YÜKSEK ŞİDDETLİ İNTERVAL ANTRENMANIN METABOLİK SENDROM ÜZERİNDEKİ ETKİSİ

Yıl 2023, , 1 - 20, 30.09.2023

Büke Çelenk Durgut , Günay Eskici

https://doi.org/10.33689/spormetre.1214427

Öz

Metabolik sendrom (MetS); insülin direnci, abdominal obezite, hiperlipidemi ve hipertansiyon ile karakterize bir durumdur. Metabolik sendromlu bireyler; diyabet açısından 2 kat ve kardiyovasküler hastalık açısından 5 kat artmış risk ile ilişkilendirilmiştir. Modern toplumların en büyük problemlerinden biri olan sedanter yaşam tarzı, birçok hastalık için risk faktörüdür. Fiziksel aktivite ve egzersiz yapmamak için farklı sebepler bulunsa da, en büyük engel genellikle zaman eksikliğidir. Daha kısa egzersiz ve dinlenme süreleriyle uygulanan antrenman programları, yeni bir yaklaşım sunmaktadır. Yüksek Şiddetli İnterval Antrenman (High Intensity Interval Training-HIIT), aralarına düşük yoğunluklu toparlanma periyotları serpiştirilmiş kısa aralıklı şiddetli egzersiz patlamaları ile karakterizedir. Bireysel ihtiyaçlara göre uyarlanan HIIT, çoğu egzersiz ortamında kullanılabilen egzersiz reçetelerini kapsar. Bu uyum yeteneği, HIIT'i kronik hastalığı olan kişilerin egzersiz programlamasında önemli bir araç haline getirmiştir. HIIT antrenmanları da MetS’li bireylerde sağlığı geliştirmiş, komplikasyonları azaltmıştır. MetS’li kişilerde HIIT her konuda Orta Şiddette Sürekli Devam Eden Antrenman (Moderate Intensity Continuous Training-MICT)’dan üstün bulunmamış ancak sağlığa benzer faydalar sağladığı belirlenmiştir. HIIT zaman tasarrufu açısından MICT’e göre avantajlıdır. Modern toplumlarda en önemli eksikliğin zaman olduğu düşünülürse HIIT bu yönüyle ön plana çıkar. HIIT’in kontraendike olduğu (kontrol altına alınamayan kardiyovasküler hastalık vb.) veya yapılamadığı dönemlerde MICT tercih edilebilir ve sağlığı iyileştirici benzer etkiler gösterir. HIIT antrenmanları klinik popülasyonda dikkatle reçetelendirilmeli ve kesinlikle bireye özgü olmalıdır. Bu konudaki hassasiyet çok önemlidir. İlerleyen çalışmalarda klinik popülasyonlara yönelik kılavuzlar oluşturulmalı ve HIIT’in uzun süreli etkileri geniş kitlelerde araştırılmalıdır.

Anahtar Kelimeler

Yüksek Yoğunluklu İnterval Antrenman, HIIT, MICT, Metabolik Sendrom, X Sendrom

Destekleyen Kurum

Herhangi bir kurum tarafından desteklenmemiştir.

THE EFFECT OF HIGH-INTENSITY INTERVAL TRAINING ON METABOLIC SYNDROME

Öz

Metabolic syndrome is a condition characterized by insulin resistance, abdominal obesity, hyperlipidemia, and hypertension. Individuals with metabolic syndrome; have been associated with a 2-fold increased risk of diabetes and a 5-fold increased risk of cardiovascular disease. A sedentary lifestyle, one of the biggest problems of modern societies, is a risk factor for many diseases. While there are different reasons for physical activity and not exercising, the biggest obstacle is often a lack of time. Training programs with shorter exercise and rest periods have become popular. High-Intensity Interval Training (HIIT) is characterized by short, intermittent bursts of vigorous exercise interspersed with periods of low-intensity recovery. Tailored to individual needs, HIIT encompasses exercise prescriptions that can be used in most exercise settings. This adaptability has made HIIT an important tool in the exercise programming of people with chronic diseases. HIIT training has also improved health and reduced complications in individuals with MetS. In people with MetS, HIIT has not been found superior to moderate-intensity sustained exercise (MICT) in all parameters, but showed similar beneficial effects on health. HIIT has advantages over MICT in terms of saving time. Considering that the most important deficiency in modern societies is time, HIIT is advantageous in this regard. In periods when HIIT is contraindicated (uncontrolled cardiovascular disease, etc.) or not applied, MICT may be preferred as it shows similar health-promoting effects. HIIT training ought to be prescribed carefully to the clinical population and the prescription should be strictly individualized. Sensitivity in this matter is very important. In future studies, guidelines for clinical populations should be established and the long-term effects of HIIT should be investigated in large populations.

