Skip to main content

Advertisement

Log in

Effect of High-Intensity Interval Training on Fitness, Fat Mass and Cardiometabolic Biomarkers in Children with Obesity: A Randomised Controlled Trial

  • Original Research Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

Background

Paediatric obesity significantly increases the risk of developing cardiometabolic diseases across the lifespan. Increasing cardiorespiratory fitness (CRF) could mitigate this risk. High-intensity interval training (HIIT) improves CRF in clinical adult populations but the evidence in paediatric obesity is inconsistent.

Objectives

The objectives of this study were to determine the efficacy of a 12-week, HIIT intervention for increasing CRF and reducing adiposity in children with obesity.

Methods

Children with obesity (n = 99, 7–16 years old) were randomised into a 12-week intervention as follows: (1) HIIT [n = 33, 4 × 4-min bouts at 85–95% maximum heart rate (HRmax), interspersed with 3 min of active recovery at 50–70% HRmax, 3 times/week] and nutrition advice; (2) moderate-intensity continuous training (MICT) [n = 32, 44 min at 60–70% HRmax, 3 times/week] and nutrition advice; and (3) nutrition advice only (nutrition) [n = 34]. CRF was quantified through a maximal exercise test (\( \dot{V}{\text{O}}_{{2_{\text{peak}} }} \)) while adiposity was assessed using magnetic resonance imaging (MRI), dual-energy X-ray absorptiometry (DXA) and air-displacement plethysmography.

Results

HIIT stimulated significant increases in relative \( \dot{V}{\text{O}}_{{2_{\text{peak}} }} \) compared with MICT (+3.6 mL/kg/min, 95% CI 1.1–6.0, P = 0.004) and the nutrition intervention (+5.4 mL/kg/min, 95% CI 2.9–7.9, P = 0.001). However, the intervention had no significant effect on visceral and subcutaneous adipose tissue, whole body composition or cardiometabolic biomarkers (P > 0.05).

Conclusion

A 12-week, HIIT intervention was highly effective in increasing cardiorespiratory fitness when compared with MICT and nutrition interventions. While there were no concomitant reductions in adiposity or blood biomarkers, the cardiometabolic health benefit conferred through increased CRF should be noted.

Clinical trials registration number

Clinicaltrials.gov; NCT01991106.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sabin MA, Kao K-T, Juonala M, Baur LA, Wake M. Viewpoint article: childhood obesity: looking back over 50 years to begin to look forward. J Paediatr Child Health. 2015;51:82–6.

    Article  PubMed  Google Scholar 

  2. Reilly JJ, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes (Lond). 2010;35:891–8.

    Article  Google Scholar 

  3. Westphal SA. Obesity, abdominal obesity, and insulin resistance. Clin Cornerstone. 2008;9:23–31.

    Article  PubMed  Google Scholar 

  4. Kuk J, Katzmarzyk P, Nichaman M, Church T, Blair S, Ross R. Visceral fat is an independent predictor of all-cause mortality in men. Obesity. 2006;14:336–41.

    Article  PubMed  Google Scholar 

  5. Benfield LL, Fox KR, Peters DM, Blake H, Rogers I, Grant C, et al. Magnetic resonance imaging of abdominal adiposity in a large cohort of British children. Int J Obes (Lond). 2008;32:91–9.

    Article  CAS  Google Scholar 

  6. Barry VW, Baruth M, Beets MW, Durstine JL, Liu J, Blair SN. Fitness vs. fatness on all-cause mortality: a meta-analysis. Prog Cardiovasc Dis. 2014;56:382–90.

    Article  PubMed  Google Scholar 

  7. LaMonte MJ, Eisenman PA, Adams TD, Shultz BB, Ainsworth BE, Yanowitz FG. Cardiorespiratory fitness and coronary heart disease risk factors: the LDS Hospital Fitness Institute cohort. Circulation. 2000;102:1623–8.

    Article  CAS  PubMed  Google Scholar 

  8. Breneman CB, Polinski K, Sarzynski MA, Lavie CJ, Kokkinos PF, Ahmed A, et al. The impact of cardiorespiratory fitness levels on the risk of developing atherogenic dyslipidemia. Am J Med. 2016;129(10):1060–6.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301:2024–35.

