# Comparison of the effects of high-intensity interval and moderate-intensity continuous training on inflammatory markers, cardiorespiratory fitness, and quality of life in breast cancer patients PMID: 37423313 Journal: Journal of sport and health science Published: 2023-11-01 Authors: Isanejad A, Nazari S, Gharib B, Motlagh AG ## Question Do supervised HIIT and MICT differ in their effects on inflammatory indices, adipokines, metabolic markers, body composition, cardiorespiratory fitness, and quality of life in breast cancer patients during adjuvant endocrine therapy? ## Summary This three-arm randomized controlled trial compared 12 weeks of supervised, volume-matched HIIT, MICT, and usual care in inactive women with non-metastatic breast cancer receiving adjuvant endocrine therapy after chemotherapy and/or radiotherapy. HIIT improved VO2peak more than MICT or control and both exercise groups improved several quality-of-life domains, but most inflammatory, adipokine, metabolic, body-composition, and sex-hormone outcomes did not differ meaningfully between groups. Adherence was high and no serious adverse events were reported, but the study was small and clinically specific. ## Population - Thirty inactive women with non-metastatic stage I-III breast cancer receiving adjuvant endocrine therapy after chemotherapy and/or radiotherapy. - Sample size: 30 - Age: Mean 45.13 +/- 6.86 years. - Sex: Women. - Fitness level: Insufficiently active; low baseline VO2peak around 16.6-17.0 mL/kg/min by group. - Health status: Non-metastatic breast cancer during adjuvant endocrine therapy. ## Methodology - Single randomized controlled trial with three parallel groups: HIIT, MICT, and usual-care control. - 12 weeks - Supervised treadmill-based exercise sessions in Iran; participants were recruited from oncology clinics in Imam Hossein and Naft hospitals in Tehran. - Randomized and controlled study design. ## Protocol - HIIT. - Modality: Treadmill walking or running. - Work intervals: 4 minutes. - Recovery: 3 minutes active walking recovery. - Sets or repetitions: 4 intervals. - Intensity: 90% VO2peak, corresponding to about 95% HRpeak. - Session duration: 33 minutes including 5-minute warm-up and 3-minute cool-down. - Frequency: 3 sessions/week. - Program length: 12 weeks. - Progression: First 2 weeks at lower intensity limit, then toward upper limit. - MICT and usual-care control. - Modality: MICT treadmill walking or running; control usual care. - Work intervals: MICT 33 minutes continuous main training. - Sets or repetitions: 1 continuous bout for MICT. - Intensity: MICT 60% VO2peak, about 75% HRpeak. - Session duration: MICT 41 minutes including 5-minute warm-up and 3-minute cool-down. - Frequency: 3 sessions/week for MICT. - Program length: 12 weeks. - Progression: Volume matched to HIIT using VO2-time relationship; treadmill speed and incline adjusted to maintain prescribed intensity. ## Outcomes ### VO2peak Status: improved HIIT increased VO2peak by 16.8% from baseline and improved VO2peak versus both control and MICT. HIIT baseline-to-post mean difference 3.61 mL/kg/min, p=0.023; HIIT vs control mean difference 3.609 mL/kg/min, p=0.001; HIIT vs MICT mean difference 2.974 mL/kg/min, p=0.005. ### HDL-C Status: improved Both HIIT and MICT increased HDL-C compared with control, with no HIIT-MICT difference. Between-group p=0.005; HIIT vs control mean difference 9.172 mg/dL, p=0.003; MICT vs control mean difference 7.879 mg/dL, p=0.014. ### Inflammatory markers and adipokines Status: mixed Most inflammatory and adipokine markers did not significantly change; SOCS3 increased in the HIIT group from baseline. No significant changes in IL-6, TNF-alpha, IL-10, leptin, or adiponectin; HIIT SOCS3 mean difference 0.09 pg/mL, p=0.032. ### Quality of life Status: improved HIIT improved social, emotional, functional, and total FACT-G outcomes compared with control; both exercise groups improved total FACT-G versus control. Total FACT-G between-group p=0.001; HIIT vs control mean difference 14.204, p=0.001; MICT vs control mean difference 10.036, p=0.001. ### Body composition Status: no clear change Neither HIIT nor MICT produced substantial changes in body weight, BMI, fat mass, body fat percentage, waist circumference, or hip circumference. Between-group p values included body weight p=0.613, BMI p=0.497, fat mass p=0.255, waist circumference p=0.397. ### Safety Status: mixed Muscle soreness and joint pain were reported, but no serious adverse events occurred. ## Practical Insights - A supervised 4 x 4-minute HIIT format can improve VO2peak in medically screened breast cancer patients over 12 weeks. - Clinical HIIT claims should focus on fitness and quality of life rather than inflammation, metabolic markers, or body composition. - The protocol is reproducible but requires clinical screening, HR/RPE monitoring, and conservative safety rules. - High adherence in this study occurred under close supervision and should not be assumed for unsupervised consumer workouts. ## Limitations - Small sample size with only 10 participants per group. - Body composition was measured by skinfold thickness rather than DXA or hydrostatic weighing. - No diet recommendations were provided. - No long-term follow-up or clinical oncology endpoints. - Clinical population and supervised treadmill setting limit generalization to ordinary app users. ## Safety And Adherence - Muscle soreness and joint pain were reported as possibly related to participation. - No serious adverse events were reported. - The study used medical screening and day-of-session exclusion criteria for abnormal vital signs, infection, bleeding signs, thrombocyte count, and leucocyte count. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/37423313/) (pubmed) - [DOI](https://doi.org/10.1016/j.jshs.2023.07.001) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658315/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.