Anahtar Kelimeler

High-Intensity Interval Training, Metabolic Syndrome, HIIT, MICT, Syndrome X

Kaynakça

• Alberti, K. G., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., ... & Smith Jr, S. C. (2009). Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation, 120(16), 1640-1645.
• Alshehri, A. M. (2010). Metabolic syndrome and cardiovascular risk. Journal of Family and Community Medicine, 17(2), 73.
• Ansarimoghaddam, A., Adineh, H. A., Zareban, I., Iranpour, S., HosseinZadeh, A., & Kh, F. (2018). Prevalence of metabolic syndrome in Middle-East countries: Meta-analysis of cross-sectional studies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 12(2), 195-201.
• Aristizabal, J. C., Montoya, E., Sánchez, Y. L., Yepes-Calderón, M., Narvaez-Sanchez, R., Gallo-Villegas, J. A., & Calderón, J. C. (2021). Effects of low-volume, high-intensity interval training compared with continuous training on regional and global body composition in adults with metabolic syndrome: a post hoc analysis of a randomized clinical trial. Annals of Nutrition and Metabolism, 77(5), 279-288.
• Balkan, F. (2013). Metabolik sendrom. Ankara Medical Journal, 13(2), 85-90.
• Beals, J. W., & Kayser, B. D. (2021). When exercising for metabolic health, the work is never done, but HIIT will save you time. The Journal of Clinical Endocrinology & Metabolism, 106(1), e365-e366.
• Bilge, M., Yildirim, D. S., & Ersoz, G. (2021). Güncel Yüksek Şiddetli Aralıklı Antrenman (High Intensity Interval Training-HIIT) Uygulamalarının Kardiyovasküler-Metabolik ve Performans Yanıtları: Sistematik Derleme. Türkiye Klinikleri Spor Bilimleri Dergisi.
• Campbell, W. W., Kraus, W. E., Powell, K. E., Haskell, W. L., Janz, K. F., Jakicic, J. M., ... & 2018 Physical Activity Guidelines Advisory Committee. (2019). High-intensity interval training for cardiometabolic disease prevention. Medicine and science in sports and exercise, 51(6), 1220.
• Da Silva, M. A. R., Baptista, L. C., Neves, R. S., De França, E., Loureiro, H., Lira, F. S., ... & Martins, R. A. (2020). The effects of concurrent training combining both resistance exercise and high-intensity interval training or moderate-intensity continuous training on metabolic syndrome. Frontiers in physiology, 11, 572.
• de Matos, D. G., de Almeida-Neto, P. F., Moreira, O. C., de Souza, R. F., Tinoco Cabral, B. G. D. A., Chilibeck, P., & Aidar, F. J. (2021). Two weekly sessions of high-intensity interval training improve metabolic syndrome and hypertriglyceridemic waist phenotype in older adults: A randomized controlled trial. Metabolic Syndrome and Related Disorders, 19(6), 332-339.
• Drigny, J., Gremeaux, V., Guiraud, T., Gayda, M., Juneau, M., & Nigam, A. (2013). Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Annals of physical and rehabilitation medicine, 56(5), 356-370.
• Dun, Y., Thomas, R. J., Smith, J. R., Medina-Inojosa, J. R., Squires, R. W., Bonikowske, A. R., ... & Olson, T. P. (2019). High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovascular diabetology, 18(1), 1-11.
• Engin, A. (2017). The definition and prevalence of obesity and metabolic syndrome. Obesity and lipotoxicity, 1-17.
• Expert Panel on Detection, E. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Jama, 285(19), 2486-2497.
• Fisher, G., Brown, A. W., Bohan Brown, M. M., Alcorn, A., Noles, C., Winwood, L., ... & Allison, D. B. (2015). High intensity interval-vs moderate intensity-training for improving cardiometabolic health in overweight or obese males: a randomized controlled trial. PloS one, 10(10), e0138853.
• Gallo-Villegas, J., Castro-Valencia, L. A., Pérez, L., Restrepo, D., Guerrero, O., Cardona, S., ... & Calderón, J. C. (2022). Efficacy of high-intensity interval-or continuous aerobic-training on insulin resistance and muscle function in adults with metabolic syndrome: a clinical trial. European Journal of Applied Physiology, 1-14.