    Article  CAS  PubMed  Google Scholar 

  10. Raitakari OT, Taimela S, Porkka KV, Telama R, Välimäki I, Akerblom HK, et al. Associations between physical activity and risk factors for coronary heart disease: the Cardiovascular Risk in Young Finns Study. Med Sci Sports Exerc. 1997;29:1055–61.

    Article  CAS  PubMed  Google Scholar 

  11. Katzmarzyk PT, Malina RM, Bouchard C. Physical activity, physical fitness, and coronary heart disease risk factors in youth: the Quebec Family Study. Prev Med. 1999;29:555–62.

    Article  CAS  PubMed  Google Scholar 

  12. Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu W-C, et al. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2015;4:1–28.

    Google Scholar 

  13. Vissers D, Hens W, Hansen D, Taeymans J. The effect of diet or exercise on visceral adipose tissue in overweight youth. Med Sci Sports Exerc. 2016;48:1415–24.

    Article  CAS  PubMed  Google Scholar 

  14. Vissers D, Hens W, Taeymans J, Baeyens J-P, Poortmans J, Van Gaal L. The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis. PLoS One. 2013;8:e56415.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Atlantis E, Barnes EH, Singh MAF. Efficacy of exercise for treating overweight in children and adolescents: a systematic review. Int J Obes (Lond). 2006;30:1027–40.

    Article  CAS  Google Scholar 

  16. Tremblay MS, Gray CE, Akinroye K, Harrington DM, Katzmarzyk PT, Lambert EV, et al. Physical activity of children: a global matrix of grades comparing 15 countries. J Phys Act Health. 2014;11(Suppl. 1):S113–25.

    Article  PubMed  Google Scholar 

  17. McManus AM, Mellecker RR. Physical activity and obese children. J Sport Health Sci. 2012;1:141–8.

    Article  Google Scholar 

  18. Weston KS, Wisloff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med. 2014;48:1227–34.

    Article  PubMed  Google Scholar 

  19. Ingul CB, Tjonna AE, Stolen TO, Stoylen A, Wisloff U. Impaired cardiac function among obese adolescents: effect of aerobic interval training. Arch Pediatr Adolesc Med. 2010;164:852–9.

    Article  PubMed  Google Scholar 

  20. Corte de Araujo AC, Roschel H, Picanço AR, Do D, Villares SMF, de Sá Pinto AL, et al. Similar health benefits of endurance and high-intensity interval training in obese children. PLoS One. 2012;7:e42747.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Racil G, Ben Ounis O, Hammouda O, Kallel A, Zouhal H, Chamari K, et al. Effects of high vs. moderate exercise intensity during interval training on lipids and adiponectin levels in obese young females. Eur J Appl Physiol. 2013;113:2531–40.

    Article  CAS  PubMed  Google Scholar 

  22. Koubaa A, Trabelsi H, Masmoudi L, Elloumi M, Sahnoun Z, Zeghal KM, et al. Effect of intermittent and continuous training on body composition cardio-respiratory fitness and lipid profile in obese adolescents. IOSR-JPBS. 2013;3:31–7.

    Google Scholar 

  23. Racil G, Coquart JB, Elmontassar W, Haddad M, Goebel R, Chaouachi A, et al. Greater effects of high- compared with moderate-intensity interval training on cardio-metabolic variables, blood leptin concentration and ratings of perceived exertion in obese adolescent females. Biol Sport. 2016;33:145–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Logan GRM, Harris N, Duncan S, Schofield G. A review of adolescent high-intensity interval training. Sports Med. 2014;44:1071–85.

    Article  PubMed  Google Scholar 

  25. Brambilla P, Pozzobon G, Pietrobelli A. Physical activity as the main therapeutic tool for metabolic syndrome in childhood. Int J Obes (Lond). 2011;35:16–28.

    Article  CAS  Google Scholar 

  26. Craike MJ, Hibbins R, Cuskelly G. The influence of various aspects of enjoyment on participation in leisure time physical activity. World Leis J. 2010;1:20–33.

