We tested the hypothesis that low-volume high-intensity swimming has a larger impact on insulin sensitivity and glucose control than high-volume low-intensity swimming in inactive premenopausal women with mild hypertension.
Sixty-two untrained premenopausal women were randomised to an inactive control (n = 20; CON), a high-intensity low-volume (n = 21; HIT) or a low-intensity high-volume (n = 21; LIT) training group. During the 15-week intervention period, HIT performed 3 weekly 6–10 × 30-s all-out swimming intervals (average heart rate (HR) = 86 ± 3 % HRmax) interspersed by 2-min recovery periods and LIT swam continuously for 1 h at low intensity (average HR = 73 ± 3 % HRmax). Fasting blood samples were taken and an oral glucose tolerance test (OGTT) was conducted pre- and post-intervention.
After HIT, resting plasma [insulin] was lowered (17 ± 34 %; P < 0.05) but remained similar after LIT and CON. Following HIT, 60-min OGTT plasma [insulin] and [glucose] was lowered (24 ± 30 % and 10 ± 16 %; P < 0.05) but remained similar after LIT and CON. Total area under the curve for plasma [glucose] was lower (P < 0.05) after HIT than LIT (660 ± 141 vs. 860 ± 325 mmol min L−1). Insulin sensitivity (HOMA-IR) had increased (P < 0.05) by 22 ± 34 % after HIT, with no significant change after LIT or CON, respectively. Plasma soluble intracellular cell adhesion molecule 1 was lowered (P < 0.05) by 4 ± 8 and 3 ± 9 % after HIT and CON, respectively, while plasma soluble vascular cell adhesion molecule 1 had decreased (P < 0.05) by 8 ± 23 % after HIT only.
These findings suggest that low-volume high-intensity intermittent swimming is an effective and time-efficient training strategy for improving insulin sensitivity, glucose control and biomarkers of vascular function in inactive, middle-aged mildly hypertensive women.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Analysis of variance
Homeostatic model assessment of insulin resistance
Oral glucose tolerance test
Standard error of the mean
Soluble intracellular cell adhesion molecule 1
Soluble vascular cell adhesion molecule 1
Type 2 diabetes mellitus
Total area under the curve
Adams OP (2013) The impact of brief high-intensity exercise on blood glucose levels. Diabetes Metab Syndr Obes 6:113–122. doi:10.2147/DMSO.S29222
Al Tunaiji H, Davis JC, Mackey DC, Khan KM (2014) Population attributable fraction of type 2 diabetes due to physical inactivity in adults: a systematic review. BMC Public Health 14:469. doi:10.1186/1471-2458-14-469
Appelman Y, van Rijn BB, Ten Haaf ME, Boersma E, Peters SA (2015) Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis 241:211–218. doi:10.1016/j.atherosclerosis.2015.01.027
Arad AD, DiMenna FJ, Thomas N, Tamis-Holland J, Weil R, Geliebter A, Albu JB (2015) High-intensity interval training without weight loss improves exercise but not basal or insulin-induced metabolism in overweight/obese African American women. J Appl Physiol 119:352–362. doi:10.1152/japplphysiol.00306.2015
Burgomaster KA, Cermak NM, Phillips SM, Benton CR, Bonen A, Gibala MJ (2007) Divergent response of metabolite transport proteins in human skeletal muscle after sprint interval training and detraining. Am J Physiol Regul Integr Comp Physiol 292:R1970–R1976. doi:10.1152/ajpregu.00503.2006
Chedraui P, Perez-Lopez FR (2013) Nutrition and health during mid-life: searching for solutions and meeting challenges for the aging population. Climacteric 16(Suppl 1):85–95. doi:10.3109/13697137.2013.802884