• Gallo-Villegas, J., Restrepo, D., Pérez, L., Castro-Valencia, L. A., Narvaez-Sanchez, R., Osorio, J., ... & Calderón, J. C. (2022). Safety of high-intensity, low-volume interval training or continuous aerobic training in adults with metabolic syndrome. Journal of Patient Safety, 18(4), 295-301.
• Grace, F., Herbert, P., Elliott, A. D., Richards, J., Beaumont, A., & Sculthorpe, N. F. (2018). High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men. Experimental Gerontology, 109, 75-81.
• Guio de Prada, V., Ortega, J. F., Morales-Palomo, F., Ramirez-Jimenez, M., Moreno-Cabañas, A., & Mora-Rodriguez, R. (2019). Women with metabolic syndrome show similar health benefits from high-intensity interval training than men. PloS one, 14(12), e0225893.
• Gyorkos, A., Baker, M. H., Miutz, L. N., Lown, D. A., Jones, M. A., & Houghton-Rahrig, L. D. (2019). Carbohydrate-restricted diet and high-intensity interval training exercise improve cardio-metabolic and inflammatory profiles in metabolic syndrome: a randomized crossover trial. Cureus, 11(9).
• Jiménez-Maldonado, A., García-Suárez, P. C., Rentería, I., Moncada-Jiménez, J., & Plaisance, E. P. (2020). Impact of high-intensity interval training and sprint interval training on peripheral markers of glycemic control in metabolic syndrome and type 2 diabetes. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, 1866(8), 165820.
• Jo, E. A., Cho, K. I., Park, J. J., Im, D. S., Choi, J. H., & Kim, B. J. (2020). Effects of high-intensity interval training versus moderate-intensity continuous training on epicardial fat thickness and endothelial function in hypertensive metabolic syndrome. Metabolic Syndrome and Related Disorders, 18(2), 96-102.
• Kemmler, W., Scharf, M., Lell, M., Petrasek, C., & Von Stengel, S. (2014). High versus moderate intensity running exercise to impact cardiometabolic risk factors: the randomized controlled RUSH-study. BioMed research international, 2014.
• Khalafi, M., & Symonds, M. E. (2020). The impact of high‐intensity interval training on inflammatory markers in metabolic disorders: A meta‐analysis. Scandinavian Journal of Medicine & Science in Sports, 30(11), 2020-2036.
• Lakka, H. M., Laaksonen, D. E., Lakka, T. A., Niskanen, L. K., Kumpusalo, E., Tuomilehto, J., & Salonen, J. T. (2002). The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. Jama, 288(21), 2709-2716.
• Madsen, S. M., Thorup, A. C., Overgaard, K., Bjerre, M., & Jeppesen, P. B. (2015). Functional and structural vascular adaptations following 8 weeks of low volume high intensity interval training in lower leg of type 2 diabetes patients and individuals at high risk of metabolic syndrome. Archives of physiology and biochemistry, 121(5), 178-186.
• Matsuo, T., So, R., Shimojo, N., & Tanaka, K. (2015). Effect of aerobic exercise training followed by a low-calorie diet on metabolic syndrome risk factors in men. Nutrition, Metabolism and Cardiovascular Diseases, 25(9), 832-838.
• Moholdt, T., Madssen, E., Rognmo, Ø., & Aamot, I. L. (2014). The higher the better? Interval training intensity in coronary heart disease. Journal of science and medicine in sport, 17(5), 506-510.
• Morales-Palomo, F., Ramirez-Jimenez, M., Ortega, J. F., Pallares, J. G., & Mora-Rodriguez, R. (2017). Acute hypotension after high-intensity interval exercise in metabolic syndrome patients. International Journal of Sports Medicine, 38(07), 560-567.
• Moreno-Cabañas, A., Ortega, J. F., Morales-Palomo, F., Ramirez-Jimenez, M., Alvarez-Jimenez, L., & Mora-Rodriguez, R. (2021). Substitution of parts of aerobic training by resistance training lowers fasting hyperglycemia in individuals with metabolic syndrome. Applied Physiology, Nutrition, and Metabolism, 46(1), 69-76.
• Morales-Palomo, F., Ramirez-Jimenez, M., Ortega, J. F., & Mora-Rodriguez, R. (2019). Effectiveness of Aerobic Exercise Programs for Health Promotion in Metabolic Syndrome. Medicine and science in sports and exercise, 51(9), 1876-1883.
