The John Sutton Memorial Lectureship: Interval Training in Health and Disease

Transcription

1 The John Sutton Memorial Lectureship: Interval Training in Health and Disease Martin Gibala, PhD McMaster University Hamilton,

2 The John Sutton Memorial Lectureship: Interval Training in Health and Disease

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4 Take Home Point Interval training is an infinitely variable form of exercise that can elicit physiological adaptations linked to improved health especially gains in cardiorespiratory fitness in a time-efficient manner.

5 1-MET é CRF comparable to: - 7-cm ê in waist circumference - 5-mm Hg ê in systolic BP - 1 mmol in ê plasma glucose (Kodama et al., JAMA, 2009) Circulation 134:e653-e699, 2016.

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9 Characterizing Interval Training Karlsen et al. Prog Cardiovasc Dis. 60: 67-77, 2017.

10 Characterizing Interval Training 100 Near-Maximal to Maximal Vigorous Moderate Light % HR Max

11 N = 32 (age 60 y, BMI 30); 60 min/session, 5 d/wk for 4 months Continuous or Interval Walking (~66% HR max ) or non-training Control Interval walking is superior to energy-matched continuous walking (and) may therefore be a good option when considering which type of training should be offered in primary care. Diabetes Care 36: , 2013.

12 Characterizing Interval Training % HR Max near max to all out Sprint Interval Training (SIT) Near-Maximal to Maximal High-Intensity Interval Training (HIIT) 80% max Vigorous Moderate Light

13 65 intervention studies stratified based on BMI and training duration Normal weight, 12 wk Batacan et al. Br J Sports Med 51: , 2017.

14 65 intervention studies stratified based on BMI and training duration Overweight and obese, >12 wk HIIT may serve as a timeefficient substitute or as a compliment to commonly recommended MICT Batacan et al. Br J Sports Med 51: , 2017.

15 Sports Med 45: , In healthy, young to middle-aged adults, high intensity interval training improves maximal oxygen uptake to a greater extent than traditional endurance training.

16 Weston et al. Br J Sports Med 48: , 2014 HIIT significantly increases CRF by almost double that of MICT in patients with lifestyle-induced chronic diseases.

17 Circulation 126: , The risk of a cardiovascular event is low after both highintensity exercise and moderate-intensity exercise.

18 HIIT should now be more fully and systematically integrated into cardiac rehabilitation programs HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure. Can J Cardiol 32: , 2016 (top): Circulation 135: , 2017 (bottom).

19 What We Know 1) Large improvements in cardiorespiratory fitness, often superior to continuous exercise 2) Modest improvements in other health indices, similar to traditional exercise but in less time 3) Mounting evidence that it is generally safe but real world effectiveness is contentious

20 Cassidy et al., Diabetologia 60: 7-23, 2017.

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22 Protocol (3x/wk) SIT 3 x 20-s sprints within 10 min MICT 50 min continuous Workload ~ 500 W (50 W) ~ 110 W RPE 16 (hard) 13 (somewhat hard) Mean HR ~83% ~73% Work/session ~60 kj ~300 kj PLoS One 11: e , 2016.

23 CRF é 19% (~ 2 METs) Insulin Sensitivity (IVGTT) 10 Δ VO 2 peak (ml/kg/min) MICT SIT CTL PLoS One 11: e , 2016.

24 What We Need to Know 1) It is feasible outside the lab? 2) Effect on mortality? 3) Will people do it?

25 3 x 20-s sprints within a 10-min period (RPE ~15/20 or hard ) Med Sci Sports Exerc 49: , 2017.

26 3 x 20-s sprints within a 10-min period (RPE ~15/20 or hard ) VO 2 (ml O2 kg -1 min -1 ) Med Sci Sports Exerc 49: , Pre Post * * Stair Climbing Cycling (Gillen et al. 2014)

27 BMJ Open Feb 12;5(2):e007519; the first study to evaluate the long-term effect of both highintensity training and moderate intensity on how people age.

28 The emerging data support the viability of interval exercise as an alternative to continuous exercise While interval exercise may not be ideal or preferred by all, it may provide a viable option for many. Health Psych Rev 11: , 2017.