    Article  Google Scholar 

  27. Deforche B, Haerens L, De Bourdeaudhuij I. How to make overweight children exercise and follow the recommendations. Int J Pediatr Obes. 2011;6(Suppl. 1):35–41.

    Article  PubMed  Google Scholar 

  28. Trapp EG, Chisholm DJ, Boutcher SH. Metabolic response of trained and untrained women during high-intensity intermittent cycle exercise. Am J Physiol Regul Integr Comp Physiol. 2007;293:R2370–5.

    Article  CAS  PubMed  Google Scholar 

  29. Burguera B, Proctor D, Dietz N, Guo Z, Joyner M, Jensen MD. Leg free fatty acid kinetics during exercise in men and women. Am J Physiol Endocrinol Metab. 2000;278:E113–7.

    Article  CAS  PubMed  Google Scholar 

  30. Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012;7:284–94.

    Article  CAS  PubMed  Google Scholar 

  31. Dias KA, Coombes JS, Green DJ, Gomersall SR, Keating SE, Tjonna AE, et al. Effects of exercise intensity and nutrition advice on myocardial function in obese children and adolescents: a multicentre randomised controlled trial study protocol. BMJ Open. 2016;6:e010929.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44:291–303.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970;45:13–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. University of Oxford. Diabetes Trials Unit, The Oxford Centre for Diabetes, Endocrinology and Metabolism. http://www.dtu.ox.ac.uk. Accessed 17 Aug 2016.

  35. Helsedirektoratet. Anbefalinger om kosthold, ernæring og fysisk aktivitet; 2014. Norwegian Directorate of Health, Oslo, p. 1–28.

  36. National Health and Medical Research Council. Australian dietary guidelines. Canberra: National Health and Medical Research Council; 2013. National Health and Medical Research Council, p. 1–226.

    Google Scholar 

  37. Irving BA, Davis CK, Brock DW, Weltman JY, Swift D, Barrett EJ, et al. Effect of exercise training intensity on abdominal visceral fat and body composition. Med Sci Sports Exerc. 2008;40:1863–72.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Starkoff BE, Eneli IU, Bonny AE, Hoffman RP, Devor ST. Estimated aerobic capacity changes in adolescents with obesity following high intensity interval exercise. IJKSS. 2014;2:1–8.

    Article  Google Scholar 

  39. Murphy A, Kist C, Gier AJ, Edwards NM, Gao Z, Siegel RM. The feasibility of high-intensity interval exercise in obese adolescents. Clin Pediatr (Phila). 2015;54:87–90.

    Article  Google Scholar 

  40. Ross R, Blair SN, Arena R, Church TS, Després JP, Franklin BA, et al. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a Scientific statement from the American Heart Association. Circulation. 2016;134:e653–99.

    Article  PubMed  Google Scholar 

  41. Vanhala M, Vanhala P, Kumpusalo E, Halonen P, Takala J. Relation between obesity from childhood to adulthood and the metabolic syndrome: population based study. BMJ. 1998;317:319.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Hay J, Wittmeier K, MacIntosh A, Wicklow B, Duhamel T, Sellers E, et al. Physical activity intensity and type 2 diabetes risk in overweight youth: a randomized trial. Int J Obes (Lond). 2016;40:607–14.

    Article  CAS  Google Scholar 

  43. Gutin B, Barbeau P, Owens S, Lemmon CR, Bauman M, Allison J, et al. Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents. Am J Clin Nutr. 2002;75:818–26.

    Article  CAS  PubMed  Google Scholar 

  44. Mora-Rodriguez R, Coyle EF. Effects of plasma epinephrine on fat metabolism during exercise: interactions with exercise intensity. Am J Physiol Endocrinol Metab. 2000;278:E669–76.

    Article  CAS  PubMed  Google Scholar 

  45. Kanaley JA, Weatherup-Dentes MM, Jaynes EB, Hartman ML. Obesity attenuates the growth hormone response to exercise. J Clin Endocrinol Metab. 1999;84:3156–61.