• Ramirez‐Jimenez, M., Morales‐Palomo, F., Moreno‐Cabañas, A., Alvarez‐Jimenez, L., Ortega, J. F., & Mora‐Rodriguez, R. (2021). Effects of antihypertensive medication and high‐intensity interval training in hypertensive metabolic syndrome individuals. Scandinavian Journal of Medicine & Science in Sports, 31(7), 1411-1419.
• Ramirez-Jimenez, M., Morales-Palomo, F., Pallares, J. G., Mora-Rodriguez, R., & Ortega, J. F. (2017). Ambulatory blood pressure response to a bout of HIIT in metabolic syndrome patients. European Journal of Applied Physiology, 117(7), 1403-1411.
• Ramos, J. S., Dalleck, L. C., Borrani, F., Beetham, K. S., Mielke, G. I., Dias, K. A., ... & Coombes, J. S. (2017). High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: a randomised trial. International journal of cardiology, 245, 245-252.
• Ramos, J. S., Dalleck, L. C., Borrani, F., Beetham, K. S., Wallen, M. P., Mallard, A. R., ... & Coombes, J. S. (2017). Low-volume high-intensity interval training is sufficient to ameliorate the severity of metabolic syndrome. Metabolic syndrome and related disorders, 15(7), 319-328.
• Ramos, J. S., Dalleck, L. C., Borrani, F., Mallard, A. R., Clark, B., Keating, S. E., ... & Coombes, J. S. (2016). The effect of different volumes of high-intensity interval training on proinsulin in participants with the metabolic syndrome: a randomised trial. Diabetologia, 59, 2308-2320.
• Ramos, J. S., Dalleck, L. C., Ramos, M. V., Borrani, F., Roberts, L., Gomersall, S., ... & Coombes, J. S. (2016). 12 min/week of high-intensity interval training reduces aortic reservoir pressure in individuals with metabolic syndrome: a randomized trial. Journal of hypertension, 34(10), 1977-1987.
• Ramos, J. S., Dalleck, L. C., Stennett, R. C., Mielke, G. I., Keating, S. E., Murray, L., ... & Coombes, J. S. (2020). Effect of different volumes of interval training and continuous exercise on interleukin-22 in adults with metabolic syndrome: A randomized trial. Diabetes, Metabolic Syndrome and Obesity, 2443-2453.
• Reljic, D., Frenk, F., Herrmann, H. J., Neurath, M. F., & Zopf, Y. (2021). Effects of very low volume high intensity versus moderate intensity interval training in obese metabolic syndrome patients: a randomized controlled study. Scientific Reports, 11(1), 1-14.
• Ross, L. M., Porter, R. R., & Durstine, J. L. (2016). High-intensity interval training (HIIT) for patients with chronic diseases. Journal of sport and health science, 5(2), 139-144.
• Saklayen, M. G. (2018). The global epidemic of the metabolic syndrome. Current hypertension reports, 20(2), 1-8. Alberti, K. G., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., ... & Smith Jr, S. C. (2009). Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation, 120(16), 1640-1645.
• Alshehri, A. M. (2010). Metabolic syndrome and cardiovascular risk. Journal of Family and Community Medicine, 17(2), 73.
• Ansarimoghaddam, A., Adineh, H. A., Zareban, I., Iranpour, S., HosseinZadeh, A., & Kh, F. (2018). Prevalence of metabolic syndrome in Middle-East countries: Meta-analysis of cross-sectional studies. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 12(2), 195-201.
• Aristizabal, J. C., Montoya, E., Sánchez, Y. L., Yepes-Calderón, M., Narvaez-Sanchez, R., Gallo-Villegas, J. A., & Calderón, J. C. (2021). Effects of low-volume, high-intensity interval training compared with continuous training on regional and global body composition in adults with metabolic syndrome: a post hoc analysis of a randomized clinical trial. Annals of Nutrition and Metabolism, 77(5), 279-288.
• Balkan, F. (2013). Metabolik sendrom. Ankara Medical Journal, 13(2), 85-90.
• Beals, J. W., & Kayser, B. D. (2021). When exercising for metabolic health, the work is never done, but HIIT will save you time. The Journal of Clinical Endocrinology & Metabolism, 106(1), e365-e366.
