PMID 38892984

Research
All papers

Moderate-Intensity Constant and High-Intensity Interval Training Confer Differential Metabolic Benefits in Skeletal Muscle, White Adipose Tissue, and Liver of Candidates to Undergo Bariatric Surgery

Ruíz-Uribe M, Enríquez-Schmidt J, Monrroy-Uarac M, Mautner-Molina C, Kalazich-Rosales M, Muñoz M, Fuentes-Leal F, Cárcamo-Ibaceta C, Fazakerley DJ, Larance M, Ehrenfeld P, Martínez-Huenchullán S

Question

Do short preoperative HIIT and MICT programs produce different metabolic marker changes in skeletal muscle, subcutaneous adipose tissue, and liver among bariatric surgery candidates?

Summary

In adults awaiting bariatric surgery, 4 weeks of supervised HIIT or moderate continuous training before surgery produced different tissue-marker patterns. HIIT was linked to higher subcutaneous adipose adiponectin and lower liver collagen/AMPK/PGC-1alpha markers than MICT, but the study was small and lacked pre-training tissue samples.

Methodology

  • Adults selected for sleeve gastrectomy who completed preoperative exercise and accepted tissue extraction
  • 17 participants.
  • Treadmill walking or cycling plus strengthening.
  • Work intervals: 2.5 min.
  • Recovery: 2.5 min active rest.
  • Intensity: 80% HRR and/or Borg modified RPE 7-8/10; recovery 20% HRR and/or RPE 1-2/10.
  • 30 min aerobic interval component plus common strengthening program.
  • 2-3 sessions/week.
  • 4 weeks; 10 sessions.
  • Randomized controlled preoperative exercise trial
  • Tissue metabolic markers, Body composition, Glycemic markers, and Liver fibrosis marker were tracked.

Outcomes

Adipose adiponectin

Subcutaneous adipose adiponectin was higher after HIIT than MICT.

HIIT 1.9 +/- 0.69 vs MICT 1.1 +/- 0.48 fold, p < 0.05

Improved

Liver markers

HIIT showed lower liver phospho-AMPK/AMPK, PGC-1alpha, and collagen 1 than MICT.

Phospho-AMPK/AMPK 0.52 +/- 0.22 vs 1.0 +/- 0.37; PGC-1alpha 0.69 +/- 0.15 vs 1.0 +/- 0.18; collagen 1 0.59 +/- 0.28 vs 1.0 +/- 0.26; all p < 0.05

Improved

Muscle PGC-1alpha

Skeletal muscle PGC-1alpha was higher after MICT than HIIT.

MICT 1.1 +/- 0.27 vs HIIT 0.7 +/- 0.4 fold, p < 0.05

Safety concern

Clinical markers

MICT showed small body-weight/composition changes, while HIIT reduced waist/hip circumference and HbA1c slightly.

Article reports significant within-group changes but small sample and limited between-group clinical separation

Mixed

Insights

  • Short preoperative HIIT may affect tissue markers differently from moderate continuous training.
  • The clinical consumer relevance is limited because tissue samples were collected during surgery.
  • Interval walking/cycling can be adapted for severe-obesity clinical settings with professional supervision.

Limitations

  • Very small completer sample
  • No untrained control group
  • No pre-exercise tissue samples
  • Mostly women, creating possible sex bias
  • Clinical bariatric population limits generalizability

Safety

  • Participants were screened for exercise contraindications and supervised by a physiotherapist.
  • The the paper did not report specific adverse-event counts.