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      High‐intensity interval training and cardiorespiratory fitness in adults: An umbrella review of systematic reviews and meta‐analyses

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          Abstract

          Background

          High‐intensity interval training (HIIT) is characterized by repeated bouts of relatively intense exercise interspersed with recovery periods. Previous studies have evaluated this exercise strategy with various population subgroups, regimens, and comparator groups, limiting the generalizability of findings. We performed a novel umbrella review to generate an up‐to‐date synthesis of the available evidence regarding the effect of HIIT on cardiorespiratory fitness (CRF) in adults as compared to non‐exercise control and traditional continuous forms of exercise such as moderate‐intensity continuous training (MICT).

          Methods

          An umbrella review was conducted in accordance with the Preferred Reporting Items for Overviews of Reviews guideline. Seven databases (MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science) were searched until February 2024. Systematic reviews with meta‐analyses comparing HIIT and active/non‐active control conditions were included. Literature search, data extraction, and methodological quality assessment (AMSTAR‐2) were conducted independently by two reviewers.

          Results

          Twenty‐four systematic reviews with meta‐analyses, representing 429 primary studies and 12 967 unique participants, met the inclusion criteria. Most of the systematic reviews received moderate‐to‐critically low AMSTAR‐2 scores. The data showed that HIIT, including the particularly intense variant “sprint interval training” (SIT), significantly increases CRF in adults compared to non‐exercise control (standardized mean difference [SMD]: 0.28 to 4.31; weighted mean difference [WMD]: 3.25 to 5.5 mL/kg/min) and MICT (SMD: 0.18 to 0.99; WMD: 0.52 to 3.76 mL/kg/min). This effect was consistently observed across specific groups of individuals (e.g., apparently healthy adults, individuals with overweight/obesity, older adults, and high‐level athletes) and HIIT modalities (e.g., low‐volume HIIT, whole‐body HIIT, home‐based HIIT, aquatic HIIT, and short SIT).

          Conclusion

          Existing evidence from systematic reviews consistently supports the effect of HIIT on enhancing CRF in adults when compared to non‐exercise control and MICT. Our findings offer a comprehensive basis that may potentially contribute to informing physical activity guidelines aimed at improving CRF in the general population.

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          Most cited references56

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          AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both

          The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.
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            World Health Organization 2020 guidelines on physical activity and sedentary behaviour

            Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.
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              Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants

              Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical activity across countries, and estimate global and regional trends.
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                Author and article information

                Contributors
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                Journal
                Scandinavian Journal of Medicine & Science in Sports
                Scandinavian Med Sci Sports
                Wiley
                0905-7188
                1600-0838
                May 2024
                May 17 2024
                May 2024
                : 34
                : 5
                Affiliations
                [1 ] Department of Sports Science and Physical Education The Chinese University of Hong Kong Shatin Hong Kong
                [2 ] Department of Kinesiology McMaster University Hamilton Ontario Canada
                Article
                10.1111/sms.14652
                38760916
                b80aa77d-2dee-4ea6-bda0-8b20339cd6f9
                © 2024

                http://creativecommons.org/licenses/by-nc-nd/4.0/

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