Chen NG, Azhar S, Abbasi F, Carantoni M, Reaven GM (2000) The relationship between plasma glucose and insulin responses to oral glucose, LDL oxidation, and soluble intercellular adhesion molecule-1 in healthy volunteers. Atherosclerosis 152:203–208. doi:10.1016/S0021-9150(99)00460-8
Chen HH, Chen YL, Huang CY, Lee SD, Chen SC, Kuo CH (2010) Effects of one-year swimming training on blood pressure and insulin sensitivity in mild hypertensive young patients. Chin J Physiol 53:185–189. doi:10.4077/cjp.2010.amk042
Ciolac EG, Bocchi EA, Bortolotto LA, Carvalho VO, Greve JM, Guimaraes GV (2010) Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension. Hypertens Res 33:836–843. doi:10.1038/hr.2010.72
Cox KL, Burke V, Beilin LJ, Puddey IB (2010) A comparison of the effects of swimming and walking on body weight, fat distribution, lipids, glucose, and insulin in older women-the Sedentary Women Exercise Adherence Trial 2. Metabolism 59:1562–1573. doi:10.1016/j.metabol.2010.02.001
Daugaard JR, Richter EA (2001) Relationship between muscle fibre composition, glucose transporter protein 4 and exercise training: possible consequences in non-insulin-dependent diabetes mellitus. Acta Physiol Scand 171:267–276. doi:10.1046/j.1365-201x.2001.00829.x
Durrer C et al (2015) Differential impact of acute high-intensity exercise on circulating endothelial microparticles and insulin resistance between overweight/obese males and females. PLoS ONE 10:e0115860. doi:10.1371/journal.pone.0115860
Ferrannini E, Camastra S, Coppack SW, Fliser D, Golay A, Mitrakou A (1997) Insulin action and non-esterified fatty acids. The European Group for the Study of Insulin Resistance (EGIR). Proc Nutr Soc 56:753–761
Fujimoto E, Machida S, Higuchi M, Tabata I (2010) Effects of nonexhaustive bouts of high-intensity intermittent swimming training on GLUT-4 expression in rat skeletal muscle. J Physiol Sci 60:95–101. doi:10.1007/s12576-009-0072-4
Gillen JB, Percival ME, Ludzki A, Tarnopolsky MA, Gibala MJ (2013) Interval training in the fed or fasted state improves body composition and muscle oxidative capacity in overweight women. Obesity 21:2249–2255. doi:10.1002/oby.20379
Glowinska B, Urban M, Peczynska J, Florys B (2005) Soluble adhesion molecules (sICAM-1, sVCAM-1) and selectins (sE selectin, sP selectin, sL selectin) levels in children and adolescents with obesity, hypertension, and diabetes. Metabolism 54:1020–1026. doi:10.1016/j.metabol.2005.03.004
Goodpaster BH, Katsiaras A, Kelley DE (2003) Enhanced fat oxidation through physical activity is associated with improvements in insulin sensitivity in obesity. Diabetes 52:2191–2197. doi:10.2337/diabetes.52.9.2191
Holloszy JO, Booth FW (1976) Biochemical adaptations to endurance exercise in muscle. Annu Rev Physiol 38:273–291. doi:10.1146/annurev.ph.38.030176.001421
Iaia FM, Hellsten Y, Nielsen JJ, Fernstrom M, Sahlin K, Bangsbo J (2009) Four weeks of speed endurance training reduces energy expenditure during exercise and maintains muscle oxidative capacity despite a reduction in training volume. J Appl Physiol 106:73–80. doi:10.1152/japplphysiol.90676.2008
Keating SE et al (2015) Effect of aerobic exercise training dose on liver fat and visceral adiposity. J Hepatol 63:174–182. doi:10.1016/j.jhep.2015.02.022
Kim JA, Montagnani M, Koh KK, Quon MJ (2006) Reciprocal relationships between insulin resistance and endothelial dysfunction: molecular and pathophysiological mechanisms. Circulation 113:1888–1904. doi:10.1161/CIRCULATIONAHA.105.563213