    CAS  PubMed  Google Scholar 

  46. Vettor R, Macor C, Rossi E, Piemonte G, Federspil G. Impaired counterregulatory hormonal and metabolic response to exhaustive exercise in obese subjects. Acta Diabetol. 1997;34:61–6.

    Article  CAS  PubMed  Google Scholar 

  47. Eliakim A, Nemet D, Zaldivar F, McMurray RG, Culler FL, Galassetti P, et al. Reduced exercise-associated response of the GH-IGF-I axis and catecholamines in obese children and adolescents. J Appl Physiol. 2006;100:1630–7.

    Article  CAS  PubMed  Google Scholar 

  48. Verheggen RJHM, Maessen MFH, Green DJ, Hermus ARMM, Hopman MTE, Thijssen DHT. A systematic review and meta-analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue. Obes Rev. 2016;17:664–90.

    Article  CAS  PubMed  Google Scholar 

  49. Lee S, Deldin AR, White D, Kim Y, Libman I, Rivera-Vega M, et al. Aerobic exercise but not resistance exercise reduces intrahepatic lipid content and visceral fat and improves insulin sensitivity in obese adolescent girls: a randomized controlled trial. Am J Prev Med. 2013;305:E1222–9.

    CAS  Google Scholar 

  50. Lee S, Bacha F, Hannon T, Kuk JL, Boesch C, Arslanian S. Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys: a randomized, controlled trial. Diabetes. 2012;61:2787–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee report. Washington, DC: Department of Health and Human Services; 2008.

    Google Scholar 

  52. Cassidy S, Thoma C, Houghton D, Trenell MI. High-intensity interval training: a review of its impact on glucose control and cardiometabolic health. Diabetologia. 2017;60(1):7–23.

    Article  PubMed  Google Scholar 

  53. Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2006;(3):CD002968.

Download references

Acknowledgements

The authors thank Ms Rachel Haddow for holding the nutrition consultations with participants and their families at The University of Queensland, as well as Mr. Aiman Al Najjar and Mrs. Nicole Atcheson for their magnetic resonance imaging technical support. Cardiorespiratory fitness assessments and exercise sessions were conducted at the core facility NeXt Move, Norwegian University of Science and Technology.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jeff S. Coombes.

Ethics declarations

Funding

This work was supported by St Olav’s Hospital and the Norwegian University of Science and Technology (Grant no. 9527), Sports Medicine Australia Research Foundation, and The Wesley and St Andrew’s Research Institute (Grant no. 2014-01). Shelley E. Keating is supported by a National Health and Medical Research Council Early Career Fellowship.

Conflict of interest

Jeff S. Coombes reports grants outside the submitted work from Coca Cola and Renew Corp and personal fees from Tolmar and Novo Nordisk Pharmaceuticals. Shelley E. Keating reports grants outside the submitted work from Exercise and Sports Science Australia and Diabetes Australia. Sjaan R. Gomersall reports grants outside the submitted work from Exercise and Sports Science Australia and Cycling Victoria. Katrin A. Dias, Charlotte B. Ingul, Arnt E. Tjonna, Turid Follestad, Mansoureh S. Hosseini, Siri M. Hollekim-Strand, Torstein B. Ro, Margrete Haram, Else Marie Huuse, Peter SW. Davies, Peter A. Cain and Gary M. Leong have no conflicts of interest directly relevant to the content of this article.

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Regional Committee for Medical and Health Research Ethics (Reference no. 2009/1313-4), The University of Queensland Human Research Ethics Committee (Reference no. 2013000539), The Mater Hospital Human Research Ethics Committee (Reference no. HREC/13/MHS/119/AM01) and the Uniting Care Health Human Research Ethics Committee (Reference no. 1324), and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 114 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dias, K.A., Ingul, C.B., Tjønna, A.E. et al. Effect of High-Intensity Interval Training on Fitness, Fat Mass and Cardiometabolic Biomarkers in Children with Obesity: A Randomised Controlled Trial. Sports Med 48, 733–746 (2018). https://doi.org/10.1007/s40279-017-0777-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40279-017-0777-0

Navigation