• Bilge, M., Yildirim, D. S., & Ersoz, G. (2021). Güncel Yüksek Şiddetli Aralıklı Antrenman (High Intensity Interval Training-HIIT) Uygulamalarının Kardiyovasküler-Metabolik ve Performans Yanıtları: Sistematik Derleme. Türkiye Klinikleri Spor Bilimleri Dergisi.
• Campbell, W. W., Kraus, W. E., Powell, K. E., Haskell, W. L., Janz, K. F., Jakicic, J. M., ... & 2018 Physical Activity Guidelines Advisory Committee. (2019). High-intensity interval training for cardiometabolic disease prevention. Medicine and science in sports and exercise, 51(6), 1220.
• Da Silva, M. A. R., Baptista, L. C., Neves, R. S., De França, E., Loureiro, H., Lira, F. S., ... & Martins, R. A. (2020). The effects of concurrent training combining both resistance exercise and high-intensity interval training or moderate-intensity continuous training on metabolic syndrome. Frontiers in physiology, 11, 572.
• de Matos, D. G., de Almeida-Neto, P. F., Moreira, O. C., de Souza, R. F., Tinoco Cabral, B. G. D. A., Chilibeck, P., & Aidar, F. J. (2021). Two weekly sessions of high-intensity interval training improve metabolic syndrome and hypertriglyceridemic waist phenotype in older adults: A randomized controlled trial. Metabolic Syndrome and Related Disorders, 19(6), 332-339.
• Drigny, J., Gremeaux, V., Guiraud, T., Gayda, M., Juneau, M., & Nigam, A. (2013). Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Annals of physical and rehabilitation medicine, 56(5), 356-370.
• Dun, Y., Thomas, R. J., Smith, J. R., Medina-Inojosa, J. R., Squires, R. W., Bonikowske, A. R., ... & Olson, T. P. (2019). High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovascular diabetology, 18(1), 1-11.
• Engin, A. (2017). The definition and prevalence of obesity and metabolic syndrome. Obesity and lipotoxicity, 1-17.
• Expert Panel on Detection, E. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Jama, 285(19), 2486-2497.
• Fisher, G., Brown, A. W., Bohan Brown, M. M., Alcorn, A., Noles, C., Winwood, L., ... & Allison, D. B. (2015). High intensity interval-vs moderate intensity-training for improving cardiometabolic health in overweight or obese males: a randomized controlled trial. PloS one, 10(10), e0138853.
• Gallo-Villegas, J., Castro-Valencia, L. A., Pérez, L., Restrepo, D., Guerrero, O., Cardona, S., ... & Calderón, J. C. (2022). Efficacy of high-intensity interval-or continuous aerobic-training on insulin resistance and muscle function in adults with metabolic syndrome: a clinical trial. European Journal of Applied Physiology, 1-14.
• Gallo-Villegas, J., Restrepo, D., Pérez, L., Castro-Valencia, L. A., Narvaez-Sanchez, R., Osorio, J., ... & Calderón, J. C. (2022). Safety of high-intensity, low-volume interval training or continuous aerobic training in adults with metabolic syndrome. Journal of Patient Safety, 18(4), 295-301.
• Grace, F., Herbert, P., Elliott, A. D., Richards, J., Beaumont, A., & Sculthorpe, N. F. (2018). High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men. Experimental Gerontology, 109, 75-81.
• Guio de Prada, V., Ortega, J. F., Morales-Palomo, F., Ramirez-Jimenez, M., Moreno-Cabañas, A., & Mora-Rodriguez, R. (2019). Women with metabolic syndrome show similar health benefits from high-intensity interval training than men. PloS one, 14(12), e0225893.
• Gyorkos, A., Baker, M. H., Miutz, L. N., Lown, D. A., Jones, M. A., & Houghton-Rahrig, L. D. (2019). Carbohydrate-restricted diet and high-intensity interval training exercise improve cardio-metabolic and inflammatory profiles in metabolic syndrome: a randomized crossover trial. Cureus, 11(9).
• Jiménez-Maldonado, A., García-Suárez, P. C., Rentería, I., Moncada-Jiménez, J., & Plaisance, E. P. (2020). Impact of high-intensity interval training and sprint interval training on peripheral markers of glycemic control in metabolic syndrome and type 2 diabetes. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, 1866(8), 165820.
