High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: a randomised trial

Background: Insulin resistance has been postulated to play a central role in the co-appearance of various cardiovascular disease risk factors constituting the metabolic syndrome (MetS). There is evidence that altered cardiac autonomic function (CAF) may precede the onset of insulin resistance. Exercise training has been shown to improve CAF in different populations, yet little is known regarding the exercise dose response for CAF. The aim of this study was to investigate the impact of different volumes of high-intensity interval training (HIIT) and traditional moderate-intensity continuous training (MICT) on CAF in participants with MetS. Methods: Individuals with MetS (n = 56) were randomised into the following 16-week training interventions: i) MICT (n = 16, 30 min at 60–70%HRpeak, 5×/week); ii) 4HIIT (n = 19, 4 × 4 min bouts at 85–95%HRpeak, interspersed with 3 min of active recovery at 50–70%HRpeak, 3×/week); or iii) 1HIIT (n = 21, 1 × 4 min bout at 85–95%HRpeak, 3×/week). R-R interval recorded for 5 min in a supine position at pre- and postintervention was used to derive linear (SDNN, RMSSD, pNN50, LF, HF, LF/HF) and non-linear (SD1, SD2, Alpha1, Alpha2, SampEn) heart rate variability (HRV) indices as measures of CAF. Group × time interaction effects were examined (ANCOVA) and Eta squared (η2 ) interaction effect sizes calculated. Results: While there were no significant between-group differences in CAF indices, there were small-to-medium group × time interaction effects on SDNN [F(2,52) = 0.70, p = 0.50, η2 = 0.02], RMSSD [F(2,52) = 1.35, p = 0.27, η2 = 0.03], HF power [F(2,52) = 1.27, p = 0.29, η2 = 0.03], SD1 [F(2,52) = 0.47, p = 0.63, η2 = 0.01], and SD2 [F(2,52) = 0.41, p = 0.67, η2 = 0.01]. The following represent the relative percentage increases across these variables for 4HIIT, MICT, and 1HIIT respectively (SDNN, +30%, +17%, 9%; RMSSD, +30%, +22%, −2%; HF power, +69%, +18%, +7%; SD1, +30%, +22%,-2%; SD2, +22%, +14%, 4%). Conclusions: There were no significant between-group differences for the effects of exercise dose on CAF indices, however; high-volume HIIT demonstrated the greatest magnitude of effect for improving CAF in individuals with MetS.