
Cristi-Montero C, Saavedra JM, Martı́nez-Vizcaı́no V. Is high-
intensity interval training more effective on improving car-
diometabolic risk and aerobic capacity than other forms of
Meta-Analysis in Interval Training

exercise in overweight and obese youth? A meta-analysis. Obes of study quality and reporting in exercise training studies. Int J
Rev. 2016;17:531–40. Evid Based Healthc. 2015;13:9–18.
84. Smart NA, Waldron M, Ismail H, Giallauria F, Vigorito C,
Cornelissen V, et al. Validation of a new tool for the assessment

123