• Jo, E. A., Cho, K. I., Park, J. J., Im, D. S., Choi, J. H., & Kim, B. J. (2020). Effects of high-intensity interval training versus moderate-intensity continuous training on epicardial fat thickness and endothelial function in hypertensive metabolic syndrome. Metabolic Syndrome and Related Disorders, 18(2), 96-102.
• Kemmler, W., Scharf, M., Lell, M., Petrasek, C., & Von Stengel, S. (2014). High versus moderate intensity running exercise to impact cardiometabolic risk factors: the randomized controlled RUSH-study. BioMed research international, 2014.
• Khalafi, M., & Symonds, M. E. (2020). The impact of high‐intensity interval training on inflammatory markers in metabolic disorders: A meta‐analysis. Scandinavian Journal of Medicine & Science in Sports, 30(11), 2020-2036.
• Lakka, H. M., Laaksonen, D. E., Lakka, T. A., Niskanen, L. K., Kumpusalo, E., Tuomilehto, J., & Salonen, J. T. (2002). The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. Jama, 288(21), 2709-2716.
• Madsen, S. M., Thorup, A. C., Overgaard, K., Bjerre, M., & Jeppesen, P. B. (2015). Functional and structural vascular adaptations following 8 weeks of low volume high intensity interval training in lower leg of type 2 diabetes patients and individuals at high risk of metabolic syndrome. Archives of physiology and biochemistry, 121(5), 178-186.
• Matsuo, T., So, R., Shimojo, N., & Tanaka, K. (2015). Effect of aerobic exercise training followed by a low-calorie diet on metabolic syndrome risk factors in men. Nutrition, Metabolism and Cardiovascular Diseases, 25(9), 832-838.
• Moholdt, T., Madssen, E., Rognmo, Ø., & Aamot, I. L. (2014). The higher the better? Interval training intensity in coronary heart disease. Journal of science and medicine in sport, 17(5), 506-510.
• Morales-Palomo, F., Ramirez-Jimenez, M., Ortega, J. F., Pallares, J. G., & Mora-Rodriguez, R. (2017). Acute hypotension after high-intensity interval exercise in metabolic syndrome patients. International Journal of Sports Medicine, 38(07), 560-567.
• Moreno-Cabañas, A., Ortega, J. F., Morales-Palomo, F., Ramirez-Jimenez, M., Alvarez-Jimenez, L., & Mora-Rodriguez, R. (2021). Substitution of parts of aerobic training by resistance training lowers fasting hyperglycemia in individuals with metabolic syndrome. Applied Physiology, Nutrition, and Metabolism, 46(1), 69-76.
• Morales-Palomo, F., Ramirez-Jimenez, M., Ortega, J. F., & Mora-Rodriguez, R. (2019). Effectiveness of Aerobic Exercise Programs for Health Promotion in Metabolic Syndrome. Medicine and science in sports and exercise, 51(9), 1876-1883.
• Ramirez‐Jimenez, M., Morales‐Palomo, F., Moreno‐Cabañas, A., Alvarez‐Jimenez, L., Ortega, J. F., & Mora‐Rodriguez, R. (2021). Effects of antihypertensive medication and high‐intensity interval training in hypertensive metabolic syndrome individuals. Scandinavian Journal of Medicine & Science in Sports, 31(7), 1411-1419.
• Ramirez-Jimenez, M., Morales-Palomo, F., Pallares, J. G., Mora-Rodriguez, R., & Ortega, J. F. (2017). Ambulatory blood pressure response to a bout of HIIT in metabolic syndrome patients. European Journal of Applied Physiology, 117(7), 1403-1411.
• Ramos, J. S., Dalleck, L. C., Borrani, F., Beetham, K. S., Mielke, G. I., Dias, K. A., ... & Coombes, J. S. (2017). High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: a randomised trial. International journal of cardiology, 245, 245-252.
• Ramos, J. S., Dalleck, L. C., Borrani, F., Beetham, K. S., Wallen, M. P., Mallard, A. R., ... & Coombes, J. S. (2017). Low-volume high-intensity interval training is sufficient to ameliorate the severity of metabolic syndrome. Metabolic syndrome and related disorders, 15(7), 319-328.
• Ramos, J. S., Dalleck, L. C., Borrani, F., Mallard, A. R., Clark, B., Keating, S. E., ... & Coombes, J. S. (2016). The effect of different volumes of high-intensity interval training on proinsulin in participants with the metabolic syndrome: a randomised trial. Diabetologia, 59, 2308-2320.
