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      Anthropometric, Cardiopulmonary and Metabolic Benefits of the High-Intensity Interval Training Versus Moderate, Low-Intensity or Control for Type 2 Diabetes: Systematic Review and Meta-Analysis

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          Abstract

          This study aims to evaluate the effectiveness of high-intensity interval training compared with no intervention and other types of training interventions for people with Type 2 diabetes. A systematic review and meta-analysis of randomized controlled trials that used high-interval intensity training to improve anthropometric, cardiopulmonary and metabolic conditions were conducted. The search was performed during October–December 2017 using the databases PubMed, Web of Science and Physiotherapy Evidence Database (PEDro). The methodological quality of the studies was evaluated using the PEDro scale. A total of 10 articles were included in this meta-analysis. After statistical analysis, favorable results were obtained for high-Intensity Interval Training compared with control (non-intervention): [Weight: Standardized mean difference (SMD) = −2.09; confidence interval (CI) 95%: (−3.41; −0.78); body-mass index: SMD = −3.73; CI 95%: (−5.53; −1.93); systolic blood pressure: SMD = −4.55; CI 95%: (−8.44; −0.65); VO 2max: SMD = 12.20; CI 95%: (0.26; 24.14); HbA 1c: SMD = −3.72; CI 95%: (−7.34; −0.10)], moderate intensity continuous training: [body-mass index: SMD = −0.41; CI 95%: (−0.80; −0.03); VO 2max: SMD = 1.91; CI 95%: (0.18; 3.64)], and low intensity training: [Weight: SMD = −2.06; CI 95%: (−2.80; −1.31); body-mass index: SMD = −3.04; CI 95%: (−5.16; −0.92); systolic blood pressure: SMD = −2.17; CI 95%: (−3.93; −0.41); HbA 1c: SMD = −1.58; CI 95%: (−1.84; −1.33)]. The results show that high-intensity interval training can be a useful strategy in order to improve anthropometric, cardiopulmonary and metabolic parameters in people with Type 2 diabetes. Despite this, it could be essential to clarify and unify criteria in the intervention protocols, being necessary new lines of research.

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          Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies.

          The current review clarifies the cardiometabolic health effects of high-intensity interval training (HIIT) in adults. A systematic search (PubMed) examining HIIT and cardiometabolic health markers was completed on 15 October 2015. Sixty-five intervention studies were included for review and the methodological quality of included studies was assessed using the Downs and Black score. Studies were classified by intervention duration and body mass index classification. Outcomes with at least 5 effect sizes were synthesised using a random-effects meta-analysis of the standardised mean difference (SMD) in cardiometabolic health markers (baseline to postintervention) using Review Manager 5.3. Short-term (ST) HIIT (<12 weeks) significantly improved maximal oxygen uptake (VO2 max; SMD 0.74, 95% CI 0.36 to 1.12; p<0.001), diastolic blood pressure (DBP; SMD -0.52, 95% CI -0.89 to -0.16; p<0.01) and fasting glucose (SMD -0.35, 95% CI -0.62 to -0.09; p<0.01) in overweight/obese populations. Long-term (LT) HIIT (≥12 weeks) significantly improved waist circumference (SMD -0.20, 95% CI -0.38 to -0.01; p<0.05), % body fat (SMD -0.40, 95% CI -0.74 to -0.06; p<0.05), VO2 max (SMD 1.20, 95% CI 0.57 to 1.83; p<0.001), resting heart rate (SMD -0.33, 95% CI -0.56 to -0.09; p<0.01), systolic blood pressure (SMD -0.35, 95% CI -0.60 to -0.09; p<0.01) and DBP (SMD -0.38, 95% CI -0.65 to -0.10; p<0.01) in overweight/obese populations. HIIT demonstrated no effect on insulin, lipid profile, C reactive protein or interleukin 6 in overweight/obese populations. In normal weight populations, ST-HIIT and LT-HIIT significantly improved VO2 max, but no other significant effects were observed. Current evidence suggests that ST-HIIT and LT-HIIT can increase VO2 max and improve some cardiometabolic risk factors in overweight/obese populations.
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            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.

            The objective of this study is to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) for improvements in body composition in overweight and obese adults.
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              Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study.

              We sought to determine whether structured exercise training (ET) improves maximal exercise capacity, left ventricular diastolic function, and quality of life (QoL) in patients with heart failure with preserved ejection fraction (HFpEF). Nearly one-half of patients with heart failure experience HFpEF, but effective therapeutic strategies are sparse. A total of 64 patients (age 65 ± 7 years, 56% female) with HFpEF were prospectively randomized (2:1) to supervised endurance/resistance training in addition to usual care (ET, n = 44) or to usual care alone (UC) (n = 20). The primary endpoint was the change in peak Vo(2) after 3 months. Secondary endpoints included effects on cardiac structure, diastolic function, and QoL. Peak Vo(2) increased (16.1 ± 4.9 ml/min/kg to 18.7 ± 5.4 ml/min/kg; p < 0.001) with ET and remained unchanged (16.7 ± 4.7 ml/min/kg to 16.0 ± 6.0 ml/min/kg; p = NS) with UC. The mean benefit of ET was 3.3 ml/min/kg (95% confidence interval [CI]: 1.8 to 4.8, p < 0.001). E/e' (mean difference of changes: -3.2, 95% CI: -4.3 to -2.1, p < 0.001) and left atrial volume index (milliliters per square meter) decreased with ET and remained unchanged with UC (-4.0, 95% CI: -5.9 to -2.2, p < 0.001). The physical functioning score (36-Item Short-Form Health Survey) improved with ET and remained unchanged with UC (15, 95% CI: 7 to 24, p < 0.001). The ET-induced decrease of E/e' was associated with 38% gain in peak Vo(2) and 50% of the improvement in physical functioning score. Exercise training improves exercise capacity and physical dimensions of QoL in HFpEF. This benefit is associated with atrial reverse remodeling and improved left ventricular diastolic function. (Exercise Training in Diastolic Heart Failure-Pilot Study: A Prospective, Randomised, Controlled Study to Determine the Effects of Physical Training on Exercise Capacity and Quality of Life [Ex-DHF-P]; ISRCTN42524037). Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                15 November 2019
                November 2019
                : 16
                : 22
                : 4524
                Affiliations
                [1 ]Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; ivan.lorapozo95@ 123456gmail.com (I.L.-P.); alejandro.galan@ 123456uca.es (A.G.-M.); joseantonio.moral@ 123456uca.es (J.A.M.-M.)
                [2 ]Department of Statistics and Operational Research, University of Cadiz, 11009 Cadiz, Spain; alejandro.salazar@ 123456uca.es
                [3 ]Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), University of Cadiz, 11009 Cadiz, Spain
                [4 ]Observatory of Pain, Grünenthal Foundation-University of Cadiz, 11009 Cadiz, Spain
                Author notes
                [* ]Correspondence: david.lucena@ 123456uca.es ; Tel.: +34-635-695-203
                Author information
                https://orcid.org/0000-0003-2441-5342
                https://orcid.org/0000-0001-9567-462X
                https://orcid.org/0000-0003-3581-0372
                Article
                ijerph-16-04524
                10.3390/ijerph16224524
                6887993
                31731764
                81600fa8-5e42-4756-a665-ea1a0fed2c58
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 22 October 2019
                : 11 November 2019
                Categories
                Review

                Public health
                high-intensity interval training,physical activity,physical exercise,type 2 diabetes

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