Kohl HW, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, Kahlmeier S (2012) The pandemic of physical inactivity: global action for public health. Lancet 380:294–305. doi:10.1016/s0140-6736(12)60898-8
Lazar JM, Khanna N, Chesler R, Salciccioli L (2013) Swimming and the heart. Int J Cardiol 168:19–26. doi:10.1016/j.ijcard.2013.03.063
Little JP, Francois ME (2014) High-intensity interval training for improving postprandial hyperglycemia. Res Q Exerc Sport 85:451–456. doi:10.1080/02701367.2014.963474
Little JP et al (2011) Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. J Appl Physiol 111:1554–1560. doi:10.1152/japplphysiol.00921.2011
Marsh SA, Coombes JS (2005) Exercise and the endothelial cell. Int J Cardiol 99:165–169. doi:10.1016/j.ijcard.2004.02.005
Mohr M, Krustrup P, Nielsen JJ, Nybo L, Rasmussen MK, Juel C, Bangsbo J (2007) Effect of two different intense training regimens on skeletal muscle ion transport proteins and fatigue development. Am J Physiol Regul Integr Comp Physiol 292:R1594–R1602. doi:10.1152/ajpregu.00251.2006
Mohr M, Lindenskov A, Holm PM, Nielsen HP, Mortensen J, Weihe P, Krustrup P (2014a) Football training improves cardiovascular health profile in sedentary, premenopausal hypertensive women. Scand J Med Sci Sports 24(Suppl 1):36–42. doi:10.1111/sms.12278
Mohr M et al (2014b) High-intensity intermittent swimming improves cardiovascular health status for women with mild hypertension. BioMed research international 2014:728289. doi:10.1155/2014/728289
Motta VF, Aguila MB, Mandarim-De-Lacerda CA (2015) High-intensity interval training (swimming) significantly improves the adverse metabolism and comorbidities in diet-induced obese mice. The Journal of Sports Medicine and Physical Fitness 54:203–209
Nordsborg NB, Connolly L, Weihe P, Iuliano E, Krustrup P, Saltin B, Mohr M (2015) Oxidative capacity and glycogen content increase more in arm than leg muscle in sedentary women after intense training. J Appl Physiol 119:116–123. doi:10.1152/japplphysiol.00101.2015
Nualnim N, Parkhurst K, Dhindsa M, Tarumi T, Vavrek J, Tanaka H (2012) Effects of swimming training on blood pressure and vascular function in adults >50 years of age. Am J Cardiol 109:1005–1010. doi:10.1016/j.amjcard.2011.11.029
Nyberg M, Seidelin K, Andersen TR, Overby NN, Hellsten Y, Bangsbo J (2014) Biomarkers of vascular function in premenopausal and recent postmenopausal women of similar age: effect of exercise training. Am J Physiol Regul Integr Comp Physiol 306:R510–R517. doi:10.1152/ajpregu.00539.2013
Padilla J, Harris RA, Rink LD, Wallace JP (2008) Characterization of the brachial artery shear stress following walking exercise. Vasc Med 13:105–111. doi:10.1177/1358863x07086671
Rizzoli R et al (2014) The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Maturitas 79:122–132. doi:10.1016/j.maturitas.2014.07.005
Sabatier MJ, Schwark EH, Lewis R, Sloan G, Cannon J, McCully K (2008) Femoral artery remodeling after aerobic exercise training without weight loss in women. Dyn Med. doi:10.1186/1476-5918-7-13
Shaban N, Kenno KA, Milne KJ (2014) The effects of a 2 week modified high intensity interval training program on the homeostatic model of insulin resistance (HOMA-IR) in adults with type 2 diabetes. J Sports Med Phys Fitness 54:203–209
Shufelt C, Braunstein GD, Pepine CJ, Bairey Merz CN (2015) Recognizing Sex Similarities in Cardiovascular Disease Research. J Am Coll Cardiol 65:2152–2153. doi:10.1016/j.jacc.2015.02.066
Song A, Wang C, Ren L, Zhao J (2014) Swimming improves high-fat induced insulin resistance by regulating lipid and energy metabolism and the insulin pathway in rats. Int J Mol Med 33:1671–1679. doi:10.3892/ijmm.2014.1738