• Ramos, J. S., Dalleck, L. C., Ramos, M. V., Borrani, F., Roberts, L., Gomersall, S., ... & Coombes, J. S. (2016). 12 min/week of high-intensity interval training reduces aortic reservoir pressure in individuals with metabolic syndrome: a randomized trial. Journal of hypertension, 34(10), 1977-1987.
• Ramos, J. S., Dalleck, L. C., Stennett, R. C., Mielke, G. I., Keating, S. E., Murray, L., ... & Coombes, J. S. (2020). Effect of different volumes of interval training and continuous exercise on interleukin-22 in adults with metabolic syndrome: A randomized trial. Diabetes, Metabolic Syndrome and Obesity, 2443-2453.
• Reljic, D., Frenk, F., Herrmann, H. J., Neurath, M. F., & Zopf, Y. (2021). Effects of very low volume high intensity versus moderate intensity interval training in obese metabolic syndrome patients: a randomized controlled study. Scientific Reports, 11(1), 1-14.
• Ross, L. M., Porter, R. R., & Durstine, J. L. (2016). High-intensity interval training (HIIT) for patients with chronic diseases. Journal of sport and health science, 5(2), 139-144.
• Saklayen, M. G. (2018). The global epidemic of the metabolic syndrome. Current hypertension reports, 20(2), 1-8.
• Serrablo-Torrejon, I., Lopez-Valenciano, A., Ayuso, M., Horton, E., Mayo, X., Medina-Gomez, G., ... & Jimenez, A. (2020). High intensity interval training exercise-induced physiological changes and their potential influence on metabolic syndrome clinical biomarkers: a meta-analysis. BMC endocrine disorders, 20, 1-12.
• So, R., & Matsuo, T. (2020). Effects of using high-intensity interval training and calorie restriction in different orders on metabolic syndrome: A randomized controlled trial. Nutrition, 75, 110666.
• Steckling, F. M., Farinha, J. B., Figueiredo, F. D. C., Santos, D. L. D., Bresciani, G., Kretzmann, N. A., ... & Soares, F. A. A. (2019). High-intensity interval training improves inflammatory and adipokine profiles in postmenopausal women with metabolic syndrome. Archives of physiology and biochemistry, 125(1), 85-91.
• Steckling, F. M., Farinha, J. B., Santos, D. L. D., Bresciani, G., Mortari, J. A., Stefanello, S. T., ... & Soares, F. A. A. (2016). High intensity interval training reduces the levels of serum inflammatory cytokine on women with metabolic syndrome. Experimental and clinical endocrinology & diabetes, 124(10), 597-601. Su, L., Fu, J., Sun, S., Zhao, G., Cheng, W., Dou, C., & Quan, M. (2019). Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: A meta-analysis. PloS one, 14(1), e0210644.
• Tuttor, M., von Stengel, S., Kohl, M., Lell, M., Scharf, M., Uder, M., ... & Kemmler, W. (2020). High intensity resistance exercise training vs. high intensity (endurance) interval training to fight cardiometabolic risk factors in overweight men 30–50 years old. Frontiers in Sports and Active Living, 2, 68.
• Üçler, R. (2014). Metabolik Sendrom. Tıp Araştırmaları Dergisi, 12(3), 153-157.
• Weston, K. S., Wisløff, U., & Coombes, J. S. (2014). High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. British journal of sports medicine, 48(16), 1227-1234.
• World Health Organization. (1999). Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus (No. WHO/NCD/NCS/99.2). World health organization.
• Viana, R. B., Naves, J. P. A., Coswig, V. S., De Lira, C. A. B., Steele, J., Fisher, J. P., & Gentil, P. (2019). Is interval training the magic bullet for fat loss? A systematic review and meta-analysis comparing moderate-intensity continuous training with high-intensity interval training (HIIT). British journal of sports medicine.
• Von Korn, P., Keating, S., Mueller, S., Haller, B., Kraenkel, N., Dinges, S., ... & Lechner, K. (2021). The effect of exercise intensity and volume on metabolic phenotype in patients with metabolic syndrome: a randomized controlled trial. Metabolic syndrome and related disorders, 19(2), 107-114.
• Zimmet, P., Magliano, D., Matsuzawa, Y., Alberti, G., & Shaw, J. (2005). The metabolic syndrome: a global public health problem and a new definition. Journal of atherosclerosis and thrombosis, 12(6), 295-300.