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Abstract Details
High-Intensity Interval Training is Safe, Feasible and Efficacious in Nonalcoholic Steatohepatitis: A Randomized Controlled Trial
Dig Dis Sci. 2022 Dec 20;1-17. doi: 10.1007/s10620-022-07779-z. Online ahead of print.
1Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia. s.keating@uq.edu.au.
2Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
3Department of Circulation and Medical Imaging, Faculty of Medicine, K.G. Jebsen Center of Exercise in Medicine- Norwegian University of Science and Technology, Trondheim, Norway.
4Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
5Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
6Institute of Health and Wellbeing, Federation University, Mount Helen, Australia.
7School of Environmental and Life Sciences, University of Newcastle, Ourimbah, Australia.
8Department of Endocrinology & Diabetes, Princess Alexandra Hospital, Brisbane, Australia.
9Endocrine Hypertension Research Centre, Faculty of Medicine, University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia.
10Queensland Diabetes and Endocrine Centre, Mater Hospital, Brisbane, Australia.
11Mater Research Institute, Translational Research Institute, The University of Queensland, Brisbane, Australia.
12Faculty of Medicine, The University of Queensland, Brisbane, Australia.
13School of Public Health, The University of Queensland, Brisbane, Australia.
14Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.
15Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia.
Abstract
Background: High-Intensity Interval Training (HIIT) involves bursts of high-intensity exercise interspersed with lower-intensity exercise recovery. HIIT may benefit cardiometabolic health in people with nonalcoholic steatohepatitis (NASH).
Aims: We aimed to examine the safety, feasibility, and efficacy of 12-weeks of supervised HIIT compared with a sham-exercise control (CON) for improving aerobic fitness and peripheral insulin sensitivity in biopsy-proven NASH.
Methods: Participants based in the community [(n = 14, 56 ± 10 years, BMI 39.2 ± 6.7 kg/m2, 64% male), NAFLD Activity Score 5 (range 3-7)] were randomized to 12-weeks of supervised HIIT (n = 8, 4 × 4 min at 85-95% maximal heart rate, interspersed with 3 min active recovery; 3 days/week) or CON (n = 6, stretching; 3 days/week). Safety (adverse events) and feasibility determined as ≥ 70% program completion and ≥ 70% global adherence (including session attendance, interval intensity adherence, and duration adherence) were assessed. Changes in cardiorespiratory fitness (V?O2peak), exercise capacity (time-on-test) and peripheral insulin sensitivity (euglycemic hyperinsulinemic clamp) were assessed. Data were analysed using ANCOVA with baseline value as the covariate.
Results: There were no HIIT-related adverse events and HIIT was globally feasible [program completion 75%, global adherence 100% (including adherence to session 95.4 ± 7.3%, interval intensity 95.3 ± 6.0% and duration 96.8 ± 2.4%)]. A large between-group effect was observed for exercise capacity [mean difference 134.2 s (95% CI 19.8, 248.6 s), ?2 0.44, p = 0.03], improving in HIIT (106.2 ± 97.5 s) but not CON (- 33.4 ± 43.3 s), and for peripheral insulin sensitivity [mean difference 3.4 mg/KgLegFFM/min (95% CI 0.9,6.8 mg/KgLegFFM/min), ?2 0.32, p = 0.046], improving in HIIT (1.0 ± 0.8 mg/KgLegFFM/min) but not CON (- 3.1 ± 1.2 mg/KgLegFFM/min).
Conclusions: HIIT is safe, feasible and efficacious for improving exercise capacity and peripheral insulin sensitivity in people with NASH.
Clinical trial registration number: Australian New Zealand Clinical Trial Registry (anzctr.org.au) identifier ACTRN12616000305426 (09/03/2016).