# Enhancing cardiometabolic health: unveiling the synergistic effects of high-intensity interval training with spirulina supplementation on selected adipokines, insulin resistance, and anthropometric indices in obese males

PMID: 38454429
Journal: Nutrition & metabolism
Published: 2024 Mar 7
Authors: Delfan M, Saeidi A, Supriya R, Escobar KA, Laher I, Heinrich KM, Weiss K, Knechtle B, Zouhal H

## Question

Does 12 weeks of spirulina supplementation combined with HIIT improve adipokines, insulin resistance, anthropometric indices, and cardiorespiratory fitness more than spirulina, HIIT, or control in obese men?

## Summary

Forty-four obese men completed a 12-week four-group trial comparing control, spirulina, treadmill HIIT, and HIIT plus spirulina. HIIT groups trained three times weekly with progressive 4-minute intervals, and the combined HIIT plus spirulina group generally showed the largest improvements in body composition, HOMA-IR, VO2peak, and adipokines, though the supplement co-intervention limits exercise-only interpretation.

## Population

- Obese men aged 25-40 years who had not engaged in regular physical activity in the prior 6 months.
- Sample size: 44
- Age: 25-40 years
- Sex: Men only
- Fitness level: Inactive, no regular physical activity during previous 6 months
- Health status: BMI >30 kg/m2; no cardiovascular or endocrine disorders and no alcohol consumption

## Methodology

- Randomized four-group intervention trial with exercise and supplement factors
- 12 weeks
- Exercise testing and treadmill training setting in Iran
- Randomized and controlled study design.

## Protocol

- Treadmill HIIT plus spirulina.
- Modality: Treadmill running.
- Work intervals: 4 minutes.
- Recovery: 4 minutes passive or active recovery depending on week.
- Sets or repetitions: 4 intervals during a 32-minute HIIT block.
- Intensity: 75-95% VO2peak for work intervals after week 2.
- Session duration: About 42 minutes during HIIT weeks.
- Frequency: 3 sessions/week.
- Program length: 12 weeks.
- Progression: 65% VO2peak week 1, 75% week 2; HIIT from week 3: 75%, 85%, 90%, then 95% VO2peak with progressively higher active recovery.
- Control/supplement/training comparators.
- Modality: Control lifestyle, spirulina only, or same treadmill HIIT with placebo.
- Work intervals: For training comparator, 4 minutes.
- Recovery: For training comparator, 4 minutes.
- Sets or repetitions: For training comparator, 4 intervals.
- Intensity: Same HIIT intensity in TG and TSG; control maintained customary daily activities.
- Session duration: Same as intervention for training comparator.
- Frequency: 3 sessions/week for training comparator.
- Program length: 12 weeks.
- Progression: Same HIIT progression for training comparator.

## Outcomes

### VO2peak
Status: improved
Training and supplement interventions improved VO2peak, with combined HIIT plus spirulina showing the largest reported post value.

TG and SG increased VO2peak p<0.05; combined group showed significant markers versus pre/control.

### HOMA-IR
Status: improved
HOMA-IR decreased in supplement, training, and combined groups but not control; training and combined groups improved more than supplement alone.

Time x group p=0.0001, eta2=0.76; TSG and TG reductions greater than SG, p=0.0001 and p=0.0002.

### Adipokines
Status: mixed
HIIT reduced asprosin and lipocalin-2 and increased omentin, irisin, and spexin; some combined-group advantages over training alone were not significant.

Reported interactions included asprosin p=0.001, spexin p=0.014, lipocalin-2 p=0.005, omentin p=0.0001.

### Body composition
Status: improved
Training and combined groups improved fat and fat-free mass, with the combined group showing the largest changes.

Significant pre/post and between-group markers reported in Table 1.

## Practical Insights

- Progressive 4-minute treadmill intervals can be used in a 12-week obesity program.
- Supplement co-interventions must be separated from exercise programming claims.
- Exercise adherence details were insufficient for implementation confidence.

## Limitations

- Men-only sample
- Supplement co-intervention
- Surrogate adipokine outcomes
- Exercise attendance and adverse-event details limited; withdrawals included unspecified medical reasons

## Safety And Adherence

- Article did not report adverse-event or injury outcomes.
- Twenty of 64 selected participants withdrew due to medical reasons, job-related constraints, or waning interest; the medical reasons were not specified or attributed.
- Participants were screened by a qualified medical professional and clinical exercise physiologist with PAR-Q; VO2peak testing used BP/HR monitoring and ACSM/AHA symptom criteria, and training HR was monitored.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/38454429/) (pubmed)
- [DOI](https://doi.org/10.1186/s12986-024-00785-0) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921712/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.