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Systematic review
High-intensity interval training for cardiometabolic health in adults with metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials
  1. Eric Tsz-Chun Poon1,
  2. Waris Wongpipit1,2,3,
  3. Hong-Yat Li1,
  4. Stephen Heung-Sang Wong1,
  5. Parco M Siu4,
  6. Alice Pik-Shan Kong5,6,
  7. Nathan A Johnson7,8
  1. 1Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong, China
  2. 2Department of Curriculum and Instruction, Faculty of Education, Chulalongkorn University, Bangkok, Thailand
  3. 3Research Unit for Sports Management & Physical Activity Policy (RU-SMPAP), Chulalongkorn University, Bangkok, Thailand
  4. 4Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
  5. 5Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
  6. 6Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
  7. 7Faculty of Medicine and Health, Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales, Australia
  8. 8Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
  1. Correspondence to Dr Waris Wongpipit; waris.w{at}chula.ac.th

Abstract

Objective To assess the effectiveness of high-intensity interval training (HIIT) compared with traditional moderate-intensity continuous training (MICT) and/or non-exercise control (CON) for modification of metabolic syndrome (MetS) components and other cardiometabolic health outcomes in individuals with MetS.

Design Systematic review and meta-analysis

Data sources Five databases were searched from inception to March 2024.

Study appraisal and synthesis Meta-analyses of randomised controlled trials (RCTs) comparing HIIT with MICT/CON were performed for components of MetS (waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and fasting blood glucose (BG)) and clinically relevant cardiometabolic health parameters. Subgroup moderator analyses were conducted based on the intervention duration and HIIT volume.

Results Out of 4819 studies, 23 RCTs involving 1374 participants were included (mean age: 46.2–67.0 years, 55% male). HIIT significantly improved WC (weighted mean difference (WMD) –4.12 cm, 95% CI –4.71 to –3.53), SBP (WMD –6.05 mm Hg, 95% CI –8.11 to –4.00), DBP (WMD –3.68 mm Hg, 95% CI –5.70 to –1.65), HDL-C (WMD 0.12 mmol/L, 95% CI 0.04 to 0.20), TG (WMD –0.34 mmol/L, 95% CI –0.41 to –0.27) and BG (WMD –0.35 mmol/L, 95% CI –0.54 to –0.16) compared with CON (all p<0.01). HIIT approaches demonstrated comparable effects to MICT across all parameters. Subgroup analyses suggested that HIIT protocols with low volume (ie, <15 min of high-intensity exercise per session) were not inferior to higher volume protocols for improving MetS components.

Conclusion This review supports HIIT as an efficacious exercise strategy for improving cardiometabolic health in individuals with MetS. Low-volume HIIT appears to be a viable alternative to traditional forms of aerobic exercise.

  • Public health
  • Meta-analysis
  • Exercise training
  • Health promotion

Data availability statement

The datasets analysed in this review are available from the corresponding author on reasonable request.

https://doi.org/10.1136/bjsports-2024-108481

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    Data availability statement

    The datasets analysed in this review are available from the corresponding author on reasonable request.

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    Footnotes

    • Contributors ET-CP, WW, HYL and SH-SW conceived the idea for the review. ET-CP, WW and HYL conducted search, study selection, data extraction and quality assessment. ET-CP and WW drafted the initial manuscript. PMS, AP-SK and NAJ contributed to writing the manuscript. ET-CP is the guarantor. All authors reviewed and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.