High-intensity interval exercise training for public health: a big HIT or shall we HIT it on the head?

Abstract

BackgroundThe efficacy of high-intensity interval training for a broad spectrum of cardio-metabolic health outcomes is not in question. Rather, the effectiveness of this form of exercise is at stake. In this paper we debate the issues concerning the likely success or failure of high-intensity interval training interventions for population-level health promotion.DiscussionBiddle maintains that high-intensity interval training cannot be a viable public health strategy as it will not be adopted or maintained by many people. This conclusion is based on an analysis of perceptions of competence, the psychologically aversive nature of high-intensity exercise, the affective component of attitudes, the less conscious elements of motivated behaviour that reflect our likes and dislikes, and analysis using the RE-AIM framework. Batterham argues that this appraisal is based on a constrained and outmoded definition of high-intensity interval training and that truly practical and scalable protocols have been - and continue to be - developed. He contends that the purported displeasure associated with this type of exercise has been overstated. Biddle suggests that the way forward is to help the least active become more active rather than the already active to do more. Batterham claims that traditional physical activity promotion has been a spectacular failure. He proposes that, within an evolutionary health promotion framework, high-intensity interval training could be a successful population strategy for producing rapid physiological adaptations benefiting public health, independent of changes in total physical activity energy expenditure.SummaryBiddle recommends that we focus our attention elsewhere if we want population-level gains in physical activity impacting public health. His conclusion is based on his belief that high-intensity interval training interventions will have limited reach, effectiveness, and adoption, and poor implementation and maintenance. In contrast, Batterham maintains that there is genuine potential for scalable, enjoyable high-intensity interval exercise interventions to contribute substantially to addressing areas of public health priority, including prevention and treatment of Type 2 diabetes and cardiovascular disease.

Modified sprint interval training protocols. Part II. Psychological responses

“…Similarly, SIT is argued to be too complex and requires such a high degree of self-regulation that placing the onus on an inexperienced exerciser to select the appropriate exercise intensity and duration may be problematic (Hardcastle et al 2014). Finally, and perhaps most importantly to the current investigation, it has been proposed that SIT will evoke negative affective responses during exercise, ultimately causing rapid attrition and future exercise avoidance (Hardcastle et al 2014;Biddle and Batterham 2015).…”

“…However, because of SIT's strenuous nature, concerns have been raised regarding its tolerability for the general public (Hardcastle et al 2014;Biddle and Batterham 2015;Del Vecchio et al 2015;Astorino and Thum 2016;Jung et al 2016). Researchers have argued that SIT is not actually time-efficient because typical SIT sessions are ϳ30 min once warm-up and cooldown periods are taken into account (Hardcastle et al 2014).…”

“…Researchers have argued that SIT is not actually time-efficient because typical SIT sessions are ϳ30 min once warm-up and cooldown periods are taken into account (Hardcastle et al 2014). Another concern is that SIT may be perceived as too difficult, and a sedentary population is unlikely to feel sufficiently confident to engage in such a demanding exercise protocol (Biddle and Batterham 2015). Similarly, SIT is argued to be too complex and requires such a high degree of self-regulation that placing the onus on an inexperienced exerciser to select the appropriate exercise intensity and duration may be problematic (Hardcastle et al 2014).…”

A comparison of the health benefits of reduced-exertion high-intensity interval training (REHIT) and moderate-intensity walking in type 2 diabetes patients

“…Despite the fact that there are no data to suggest that HIT is inherently less safe to perform by patients than aerobic or resistance exercise, opponents of the use of HIT in patients maintain the argument that the high exercise intensities must make HIT less safe (Biddle & Batterham, 2015;Holloway & Spriet, 2015). It remains unknown whether the short-term increase in heart rate associated with high-intensity exercise (reaching ~90% of maximal heart rate in our study) is more or less of a risk compared to the more sustained longer-term increase in heart rate during aerobic exercise.…”

Can Doping be a Good Thing? Using Psychoactive Drugs to Facilitate Physical Activity Behaviour

“…From an exercise adherence point of view, the main recommendation based on these findings is that moderateintensity exercise is preferable to vigorous exercise as the latter is more effortful and unpleasant [13,14]. This is a sensible recommendation because, at present, the only way to substantially reduce perception of effort and discomfort during exercise is to reduce exercise intensity.…”