Sundstedt M, Jonason T, Ahren T, Damm S, Wesslen L, Henriksen E (2003) Left ventricular volume changes during supine exercise in young endurance athletes. Acta Physiol Scand 177:467–472. doi:10.1046/j.1365-201X.2003.01098.x
Talanian JL, Galloway SD, Heigenhauser GJ, Bonen A, Spriet LL (2007) Two weeks of high-intensity aerobic interval training increases the capacity for fat oxidation during exercise in women. J Appl Physiol 102:1439–1447. doi:10.1152/japplphysiol.01098.2006
Terada S, Yokozeki T, Kawanaka K, Ogawa K, Higuchi M, Ezaki O, Tabata I (2001) Effects of high-intensity swimming training on GLUT-4 and glucose transport activity in rat skeletal muscle. J Appl Physiol 90:2019–2024
Trapp EG, Chisholm DJ, Freund J, Boutcher SH (2008) The effects of high-intensity intermittent exercise training on fat loss and fasting insulin levels of young women. Int J Obes (Lond) 32:684–691. doi:10.1038/sj.ijo.0803781
Vollestad NK, Blom PC (1985) Effect of varying exercise intensity on glycogen depletion in human muscle fibres. Acta Physiol Scand 125:395–405. doi:10.1111/j.1748-1716.1985.tb07735.x
Weyer C, Yudkin JS, Stehouwer CD, Schalkwijk CG, Pratley RE, Tataranni PA (2002) Humoral markers of inflammation and endothelial dysfunction in relation to adiposity and in vivo insulin action in Pima Indians. Atherosclerosis 161:233–242
Wisloff U, Ellingsen O, Kemi OJ (2009) High-intensity interval training to maximize cardiac benefits of exercise training? Exerc Sport Sci Rev 37:139–146. doi:10.1097/JES.0b013e3181aa65fc
World Health Organization (2016) Physical Inactivity: A Global Public Health Problem. http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/. Accessed 11/03/16 2016
Yokoyama H et al (2003) Quantitative insulin sensitivity check index and the reciprocal index of homeostasis model assessment in normal range weight and moderately obese type 2 diabetic patients. Diabetes Care 26:2426–2432
The authors would like to express their appreciation for the outstanding efforts and positive attitude of the participants. In addition, they are extremely grateful for the professional assistance given by swimming coaches Remi Lamhauge, Brynhild Klein, Pauli Øssursson Mohr, Heini Rasmussen, Oluffa á Høvdanum, and the late Jákup Mohr, and for the technical support provided by Ivy Hansen, Gunnrið Jóannesarson, Guðrið Andórsdóttir, Hergerð Joensen, Ann Østerø, Ebba Andreassen, Maud av Fløtum, Liljan av Fløtum Petersen, Marjun Thomsen, Annika Lindenskov, Jann Mortensen, David Childs, Sarah R. Jackman and Jens Jung Nielsen. The study was supported by a Grant from the Faroese Research Council, as well as by The Faroese Confederation of Sports and Olympic Committee (Ítróttarsamband Føroya), and the Danish Sports Confederation (Danmarks Idrætsforbund). In addition, financial support was obtained from Eik Bank.
Conflict of interest
The authors declare that there is no conflict of interests
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Communicated by Michael Lindinger.
About this article
Cite this article
Connolly, L.J., Nordsborg, N.B., Nyberg, M. et al. Low-volume high-intensity swim training is superior to high-volume low-intensity training in relation to insulin sensitivity and glucose control in inactive middle-aged women. Eur J Appl Physiol 116, 1889–1897 (2016). https://doi.org/10.1007/s00421-016-3441-8
- Blood glucose
- Type 2 diabetes
- Body composition
- Upper body exercise
- Metabolic health